COVID-19 and jaw osteonecrosis: A systematic review on clinical presentations and treatment outcomes

To investigate the association between COVID-19 and aseptic osteonecrosis of the jaw, clinical presentation, treatment, and follow-up outcomes. Oral manifestations of COVID-19 are amongst the most important extrapulmonary complications of the virus. Spontaneous osteonecrosis of the jaw following COVID-19 is a rare but concerning condition requiring more attention due to its relationship with the novel virus. A systematic review on case series. The current study was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors searched PubMed, Scopus, Web of Science, and Google Scholar for studies published up to June 24, 2024, on osteonecrosis of the jaws and SARS-CoV-2 infection. Data on patient demographics, study methods, medical records, interventions, and outcomes were extracted from eligible articles. Four datasets and 12 patients were included. The mean age of the patients was 49 years old, with 75 % male predominance.33.3% of patients had comorbidities (DMII and HTN). The prevalence of osteonecrosis was higher in the maxilla (83.3% vs. 16.7% in the mandible). Among the patients, 83.3% had undergone steroid therapy related to the COVID-19 treatment. All patients underwent surgical debridement as their treatment. Seven follow-ups with a mean of 7.2 months were reported and no life-threatening complication was observed. According to our results, SARS-CoV-2 may be associated with osteonecrosis of the jaw. The treatment of choice remains surgical debridement, with favorable long-term outcomes. COVID-19 patients should be closely monitored for such serious manifestations even after full recovery from the disease.