Multicentric cone beam computed tomography analysis of jaw bone destruction patterns in post-covid-19 osteomyelitis and osteonecrosis: A retrospective study

Background: Due to immune system weakness, patients recovering from coronavirus disease 2019 (COVID-19) are more susceptible to opportunistic fungal infections, of which mucormycosis is one of the most virulent and potentially fatal forms. Mucormycosis, which typically begins in the nasal and paranasal sinuses, is especially important to dentists because of its unique oral presentation and its capacity to result in widespread maxillofacial bone loss, including osteonecrosis. Aim: In patients with a history of COVID-19 infection, the current study sought to assess and contrast cone beam computed tomography (CBCT) results of mucormycotic osteomyelitis and nonmucormycotic-related osteonecrosis. Materials and Methods: Patients who recovered from COVID-19 and presented with osteomyelitis or osteonecrosis of the jaws were analyzed retrospectively using CBCT to evaluate radiographic characteristics, site involvement, and demographic distribution. Results: The majority of patients in the study were between the ages of 40 and 55, with 71.6% of the population being men and 28.4% being women. 32.9% of cases were nonmucormycotic osteonecrosis, while 67.1% were mucormycosis-associated osteomyelitis. While mandibular involvement was seen in 7.3% and 81.3% of these groups, respectively, the maxilla was mostly implicated in mucormycosis cases (85.8%) as opposed to 13.8% in nonmucormycosis cases. Conclusion: With nonmucormycotic lesions more frequently occurring in the mandible and mucormycosis exhibiting a maxillary predilection, the study demonstrates a substantial association between COVID-19 and both mucormycosis-related osteomyelitis and nonmucormycotic osteonecrosis.