There are many patients who has suffered from black fungus (mucormycosis) of Jaws after covid infection. Black fungus of upper jaw start with pain in upper teeth, and gradually progress to gums swelling, blisters, mobility of teeth and ulcers of gums. Usually these patients are initially treated as case of dental problem , but it gives no relief to patient. Gradually as the diseases progress , entire upper jaw or its part looses its blood supply, bone becomes dead and necrosed . The only treatment left at this stage is to remove entire jaw bone along with teeth
After removal of upper jaw or its part die to black fungussurgery, it becomes very difficult for patient to chew or swallow because everything he takes in mouth, comes out through nose. And apart from this there is severe disfigurement of face also.
There are various options to rebuild the resected part of upper jaw after black fungus (mucormycosis) surgery. One option is to reconstruct it a bone taken from leg , known a free fibula flap. It’s a micro vascular surgery, and lost bone and soft tissue of upper jaw can be replaced successfully. But its a very technique sensitive surgery, needs an very experienced surgeon and have higher chances of post operative complications and failures. Once the leg bone (fibula bone) is successfully attached to jaw bone, than roughly around 3 to 6 months later we can place dental implants in that bone, and again after a wait of 3 to 6 months we can give fixed prosthesis on those implants.
Another option to give fixed new teeth and jaw after mucormycosis surgery is to use special dental implants known as Zygomatic implants. These implants get attached to jaw bone ( zygomatic bone) and than on these implants fixed prosthesis with new teeth and jaw can be given . This prosthesis can be used effectively for chewing and it looks exactly sane as natural jaw and teeth. This prosthesis also blocks the communication between mouth and nose. Major advantages with zygomatic implants is there is no need for Patient to undergo an extensive micro vascular surgery. Zygomatic implant are done under local anesthesia and patient is discharged immediately.
Here we are presenting a case report of a middle aged , who has lost her right half of upper jaw and teeth due to black fungus ( mucormycosis) infection. Her right side of face was also depressed due to lack of bone and teeth support. And worst of all was her voice was not at all understandable. Whatever she was eating , used to come out through nose because of a hole in palate.
First her CBCT ( cone beam CT scan) of face was done . It was found that fortunately she has sufficient Zygomatic bone left in which Zygomatic implants can be placed and a fixed prosthesis can be given.
so she underwent a Zygomatic implants placement surgery under local anesthesia, three Noris Zygomatic implants were placed , and than later on after healing, a fixed prosthesis was given to her on Zygomatic implants.
This fixed prosthesis has not only given her back her lost jaw and teeth, but also has returned the comfort of eating and speaking. Ofcourse her moral and confidence is regained. She smiles beautifully now!