Clinical study on method of resection for carcinoma of lower gingiva. The border of marginal resection and segmental resection of the mandible.:THE BORDER OF MARGINAL RESECTION AND SEGMENTAL RESECTION OF THE MANDIBLE

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Surgery for patients with carcinoma of lower gingiva was performed mainly by segmental resection of the mandible and showed good clinical results in our clinic. On the other hand, we are making effort for the enlargement of adequacy on marginal resection of the mandible to preserve quality of life of patients.The present study of 67 patients of lower gingiva (squamous cell carcinoma) analysed the reliability of parameters to decide to preserve or sacrifice the mandible. Degrees of bone resorption by invasion of tomors were decided as Grade 0: no resorption, 1: resorption of alveolar ridge, 2: resorption of mandibular body but not involving mandibular canal, 3: resorption of mandibular body involving mandibular canal. Patterns of bone resorption were classified to pressure type and moth—eaten type. The analysis showed patients with bone resorption Grade 0, 1 and patients with pressure type in Grade 2 could be treated by marginal resection of the mandible. All patients with lower malignancy score than the mean (10.5) underwent marginal resection and resulted in no recurrence. Buccal side extending type showed relatively higher recurrence rate in primary lesion, minimizing surgery after preoperative treatment could be performed in 10 caces, 14.9% out of 67 cases. Recently, it became not so difficult to make decision to preserve or sacrifice the mandiblar margin by Dental CT.
日本頭頸部癌学会の論文