Reconstruction of Maxillary Defects Using Virtual Surgical Planning and Additive Manufacturing Technology: A Tertiary Care Centre Experience

Introduction

Maxillary reconstruction is often a challenging task for the surgeons because of the complex anatomy. However, with the advances in virtual surgical planning (VSP) and 3D printing technology there is a new avenue for the surgeons which offers a suitable alternative to conventional flap-based reconstructions.

Patients and Methods

In this article, we have described 4 case scenarios which were managed with the help of VSP and additive manufacturing technology for complex maxillary reconstruction procedures. Use of the technologies aided the clinician in achieving optimal outcomes with regards to form, function and esthetics.

Discussion

Virtual surgical planning (VSP) has gained a lot of impetus in past 1 decade. These aides the surgeon in determining the extent of disease and also carry out the treatment planning. In addition to VSP, the concept of additive manufacturing provides a viable alternative to the conventional reconstruction modalities for maxillary defect rehabilitation. Increased accuracy, rehabilitation of normal anatomical configuration, appropriate dental rehabilitation, decreased intra-operative time and post-operative complications are some of the advantages. In addition, patient-specific implants eliminate the need for a separate donor site. Apart from the treatment of pathologies, they also can be used for reconstruction of post-traumatic defect, where endosteal implant placement is not possible.

Conclusion

These modalities show promising results for reconstruction of complex maxillary defects.

Comparison of Two Types of Patient Specific Implants (PSI) and Quad Zygoma Implant (QZI) for Rehabilitation of Post-COVID Maxillary Mucormycosis Defect (PCMMD): Finite Element Analysis

Introduction

The residual post-COVID maxillary mucormycosis defect (PCMMD) were extensive, due to unilateral or bilateral maxillectomies. The Goal of rehabilitation of PCMMD is to deliver a prosthetically driven reconstruction. FEA was to evaluate the biomechanical response of PSI struts (PSI 1), PSI Screw retained (PSI 2) and QZI to masticatory load on virtual simulation to improve accuracy and enhance the design.

Aim

To validate and compare the Biomechanical benefit of the PSI struts, PSI Screw retained, QZI in a case of rehabilitation of post-COVID maxillary mucormycosis defect (PCMMD) by FEA study.

Methodology

The result of stress to masticatory load on virtual simulation for (1) Maximum and minimum stress (Von Mises stress); (2) the Displacement (in three positions) and (3) the Deformation (Plastic strain) was compared on virtual simulation for PSI 1 and PSI 2 and QZI.

Conclusion

The FEA and comparative evaluation of PSI 1, PSI 2 and QZI showed a good resistance to displacement. The stress and strain values are low and acceptable. In comparison QZI shows more stress in the anterior region.

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

INTRODUCTION

Coronavirus Disease 2019 (COVID-19) pandemic brought the clinical practice of dentistry and prosthodontics at the threshold of a new era, due to the increasing prevalence of a relative rare condition normally affecting the immunocompromised patients.

AIM

The aim of this clinical case report is to briefly describe the etiopathogenesis, the surgical and prosthodontic management of this evolving medical condition emphasizing the emerging role of the maxillofacial prosthodontist in restoring the patients' well-being.

METHODS AND RESULTS

The surgical and prosthodontic rehabilitation of a COVID-19 infected patient with a mucormycotic lesion of the maxilla will be presented.

CONCLUSION

The role of the maxillofacial prosthodontist is important in alleviating this severe COVID-19 associated morbidity.

Correlation of Mucormycosis with Various Clinical Parameters Among COVID-19 Patients: A Cross-Sectional Study

Introduction

Coronavirus disease 2019 (COVID-19), during the second wave in early 2021, caused devastating chaos in India. As daily infection rates continue to rise alarmingly, the number of severe cases also increased dramatically. Mucormycosis is an infection caused by filamentous molds, and there was a rise in mucormycosis cases after COVID-19 infection. The aim of the study is to assess various parameters associated with mucormycosis patients who suffered from COVID-19.

Material and Methodology

This study was a cross-sectional questionnaire study. The target population for the study were 70 mucormycosis-infected patients (51 = males, 19 = females). The questionnaire mainly focused on association of various parameters of COVID-19 with mucormycosis.

Results

Result showed that out of 70 cases of mucormycosis the association was found between history of diabetes mellitus 45 (64.2%), type of hospitalization, number of days of hospitalization, oxygen administered, type and maintenance of face mask, i.e., patient who had reused mask by washing 59 (84.3%), and method of oral hygiene practices.

Conclusion

Mucormycosis is extremely rare in population. The study findings emphasize the need to be aware of invasive mucormycosis developing in COVID-19 patients, especially including patients with diabetes mellitus and outside the ICU, patient who had poor oral hygiene during COVID-19, patients receiving oxygen therapy should ensure that the water in the humidifier is clean and is refilled regularly, knowledge and education about the use of the facemask.