Digitally Guided Advanced Prosthodontic Rehabilitation for Post-COVID-19 Mucormycosis Using Patient-Specific Implants: A Case Report.

ABSTRACT

This case report describes the prosthodontic rehabilitation of a middle-aged male patient who underwent bilateral low-level maxillectomy due to post-COVID-19 mucormycosis. The oronasal communication was closed using an anterior base tongue flap. Two patient-specific subperiosteal implants were placed to rehabilitate the patient's bony defect. Using a postsurgical CT scan, a virtually customized subperiosteal titanium framework was created from grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic bone bilaterally. Six months later, the right-sided patient-specific implant was infected and had to be surgically removed. After satisfactory healing, an open-tray impression was taken to create a computer-aided design/computer-aided manufacturing titanium Hader bar. An acrylic resin overdenture was then fabricated over this bar. A clasp assembly was fabricated by direct metal laser sintering of cobalt-chromium alloy for additional retention. The metal substructures were incorporated into the overdenture prosthesis to enhance the stability and retention.. This case report unveils an innovative approach to rehabilitating severely compromised maxillary bony defects and impaired oral functioning, offering a viable alternative when traditional reconstruction methods are inadequate. Prosthodontic treatment greatly affects the aesthetics, phonetics, and mastication of the patient, improving the overall quality of life of the patient.