Title : Comprehensive management of jaw bone defects as a post-COVID-19 complication

Abstract:

The COVID-19 pandemic has caused complications not only in the respiratory system but also in other areas, such as the jawbone. Disorders like osteonecrosis often result from prolonged corticosteroid use, weakened immunity, and secondary infections. Addressing these complications and exploring effective treatments is crucial to improving patient outcomes.

Purpose
This study aims to identify the main causes of jawbone defects in post-COVID-19 patients and propose a comprehensive treatment approach. The goal is to facilitate early diagnosis, effective management, and better recovery outcomes. Improvement of the application of orthopedic constructions for patients with jaw bone defects.

Materials and methods:
The study involved 75 patients treated at clinic Tashkent medical academy in Department maxillofacial surgery, all of whom experienced jawbone complications after recovering from COVID-19. Their treatments and outcomes were thoroughly analyzed. Data was collected through clinical examinations, imaging techniques (e.g., CBCT scans), and lab tests. The treatment methods included: Pharmacological therapy - use of anti-inflammatory and anti-infective medications. Surgical procedures-  removal of necrotic bone and reconstructive surgeries. Regenerative techniques- application of platelet-rich plasma (PRP) and stem cell therapies to encourage bone regeneration. Evaluation of speech efficiency after prosthesis placement.

Results
Corticosteroid overuse contributed to 15 (20%) of cases. Fungal infections- Rhizopus oryzae, Lichtheimia, Apophysomyces, Cunninghamella, Mortierella, Saksenaea caused  mucormycosis accounted for 38 (50,6 %). Immune suppression and vascular issues caused osteonecrosis in 12 (25%). Combined surgical and regenerative treatments improved bone healing by 10 (13, 3%) within six months. Several days after surgery, the construction of the prostheses made from acrylic plastic was modified, and prostheses were placed by applying soft prosthetic resin to the lateral sides of the prosthesis base to address large defects. For smaller defects, the central part of the prosthesis base was treated with soft prosthetic resin before placement.

Conclusion:
Jawbone defects related to COVID-19 require a multidisciplinary approach combining medical, surgical, and regenerative treatments. Early intervention and tailored management plans are essential to preventing long-term complications and ensuring effective rehabilitation. As a result, selecting our method of prosthesis construction reduces the accumulation of microorganisms beneath the prosthesis.