Rare Post-COVID-19 Nonmucormycotic Osteonecrosis of the Mandible: A Cone-beam Computed Tomography-based Case Series

Abstract

Jaw osteonecrosis has emerged as an increasingly recognized complication in patients recovering from COVID-19, even in the absence of mucormycosis or other fungal infections. In contrast to mucormycotic osteomyelitis, post-COVID-19 nonmucormycotic osteonecrosis is thought to result from multifactorial systemic insults, including SARS-CoV-2-induced vascular dysfunction, corticosteroid-related effects, microthrombus formation, and superimposed bacterial infection. Although prior studies have predominantly reported maxillary involvement, the present case series highlights exclusive mandibular involvement. We describe the cone-beam computed tomography imaging features of post-COVID-19 nonmucormycotic mandibular osteonecrosis, spanning the spectrum from early radiographic changes to advanced destructive disease.