Dental Courses by Indian Dental Academy 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

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

2.  Mesenchymal
 Epithelial
 Mixed
www.indiandentalacademy.com

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. Anatomical subsites
 Lip
 Buccal mucosa
 Alveolus
 Retro molar trigone
 Tongue
www.indiandentalacademy.com

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

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

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. 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. Investigations
IMAGING
 Radiographs
 CT
 MRI
 SPECT – Single photon emission computed
tomography
 PET – positron emission tomography
 Bone scan
www.indiandentalacademy.com

10.  Biopsy
 FNAC
www.indiandentalacademy.com

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. 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. M- Distant metastasis
 Mx – cannot be assessed
 M0 – No distant metastasis
 M1 – metastasis present
www.indiandentalacademy.com

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. Management
Depends on stage of presentation
 Surgery
 Radiotherapy
 Chemotherapy
 Combination
www.indiandentalacademy.com

16. Surgery
 Extent depends on the stage of presentation.
 Minimum 2 cm margin
Composite resection, Commando operation, En bloc
removal
www.indiandentalacademy.com

17. Neck dissection
www.indiandentalacademy.com

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.  Radiotherapy – curative or palliative
 56- 7- gray/30 fractions/6wks
 Chemotherapy
Generally palliative
www.indiandentalacademy.com

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