A Novel Method to Rehabilitate Post-mucormycosis Maxillectomy Defect by Using Patient-Specific Zygoma Implant.

Aim: During second wave of COVID pandemic, India faced heavy surge of mucormycosis. Treatment option for these patients included either total or partial maxillectomy with primary closure. Rehabilitation of these patients became challenging because of their age and size of defect. The purpose of the present study is to present a new digital technique for the fabrication of patient-specific zygoma implants (PSI) and to report on its survival and complication rates. Material and Methods: Total 21 patients who had undergone either partial or total maxillectomy after mucormycosis and who were disease-free clinically and radiographically for 6 or more months post-resection were rehabilitated using patient-specific zygoma implant. CT scan was obtained for all patients post-maxillectomy for evaluation of existing bone condition. Exocad software was used for virtual surgical planning of zygoma implant considering surgical and prosthetic technicality to achieve goal of maximum functionality and sustainability. Result: All the patients were followed up after 15, 30, 45 and 90 days and there after every month for evaluation of soft tissue healing, infection, dehiscence, loosening of prosthesis, eating efficiency and aesthetic. Follow-up period for all 15 patients was in the range of 6-12 months. Conclusion: In case of post-mucor maxillectomy patients, use of PSI offers the advantages of minimal bone augmentation, reduction in time required to restore lost function, and reduced financial burden of multiple procedures. Therefore, PSI may represent a valid alternative treatment for the prosthetic restoration of post-mucor maxillectomy patients.

Application of Three-Dimensional Printers for Production of Personal Orbital Implants during Pandemics

Objective: The production of personalized prosthesis depends on human resources and involves a manufacturing process in which patients are involved individually in. As the world is experiencing the COVID-19 pandemic, less contact with the manufacturer is needed to stay safe. 3D printed prosthesis has reduced the need for human resource in the process, while allowing the patient to be completely removed from the design and manufacturing process. In this study an approach in which the patient is kept out of the manufacturing process was investigated. Material(s) and Method(s): The prosthesis model was created by using the image data obtained from the medical imaging devices. The outer part of the prosthesis was shaped with a developed image sampling system. The model was produced using three-dimensional printer. A cytotoxic analysis of the raw material used in the manufacturing process was performed. Result(s): The total production cost of the orbital implants was approximately about 8$. The cytotoxic analysis showed that layered manufacturing strategies could be used to develop implants and prostheses applicable to patients. Conclusion(s): COVID-19 underlined the importance of social distancing which is hard to apply during manufacturing of an eye prosthesis. The manual method results in an eye prosthesis which suits well after numerous trials. On the contrary, Digital Imaging and Communications in Medicine (DICOM) based eye prosthesis designation and manufacturing is not only rapid but also flawlessly fitting due to precise measurement during the manufacturing. Copyright © 2022, Nobelmedicus. All rights reserved.