Restoring a Smile Post Covid-19 Associated Mucormycosis: A Case Report

Abstract

Oral health is influenced by a variety of local and systemic factors. Oral cavity is exposed to a variety of viruses, bacteria and fungi. SARS-CoV-2 caused Corona virus disease (COVID) predisposes the affected individuals to immunocompromised state, thereby increasing the risk of other infections. Mucormycosis is now-a-days most commonly encountered fungal infection in the post COVID era. Diagnosis of such aggressive infections is based on co-relation of clinical signs and symptoms and radiographic features with histopathological diagnosis. Surgical debridement of the affected area is the first line of treatment. Prosthetic rehabilitation of the surgically resected area is the next step in the treatment of such fulminant infections in order to help restore form and function for the affected individual. The present case report focusses on treating this life-threatening fungal infection by surgical debridement with adjunctive anti-fungal therapy and prosthetic rehabilitation in a mucormycosis affected patient in order to restore form and function.

A successfully rehabilitated post-mucormycosis maxillary defect with guided quad-zygomatic implants: A case report

“…Multiple reconstructive options are available for reconstruction of maxillofacial defects. Various factors defining the selection of reconstruction of defect are dimensions of the defect, presence of infra-orbital rim, extent of the palatal involvement, underlying skin, and aesthetic considerations of patients [17]. In such cases, reconstruction of palatal and orbital floor can be done following overdentures or fixed framework with attachment for removable component (obturator/ palatal plate) can be placed.…”

Prosthodontic restoration of a COVID‐19 associated mucormycosis defect: A clinical report

“…Usually as stated in relevant literature mucormycosis-related maxillectomy defects are left open without any surgical reconstruction since this facilitates monitoring by direct visual inspection for possible fungal recurrence. [15][16][17][18][19][20][21] In addition, from a prosthodontic standpoint, when the defect is unrepaired, the resulting prosthesis has enhanced stability and retention, since the impression material more efficiently engages the remaining tissue undercuts. However, in the present clinical report, and due to the patient's young age and increased anxiety regarding post-operative speech alteration and psychosocial restrictions, the surgeon decided to primarily reconstruct the maxillary defect leaving only two small oro-antral defects, an approach consistent with two previous case reports presenting the prosthodontic rehabilitation of maxillary mucormycosis related defects that were not however related to COVID-19 infection.…”

“…Consequently, a crucial demand for maxillofacial prosthetic rehabilitation arises in patients with mucormycosis‐related acquired maxillofacial defects to restore function and esthetics, preserving therefore, the patient's well‐being. Usually as stated in relevant literature mucormycosis‐related maxillectomy defects are left open without any surgical reconstruction since this facilitates monitoring by direct visual inspection for possible fungal recurrence 15–21 . In addition, from a prosthodontic standpoint, when the defect is unrepaired, the resulting prosthesis has enhanced stability and retention, since the impression material more efficiently engages the remaining tissue undercuts.…”

“…15 There are several case reports in the literature, mainly from India, presenting the prosthodontic rehabilitation of post-COVID-19 mucormycosis maxillary defects with interim obturator prostheses. [16][17][18][19][20][21] The aim of this clinical report is to present the surgical and prosthodontic management of a challenging COVID-19 related mucormycosis maxillectomy defect, raise awareness regarding this emerging during the pandemic clinical condition, and highlight the role of the maxillofacial prosthodontist in alleviating this severe COVID-19 associated morbidity by restoring patient's wellbeing.…”

“…Since the prevalence of diabetes mellitus is dramatically increasing in low‐ and middle‐income countries, and the world continues to strive against the COVD‐19 pandemic, the associated number of cases of maxillofacial mucormycosis is anticipated to increase presenting therefore, significant diagnostic and therapeutic challenges for the oral and maxillofacial surgeon and the maxillofacial prosthodontist 15 . There are several case reports in the literature, mainly from India, presenting the prosthodontic rehabilitation of post‐COVID‐19 mucormycosis maxillary defects with interim obturator prostheses 16‐21 . The aim of this clinical report is to present the surgical and prosthodontic management of a challenging COVID‐19 related mucormycosis maxillectomy defect, raise awareness regarding this emerging during the pandemic clinical condition, and highlight the role of the maxillofacial prosthodontist in alleviating this severe COVID‐19 associated morbidity by restoring patient's well‐being.…”