Prosthodontic options for Mucormycosis patient rehabilitation

Mucormycosis is an invasive, rapidly progressive fungal infection that involves the maxillofacial structures, such as the nose, maxillary sinuses, orbital region, and other associated structures, leading to a very high mortality rate and disfigurement. The aetiology of Mucormycosis is basically a compromised immune system of the individual, which may be due to chronic systemic diseases such as uncontrolled diabetes mellitus, Leukaemia, long-term use of steroids, etc. Acute surgical resection is performed, which involves the resection of the affected maxillofacial structures, such as the orbit, maxilla and/or nose, in such conditions. Rehabilitation of a Mucormycosis case is an extremely challenging situation for the clinician or maxillofacial prosthodontist, as there are very few facial structures left to provide retention for the prosthesis due to scarred soft tissues and missing anatomical landmarks, such as the posterior palatal seal area. Most of the time, there is only unsupported soft tissue covering a hollow cavity, which compromises treatment for such patients. The various options for rehabilitation of such patients include removable prosthesis, such as an obturator, which can be a surgical or definitive obturator with or without a bulb. It can also be a cast partial denture supported obturator prosthesis. Under the fixed category, we can replace the lost part of the maxillofacial structures with the help of dental implants, which may be of several types like end osseous root form implants, zygomatic implants, pterygoid implants, etc., since a great deal of maxillofacial structures are missing, zygomatic implants are an excellent option for fixed rehabilitation of Mucormycosis patients. It restores the patient's normal function and appearance and provides a psychological boost to the patient's emotional state. These patients require extra attention, patience, care and empathy from the clinician's perspective as they have already gone through a lot of pain and trauma during recovery from such a devastating illness, and it's the duty of the treating clinician to get them back to their normal function and life.

Written By:
Dr. Charu Khurana
Reader
Public Health Dentistry
Faculty of Dental Sciences ,
SGT University, Gurugram