Maxillary osteonecrosis related to post-COVID-19: A report of case series and 6-month follow-up

Abstract

Objective

Post-COVID-19-related osteonecrosis of jaws (PCRONJ) has emerged as a complication observed in patients recovered from COVID-19 infection, but PCRONJ has been understudied in the literature. We aimed to report a case series of PCRONJ, including diagnosis, treatment procedures, and discussion about related factors.

Methods

We prospectively evaluated PCRONJ patients at the National Hospital of Odonto-Stomatology in Ho Chi Minh, Vietnam. Patients’ demographics, medical history, COVID-19 treatment, clinical and preclinical features, and clinical outcomes were reported.

Results

During a six-month period, nine patients were included in this study. The mean age was 53.7 years and 56 % of patients were male. All patients were diagnosed with PCRONJ at the maxillary, diabetic and administered corticosteroids to manage COVID-19 prior to this infection. The mean time from COVID-19 recovery to the onset of symptoms was 4.6 weeks. 89 % of patients underwent tooth extractions following tooth mobility examination. Clinically, mobility of dentoalveolar maxillae, in combination with necrotic bone exposure and/or inflammatory signs were observed in all cases. Radiographically, bone destruction located in maxillae and surrounding structures reflected the extension of lesions. Surgical treatment was applied for all cases to debride the necrotic bone. All patients exhibited well-healing, and an improved quality of life after discharge.

Conclusions

PCRONJ should be distinguished from other forms of osteonecrosis of the jaws due to its distinct features. Multiple risk factors complicate the refinement of the likelihood of PCRONJ but warrant awareness for clinicians. An early diagnosis would help to plan a timely treatment and for optimal clinical outcomes.