Impact of COVID-19 Disease on the Development of Osteomyelitis of Jaws: A Systematic Review

Abstract

Background/Objectives: Osteomyelitis is characterized by an inflammatory process affecting both bone and bone marrow, leading to cell death and the formation of bone sequestrum. Recent literature from the past five years has documented instances of osteomyelitis following infections of SARS-CoV-2. This systematic review explores the link between osteomyelitis of the jaw (OMJ) and COVID-19 infections. Methods: This review adhered to the PRISMA guidelines, systematically analyzing literature from 2020 to 2024 sourced from databases including Medline, Embase, Scopus, and Web of Science. PROSPERO ID: CRD42024526257. Results: The review selected 42 articles, detailing 201 cases of osteomyelitis of the jaw related to COVID-19 (COMJ). The demographic breakdown included 195 male (74.4%) and 67 female patients (25.6%), with a median age of 52.7 years, ranging from 24 to 71 years. A significant portion of COMJ patients (41.5%) were hospitalized due to COVID-19, and 58.5% received corticosteroid therapy. Diabetes mellitus was a common comorbidity among COMJ patients (65.1%). Most cases involved maxilla (182 cases; 90.5%), with nearly half showing sinus involvement (49.4%). The mandible was affected in 19 cases (9.5%). Mucormycosis and aspergillosis emerged as the predominant fungal infections, identified in 103 (51.2%) and 50 (24.9%) cases, respectively. Conclusions: Individuals with pre-existing health conditions such as diabetes mellitus who have been treated for COVID-19 are at an increased risk of developing OMJ, particularly maxillary fungal osteomyelitis. COMJ poses a significant diagnostic and therapeutic challenge for dental and maxillofacial professionals, who are often the first to encounter these cases.