Rare surgery by army dentists gives hope to patients who suffered disfigurement due to black fungus during Covid pandemic

Vijay Mohan

Tribune News Service

Chandigarh, October 5

Doctors at the Army Dental Centre, Research and Referral, New Delhi, have performed a rare surgical procedure by reconstructing the complete lower half jaw of a patient.

The centre has become the first armed forces dental establishment in the country to perform such a surgery and this has given hope of rehabilitation to patients who had suffered disfigurement due to black fungus during the Covid pandemic.

A team of maxillofacial surgeons of the centre headed by Director General of Army Dental Corps, Lieutenant General NK Sahoo, with support from an anaesthesia team from Army Hospital (Research and Referrel), New Delhi, successfully reconstructed the lower jaw with an entirely allo-plastic titanium mandible in a patient of extensive mandibular defect.

The mandibular area consists of the largest and strongest bone of the face. It forms the lower jaw and acts as a receptacle for the lower teeth. It also articulates on either side with the temporal bone, forming the temporo-mandibular joint that comes into play when the jaw is moved for speaking or eating.

A 26-year-old patient had lost one half of his mandible due to the most dreaded odontogenic tumour of the jaws called ameloblastoma which had extensively destroyed his lower jaw and was surgically removed a year back. Ameloblastoma is a rare, benign or cancerous tumour. The rehabilitation process also involved implant analogues for subsequent teeth replacement.

Colonel Vivek Saxena, head of the maxillofacial surgery unit at Army Dental Centre, who was part of the surgical team and has been associated with the case for the past one year, said that till now the only available options for treating such severe post resection deformities required taking a part of the patient’s hip bone (ileum) or the leg (femur) for jaw reconstruction but this caused significant morbidity.

“The present treatment modality obviates the need for any additional surgical procedure. Now these patients have a more predictable treatment option available to them with lesser post-operative morbidities,” he said.

Armed Forces Medical Services in general and the Army Dental Centre in particular have been at the forefront of introducing the latest technology for patient care and with use of CAD and CAM computer-based tools and treatment planning on state-of-the-art software, it has taken a giant leap ahead.

According to Lt Gen Sahoo, this facility involves meticulous planning on a high-end virtual platform followed by precision surgery and is being extended to all serving personnel of the armed forces as well as their dependents. He said many similar cases which had lost all hopes of returning to normalcy, both functionally and cosmetically, due to disfiguring surgeries in post-Covid mucormycosis (black fungus) are already in an advanced stage of planning and awaiting rehabilitation.