ABSTRACT
Aim and objective: To report a case of surgical management and postsurgical rehabilitation COVID-19-related mucormycotic osteomyelitis of the maxilla. Background: Patients with the SARS-CoV-2 infection, also termed the COVID-19 illness, have been found to be afflicted with other associated bacterial and fungal diseases which have been termed as co-infections. In this regard, mucormycosis, a fungal infection, has been found to occur in these patients especially with a lowered immune response and has been found to cause osteomyelitis of the jaw bones. Case description: We present a case of mucormycosis in a COVID-19-affected patient that occurred in August 2020 denoted the first wave of disease in India, causing extensive osteomyelitis of the left maxilla. The patient presented clinically with odontalgia and tooth mobility in the upper anterior region. Clinical examination revealed the presence of abscesses in the attached gingiva in relation to tooth numbers 13,12, 11, 22, 23,24 and 25. A deep horizontal cleft was observed in the mucogingival junction in relation to 23 discharging pus. Computed tomography (CT) imaging revealed a diffuse radiolucency extending from the alveolar ridge of the upper anterior teeth to the left maxillary sinus, breaking the floor of the sinus. We have performed extensive medical and surgical management of this patient including postoperative prosthetic rehabilitation which is documented in the present case report. Clinical significance: Our observation of maxillary osteomyelitis secondary to mucormycosis in the first COVID wave in India makes our case extremely rare and important as this highlights that COVID-19 complications were significant but under-evaluated in the first wave of the disease. © Jaypee Brothers Medical Publishers. 2021.
ABSTRACT
Introduction: It is well known that the SARS-CoV-2 virus that causes COVID-19 could enter the human host through the oral cavity. In patients with periodontal disease, there is an increase of Furin, Cathepsin, and CD14+ CD16+ monocytes. The hypothesis stated here sheds light on the regular need of periodontal management to reduce inflammation and the levels of deleterious host enzymes and cytokines, which could pave the way for deadly viral diseases such as COVID-19. The Hypothesis: Patients with periodontal disease are at increased risk of SARS-CoV-2 infection due to elevated levels of Furin and Cathepsin in oral cavity and COVID-19 complications like cytokine storm could occur with increased frequency in patients with periodontal disease due to the significant increase of CD14+ CD16+ monocytes in blood. Evaluation of the Hypothesis: Oral and periodontal examination of patients with mild, moderate, and severe SARS-CoV-2 infection could shed light on the significant role played by periodontal disease in making an individual more prone to get SARS-CoV-2 infection by elevation of Furin and Cathepsin and the elevation of CD14+CD16+ monocytes and proinflammatory cytokines in the blood that could consequently worsen COVID-19 complications like cytokine storm. The blood counts of CD14+CD16+ monocytes need to be assayed in SARS-CoV-2 patients with and without periodontal disease to observe if periodontal disease as a coexisting condition elevates the proportion of CD14 CD16 + monocytes in SARS-CoV-2 patients. In fact, assessment of monocyte subsets in peripheral blood could be used as an immunosurveillance marker in SARS-CoV-2 patients. Hence, SARS-CoV-2 positive patients with chronic periodontal disease should be closely monitored for potential signs of a cytokine storm and its related complications. © 2021 Dental Hypotheses ;Published by Wolters Kluwer - Medknow
ABSTRACT
The SARS-CoV-2 virus has created havoc in the world by causing the COVID-19 pandemic.(1) The affected patients exhibit fever, cough, and apnea. Hospitalization is often due to progressive respiratory distress, which, in a proportion of patients, had led to fatalities.(2) The geriatric population is at a higher risk, because of their reduced immunity and the presence of comorbid conditions like diabetes mellitus, hypertension, and cardiovascular diseases. Health authorities have advocated social distancing as a method to contain the spread of this contagious disease. A landmark study has shown that the SARS-CoV-2 virus can remain viable on various surfaces like cardboard, stainless steel, plastic, and copper for a long duration. The research conducted by van Doremalen et al.(3) has created an aerosolized environment using SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) in a Goldberg drum using a 3 jet collision nebulizer and has exposed various materials such as cardboard, paper, stainless steel, plastic, and copper to the virus. The SARS-Cov-2 virus was found to be viable in aerosol for only 3 hours, although its presence on material surfaces lasted significantly longer, especially in stainless steel and plastic surfaces, wherein the virus was detected for up to 72 hours.(3).