UNIVERSIDADE ESTADUAL PAULISTA “JÚLIO DE MESQUITA FILHO” Instituto de Ciência e Tecnologia Campus de São José dos Campos CASE REPORT DOI: https://doi.org/10.4322/bds.2024.e3811 1 Braz Dent Sci 2024 Jan/Mar;27 (1): e3811 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Maxillary osteomyelitis associated with COVID-19: mucormycosis or not? A series of cases Osteomielite maxilar associada ao COVID-19: mucormicose ou não? Uma série de casos Mayank VERMANI 1 , Megha CHOPRA 2 , Neeti SWARUP 3 , Ankita PAL 4  1 - Sarvodaya Hospital. Hisar, Haryana, India. 2 - MRIIRS: Manav Rachna International Institute of Research and Studies, Faculty of Dental Sciences, Department of Prosthodontics and Crown & Bridge. Faridabad, Haryana, India. 3 - University of California, School of Dentistry, Center for Oral and Head/Neck Oncology Research. Los Angeles, USA. 4 - Department of Prosthodontics and Crown & Bridge, Santosh Dental College and Hospital, Santosh Deemed to be University, Ghaziabad. How to cite: Vermani M, Chopra M, Swarup N, Pal A. Maxillary osteomyelitis associated with COVID-19: mucormycosis or not? A series of cases. Braz Dent Sci. 2024;27(1):e3811. https://doi.org/10.4322/bds.2024.e3811 ABSTRACT Aim: A series of cases have been presented involving the oral cavity focusing on the presentation, diagnosis and treatment of mucormycosis that can form a basis for successful therapy. Background: The management of severe coronavirus disease (COVID-19) in conjunction with comorbidities such as diabetes mellitus, hematological malignancies, organ transplants, and immunosuppression have led to a rise of mucormycosis which is an opportunistic infection. Cases Description: The various forms that have been enlisted till date are rhino- cerebral, rhino-orbital, gastrointestinal, cutaneous, and disseminated mucormycosis. From the dentistry and maxillofacial surgery perspective, the cases depicting extension of mucormycosis into the oral cavity have been less frequently recorded and thus, require a detailed study. The patients that reported to our private practice had non-tender swelling, draining sinuses and mobility of teeth. A similarity was observed in the clinical signs both in osteomyelitis and mucormycosis. Thus, a histopathological examination was used to establish the definitive diagnosis. Conclusion: Mucormycosis is a life threatening pathology that requires intervention by other branches to make an early diagnosis and commence the treatment. The characteristic ulceration or necrosis is often absent in the initial stage and thus, histopathological examination and radiographic assessment are required to formulate a definitive diagnosis. Early intervention is a necessity to avoid morbidity. The treatment involves surgical debridement of the necrotic infected tissue followed by systemic antifungal therapy. Mucormycosis has recently seen a spike in its prevalence, post the second-wave of coronavirus pandemic in India. It was seen commonly in patients with compromised immunity, diabetes mellitus, hematological malignancies, or on corticosteroid therapy. Mucormycosis invading the palate mostly via maxillary sinus has been less frequently described. In the post-COVID era the features associated with mucormycosis involving oral cavity, should warrant a possible differential diagnosis and managed appropriately. KEYWORDS Eschar; Immunomodulation; Mucormycosis; Palatal ulceration; Rhino-Cerebral. RESUMO Objetivo: Apresentar uma série de casos com enfâse na apresentação, diagnóstico e tratamento da mucormicose oral, assim como uma revisão sistemática que sirva como base para estabelecimento de terapias de sucesso. Introdução: A forma severa da infecção por coronavirus (COVID-19) associada a diabetes mellitus, doenças hematológicas malignas, transplante de órgãos e imunossupressão levaram a um aumento das infecções oportunistas de mucormicose. Descrição dos Casos: As diversas apresentações clínicas que foram descritas até o momento são a rinocerebral, rino-orbital, gastrointestinal, cutânea e mucormicose disseminada.