Maxillary defects due to COVID-19 associated mucormycosis: Impact on quality of life after rehabilitation with an obturator

Gunjan Chouksey; Vikas Gupta; Pankaj Goel; Abhishek Purohit; Aman Dev; Bhimsen Kumar

doi:10.1016/j.prosdent.2023.07.005

Maxillary defects due to COVID-19 associated mucormycosis: Impact on quality of life after rehabilitation with an obturator

J Prosthet Dent. 2023 Aug 24:S0022-3913(23)00463-8. doi: 10.1016/j.prosdent.2023.07.005. Online ahead of print.

Authors

Gunjan Chouksey¹, Vikas Gupta², Pankaj Goel³, Abhishek Purohit⁴, Aman Dev⁵, Bhimsen Kumar⁵

Affiliations

¹ Associate Professor, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India. Electronic address: gunjan.dentistry@aiimsbhopal.edu.in.
² Additional Professor, Department of ENT-HNS, All India Institute of Medical Sciences, Bhopal, India.
³ Professor and Head, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India.
⁴ PhD student, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India.
⁵ Technical Officer, Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India.

PMID: 37633728
DOI: 10.1016/j.prosdent.2023.07.005

Abstract

Statement of problem: Aggressive surgical debridement including maxillectomy in patients with coronavirus disease 2019 (COVID-19) associated mucormycosis of the maxilla alters facial appearance, function, and an individual's overall quality of life (QOL). These patients require rehabilitation of defects with obturators to help them recover from esthetic and functional disabilities and regain near-normal quality of life. Because COVID-19 associated with mucormycosis is a newer entity, less is known about the quality of life of these patients after rehabilitation with obturators. Hence, the effects of COVID-19 associated with mucormycosis, treatment, and rehabilitation need to be evaluated to assess QOL.

Purpose: The purpose of this clinical study was to assess the impact on QOL after rehabilitation with obturators for participants with COVID-19-associated mucormycosis who underwent maxillectomy.

Material and methods: Oral health impact profile-14 (OHIP-14) and obturator functioning scale (OFS) questionnaires were administered to 26 participants with COVID-19-associated mucormycosis of the maxilla who underwent maxillectomy and required rehabilitation with obturators. Questionnaire responses were received on numerical Likert scales of 0 to 4 for OHIP-14 and 1 to 5 for OFS. The repeated measures analysis of variance (ANOVA) with pairwise post hoc Bonferroni tests were used to evaluate and compare mean scores of OHIP-14 and OFS at different preoperative and postoperative stages (α=.05).

Results: A total of 26 participants who underwent maxillectomy were provided with obturators. A higher mean ±standard deviation OHIP score was observed before rehabilitation at T1 (51.0 ±9.6) followed by 1 week after fabrication of the surgical obturator at T2 (18.6 ±16.4), and 1 week after fabrication of the interim obturator at T3 (4.7 ±8.2). The lower mean scores ±standard deviation were seen 1 week after the fabrication of definitive obturators at T4 (2.9 ±7.2). Comparison of the scores at T1, T2, T3, and T4 found significant difference (P≤.001). Similarly, higher mean ±standard deviation OFS scores were seen 1 week after rehabilitation with surgical obturators at T2 (27.3 ±12.6) and at least 1 week after fabrication with definitive obturators at T4 (15.7 ±5.6). A comparison of the scores at T2, T3, and T4 found significant differences (P≤.001).

Conclusions: Considerable improvement was seen in QOL with the fabrication of surgical obturators in participants who had received maxillectomy/debridement for mucormycosis. This improvement had a linear relationship with the time elapsed and the consecutive fitting of the obturators with healing.