Prosthetic Rehabilitation of Rhino Orbital Mucormycosis Associated with COVID-19: A Case Series

MB Ravi,1 Sowmya Srinivas,1 Ekaterina Silina,2 Soumee Sengupta,1 Tanvi Tekwani,1 Raghu Ram Achar3 1Department of Prosthodontics, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India; 2Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3Division of Biochemistry, School of Life Sciences, JSS Academy of Higher Education & Research, Mysuru, Karnataka, IndiaCorrespondence: MB RaviDepartment of Prosthodontics, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Shri Shivarathreeshwara Nagar, Mysuru, Karnataka, 570015, IndiaEmail dr.ravimb@jssuni.edu.inAbstract: Mucormycosis, a rare fungal infection seen in diabetes, is now very frequent owing to the deadly triad of COVID-19 infection, diabetes, and rampant use of corticosteroids. Immediate management revolves around therapeutic drugs like antifungals, antibiotics, and aggressive surgical debridement. The cases described in the article explain prosthetic rehabilitation of maxillectomy defects. The findings focus on prosthetic rehabilitation of patients with acquired maxillectomy defects after mucormycotic necrosis post-COVID-19 infection and the techniques to overcome the complications like lack of supporting tissues and post-surgical microstomia. The maxillectomies were performed on patients who suffered a superinfection of mucormycosis after COVID-19 contraction and uncontrolled blood sugar levels. Case 1 elaborates a technique to overcome the complications like lack of supporting structures and microstomia by fabrication of sectional and hollow obturator prostheses using sectional impression technique and lost salt technique. Case 2 explains the management of an extensive defect with a mobile soft tissue flap and lone standing tooth by using a functional impression technique to gain retention and support from the remaining soft and hard tissues. Both the techniques overcome the clinical complications and give predictable outcomes. Prosthetic rehabilitation of such challenging cases needs modifications depending upon the clinical challenges encountered.Keywords: maxillectomy, microstomia, sectional impression, lost salt technique, functional impression