Spread of squamous cell carcinoma to the nonirradiated edentulous mandible—A preliminary report

Abstract

The changes in the mandible and in its relationship to surrounding soft tissue structures after loss of the teeth are described; the regular presence of deficiencies in the cortical bone along the line of the occlusal ridge is emphasized. Resection specimens of squamous carcinoma of the oral cavity not treated by radiotherapy were examined where there was mandibular involvement by tumor, and showed that the main route of tumor entry into the bone was through the occlusal ridge. Subsequent perineural spread along the inferior alveolar nerve has been found to be a regular occurrence.

Assessment of perineural infiltration and spread of oral squamous cell carcinoma: A clinicohistopathologic study

“…In our study, 17 cases with lingual extension showed gross invasion of the mandibular bone, with a few cases showing pathologic fracture and all cases showing pathologic invasion of the perineural tissues. These findings corroborate with the findings of McGregor et al (1987), who suggested that there is continuity between the inferior alveolar canal and the overlying mucoperiosteum in an edentulous mandible. [5] The study by Totsuka et al(1991) also showed that the rate of spread of OSCC is unimpeded in the cancellous bone than in the cortical bone.…”

“…These findings corroborate with the findings of McGregor et al (1987), who suggested that there is continuity between the inferior alveolar canal and the overlying mucoperiosteum in an edentulous mandible. [5] The study by Totsuka et al(1991) also showed that the rate of spread of OSCC is unimpeded in the cancellous bone than in the cortical bone. [6] Pain in OSCC is a result of secondary infection in the lesion, which undergoes repeated trauma and irritation of the nerve endings, whereas neurological deficit denotes perineural invasion.…”

Mandibular invasion in oral squamous cell carcinoma: investigation by clinical examination and orthopantomogram

“…Assessment of mandibular bone involvement has therefore been regarded as a central diagnostic and therapeutic issue 16,27,33,42,44 .…”

Management of Gingivobuccal Complex Cancer

“…Subsequently,t he mandible is involved by infiltrationt hrough the dental sockets or the dental pores (in edentulous patients) on the alveolar ridge. 4 These cells proceed along the root of the tooth into the cancellous part of the mandible and then along the mandibular canal. This understanding has led to the development of mandible-sparing, surgical resections.…”