Rehabilitation of patient using a patient-specific implant with bar-retained maxillary obturator and orbital prosthesis postoperated rhino-orbital mucormycosis

Abstract

ABSTRACT The “black fungus” or Mucor mycosis affected a significant number of COVID patients during the pandemic. Aggressive surgical intervention of these cases resulted in large palatal & orbital defects that required prosthetic rehabilitation. This is a painstaking process due to compromised retention and minimum residual bone. In this dental centre, two case was rehabilitated with 3D printed titanium patient specific implants (PSI) followed by prosthetic rehabilitation.A 36-year-old male diabetic COVID patient was diagnosed with mucormycosis and underwent right orbital exenteration & maxillectomy. Upon recovery, a PSI was designed and 3D printed to provide support for orbital and maxillary prosthesis. PSI was fixed to the orbital rims and remaining zygomatic bone for supporting the prostheses and Bar-clip retained prostheses were fabricated using the conventional method.During COVID-19 pandemic, patients who contracted Mucormycosis had a poor prognosis with conventional prostheses since all the supporting structures had been affected by the infection. Conventional prostheses for maxillofacial defects do not have adequate supporting hard & soft tissues to provide retention and support. The PSI with Bar retained protheses have been selected as a treatment option for such types of defects.PSIs can be valuable aids in rehabilitating patients with large maxillofacial defects.