Outstretching challenges for rehabilitation of a mucormycotic case-a digitally designed patient-specific implant approach in the recent era

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BACKGROUND: Reconstruction of maxillofacial defects is challenging due to the region's complex anatomy. During the COVID-19 era, many patients lost their maxilla and chewing efficiency as a result of Mucormycosis. In such cases, custom-designed implants offer a graftless solution for seemingly hopeless situations. This case report aims at miraculous dental transformation utilizing the Patient Specific Implant (PSI) approach. CASE PRESENTATION: A 64-year-old male patient presented to the Prosthodontics Department with the chief complaint of missing teeth. He had been struggling with chewing for two years due to a post-mucormycotic maxillary jaw. A CT scan was obtained to evaluate and investigate the affected site. After a comprehensive diagnosis, the treatment of choice was a patient-specific implant decided using 3D printing technology. Reconstructing maxillofacial defects poses significant challenges due to the region's intricate anatomy, as well as its aesthetic and functional implications. The use of pre-formed alloplastic implants and autogenous grafts often leads to complications such as resorption, infection, and displacement. However, recent technological advances have made it possible to fabricate customized patient-specific implants (PSIs) through computer modeling, offering new opportunities for reconstructive surgery. CONCLUSION: This case report demonstrates the dental management of post-mucormycotic patients with specially designed implants, customized according to the availability and anatomy of the bone in the entire head region. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included infection, soft tissue recovery, wound separation, masticatory efficiency, stability of the prosthesis, and aesthetic outcomes. The positive outcomes observed at follow-up appointments emphasize the viability and effectiveness of patient-specific implants in addressing maxillary defects caused by post-mucormycosis.

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