INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
 Mesenchymal
 Epithelial
 Mixed

www.indiandentalacademy.com
Incidence
 20% of all cancers in India
 Tongue and floor of mouth ca in western countries
 Buccal mucosa and alveolus i...
Anatomical subsites
 Lip
 Buccal mucosa
 Alveolus
 Retro molar trigone

 Tongue

www.indiandentalacademy.com
Aetiology
 Tobacco
 Alcohol
 Viruses
 Trauma

www.indiandentalacademy.com
Spread of malignancy
 Local infiltration
 Lymphatic
 Blood borne

www.indiandentalacademy.com
Precancer
 Premalignant lesion
 Premalignant condition

Treatment by medical or surgical methods
 Leukoplakia – strippi...
Clinical features of oral ca.











Most commonly present as non healing ulcers
Exophytic growth
Submucosal...
Investigations
IMAGING





Radiographs
CT
MRI
SPECT – Single photon emission computed
tomography
 PET – positron emi...
 Biopsy
 FNAC

www.indiandentalacademy.com
Staging









T- Tumour size
Tx – primary cannot be assessed
T0 – No primary
Tis – Ca in situ
T1 – 2cm or less
...
N- Lymph node metastasis








Nx- Regionaql lymph nodes cannot be assessed
N0 – no nodes
N1 – single ipsilateral...
M- Distant metastasis
 Mx – cannot be assessed
 M0 – No distant metastasis
 M1 – metastasis present

www.indiandentalac...
Staging
 Stage I

– T1 N0M0
 Stage II
– T2N0M0
 Stage III – T3N0M0, T1,T2,N1
 Stage IVA– T4N0M0, Any T,N2
IV B – Any T...
Management
Depends on stage of presentation
 Surgery
 Radiotherapy
 Chemotherapy
 Combination

www.indiandentalacademy...
Surgery
 Extent depends on the stage of presentation.
 Minimum 2 cm margin

Composite resection, Commando operation, En ...
Neck dissection

www.indiandentalacademy.com
Radical neck dissection
Modified Radical neck dissection
Spinal accessory
Internal jugular vein
Sternocleidomastoid
(Funct...
 Radiotherapy – curative or palliative
 56- 7- gray/30 fractions/6wks
 Chemotherapy

Generally palliative

www.indiande...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Malignant diseases of oral cavity (1) /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Malignant diseases of oral cavity (1) /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2.  Mesenchymal  Epithelial  Mixed www.indiandentalacademy.com
  3. 3. Incidence  20% of all cancers in India  Tongue and floor of mouth ca in western countries  Buccal mucosa and alveolus in India(Gingivo buccal cancers or Indian oral cancer www.indiandentalacademy.com
  4. 4. Anatomical subsites  Lip  Buccal mucosa  Alveolus  Retro molar trigone  Tongue www.indiandentalacademy.com
  5. 5. Aetiology  Tobacco  Alcohol  Viruses  Trauma www.indiandentalacademy.com
  6. 6. Spread of malignancy  Local infiltration  Lymphatic  Blood borne www.indiandentalacademy.com
  7. 7. Precancer  Premalignant lesion  Premalignant condition Treatment by medical or surgical methods  Leukoplakia – stripping or excision  OSMF – Local injections, surgical release www.indiandentalacademy.com
  8. 8. Clinical features of oral ca.           Most commonly present as non healing ulcers Exophytic growth Submucosal growth with induration Trismus Restricted mobility of tongue Pain Bleeding Dysphagia Neck swelling Mobility of teeth www.indiandentalacademy.com
  9. 9. Investigations IMAGING     Radiographs CT MRI SPECT – Single photon emission computed tomography  PET – positron emission tomography  Bone scan www.indiandentalacademy.com
  10. 10.  Biopsy  FNAC www.indiandentalacademy.com
  11. 11. Staging         T- Tumour size Tx – primary cannot be assessed T0 – No primary Tis – Ca in situ T1 – 2cm or less T2 - >2 but <4 T3 - >4 cm T4 – 4A – Invading bone and adjacent muscles 4B – To skull base, pterygoid plates, ICA www.indiandentalacademy.com
  12. 12. N- Lymph node metastasis        Nx- Regionaql lymph nodes cannot be assessed N0 – no nodes N1 – single ipsilateral <3cm N2 A – single ipsilateral >3 but <6 cm N2B – Multiple ipsilateral < 6 cm N2C – Bilateral or contralateral < 6 cm N3 - >6cm www.indiandentalacademy.com
  13. 13. M- Distant metastasis  Mx – cannot be assessed  M0 – No distant metastasis  M1 – metastasis present www.indiandentalacademy.com
  14. 14. Staging  Stage I – T1 N0M0  Stage II – T2N0M0  Stage III – T3N0M0, T1,T2,N1  Stage IVA– T4N0M0, Any T,N2 IV B – Any T, N3 IV C – Any T, any N, M1 www.indiandentalacademy.com
  15. 15. Management Depends on stage of presentation  Surgery  Radiotherapy  Chemotherapy  Combination www.indiandentalacademy.com
  16. 16. Surgery  Extent depends on the stage of presentation.  Minimum 2 cm margin Composite resection, Commando operation, En bloc removal www.indiandentalacademy.com
  17. 17. Neck dissection www.indiandentalacademy.com
  18. 18. Radical neck dissection Modified Radical neck dissection Spinal accessory Internal jugular vein Sternocleidomastoid (Functional neck dissection) Selective neck dissection Extended neck dissection www.indiandentalacademy.com
  19. 19.  Radiotherapy – curative or palliative  56- 7- gray/30 fractions/6wks  Chemotherapy Generally palliative www.indiandentalacademy.com
  20. 20. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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