Clinical Interventions in Aging (Aug 2023)
Influence of Prosthodontic Rehabilitation Using Zygomatic Implants in Covid 19 Related Mucormycosis (Rhino–Orbital–Cerebral) Maxillectomy Patients Upon Post-Operative Stress, Anxiety and Functional Impairment: A Prospective Cohort Study
Abstract
Lakshya Kumar,1 Aditi Verma,1 Uma Shanker Pal,2 Khurshid Mattoo,3 Youssef Abdullah Algarni,4 Saeed Awod Bin Hassan,4 Suheel Manzoor Baba,4 Sumaya Yousuf Jeri,5 Shafait Ullah Khateeb4 1Department of Prosthodontics, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India; 2Department of Oral and Maxillofacial Surgery, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India; 3Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, 45142, Kingdom of Saudi Arabia; 4Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Kingdom of Saudi Arabia; 5Department of Orthodontics and Dentofacial Orthopedics, I.T.S Centre for Dental Studies and Research, Chaudhary Charan Singh University, Ghaziabad, Uttar Pradesh, 201206, IndiaCorrespondence: Lakshya Kumar, Department of Prosthodontics, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India, Tel +91‐9412119778, Fax +91 522 2257539, Email [email protected]: To determine the influence of prosthodontic rehabilitation using zygomatic implants in partial maxillectomy upon post-operative stress, anxiety and functional impairment, due to covid 19 associated rhino–orbital–cerebral mucormycosis (ROCM).Patients and Methods: Twenty maxillectomy patients fulfilling study criterion, received zygomatic implants (ZI) (quad zygoma) (ZDI Simpladent, Switzerland) retained/supported complete maxillary denture. Assessment of stress, anxiety, masticatory performance and speech were determined using diurnal salivary cortisol level, Appearance Anxiety Inventory, multiple sieve technique and auditory perception analysis, respectively. Data were recorded at 6 different stages of rehabilitation (after maxillectomy, implant placement, and after prosthesis delivery (1 week, 1 month, 6 months and 1 year)). Demographic data were expressed as frequency distribution, while mean values were used to find differences between various rehabilitation stages using Friedman and chi-square test with statistical significance value at p < 0.05.Results: Average daily salivary cortisol levels declined from post maxillectomy (22.80 ± 0.902) to 1 year after prosthesis wearing (8.65 ± 0.985), indicating stress reduction after ZI rehabilitation. Mean scores for appearance anxiety reduced from pre-prosthetic rehabilitation (27.350 ± 3.030) to 1 year (8.950 ± 0.887) following prosthesis wearing. Functional parameters for mastication and speech also improved significantly during the course of rehabilitation. All differences between pre-prosthetic to 1-year stage after prosthesis wearing were found to be statistically significant at p < 0.05.Conclusion: Post ROCM maxillectomy cases after prosthetic rehabilitation using zygomatic implants showed significant improvement in the psychological (stress and anxiety) as well as function (mastication and speech) characteristics. Rehabilitation post ROCM maxillectomy with the present approach of fixed prosthesis using zygomatic implants mitigates deficient mastication and speech. It also impacts positively on patient psychology by decreasing stress and anxiety.Keywords: mucormycosis, dental implant, maxillofacial prosthesis implantations, Covid-19
