Acute osteonecrosis of the jaw due to aggravation by the SARS-COV-2 virus: a clinical case report

• Autor(a) principal: Riva, Gabriel Alberto
• Data de Publicação: 2023
• Outros Autores: Oliveira, Carlos Eduardo Lopes de, Zocarato, Pedro Galvão Tavares, Ambrizzi, Dario Ravazzi, Kassis, Elias Naim
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: MedNEXT Journal of Medical and Health Sciences
• Texto Completo: https://mednext.zotarellifilhoscientificworks.com/index.php/mednext/article/view/293
• topic: COVID-19; SARS-CoV-2; Osteonecrosis; Osteomyelitis; Jaw

Although many patients recover from COVID-19, it is important to keep in mind that there may be complications after recovery. One such complication in the maxillofacial region is Avascular Necrosis. Viral downregulation of ACE-2 receptors leads to endothelial dysfunction, which together with virus-induced hyperinflammation. Several complications have been observed in the maxillofacial area in people who have suffered from the infection, including osteonecrosis and osteomyelitis of the mandible and maxilla. Osteomyelitis is an inflammatory disease, which occurs in medullary spaces or on bone cortical surfaces, originating due to insufficient blood circulation in the affected region and also by bacteria, fungi, and micro bacteria. In the specific case that will be addressed, the patient suffered a severe worsening of the infection due to micro-thrombi formed by the SARS-CoV-2 virus and severe worsening also due to diabetes mellitus. The treatment is varied, but the most efficient one is the surgical removal of the contaminated bone sequestration, accompanied by broad-spectrum systemic medications. With the combination of clinical history and laboratory tests, the possible cause of maxillary osteonecrosis was the formation of microthrombi resulting from the SARSCoV-2 virus that obliterated the sphenopalatine and descending palatine arteries. The progression and potentization of the infection are favored due to systemic decompensation caused by uncontrolled diabetes.