• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.223-226
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• 2002

The segmental mandibulectomy should be performed, if mandiblie invasion is suspected clinically and radiologically. And if tumor is located to mandible very closely or when microinvasion to mandible is suspected, marginal mandibulectomy is recommended. But in segmental mandibulectomy, reconstruction is difficult and cosmetic problem remains. In this case, we performed modified segmental resection of mandible, preserving the inferior margin of mandible, and maintains the continuity of the bone, in mucoepidermoid carcinoma of parapharynx, invading mandible. We reviewed the diagnosis, pathology, and treatment, and report the case with reviews of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.508-514
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• 1994

For the complete cure of oral cancer suspected to have invaded the mandible in clinical & radiological evaluation, the mandible resection in planned. The aim of this clinical study was to help in decision making in the method & the extent of the mandibular resection surgery. This study was conducted on 46 oral cancer patients, who received cancer surgery including mandibulectomy. And we evaluated the relationship between the pathologic results of resected mandible and the location, size and clinical newk node involvement, tumor cell differentiation. The results are that ; (1) Hiher incidence of bone invasion patterns were observed in tumor of mouth floor & gingiva compared to those of tongue & tonsil, and (2) No significant relationship was found between bone invasion of tumor and tumor size, neck node involvement tumor cell differentiation. The approximation between tumor and bone seems to be the most reliable factor among the other factors in decision making of mandibular resection.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.255-259
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• 2017

Purpose: Underlying bone sclerosis is frequently observed in clinical settings when oral squamous cell carcinoma (OSCC) invades the jaw bone. The aim of this study was to assess the prevalence and characteristics of underlying bone sclerosis in patients with OSCC. Materials and Methods: We retrospectively reviewed the computed tomographic (CT) images of 131 patients who underwent mandibulectomy between January 2012 and December 2015 to treat OSCC. The presence, degree, and extent of underlying bone sclerosis were assessed on CT images and correlated with the following imaging patterns of bone invasion: cortical invasion, medullary invasion with a smooth margin, and medullary invasion with an irregular margin. The chi-square test was used to determine the relationships between the variables. Results: The prevalence of underlying bone sclerosis on CT images was 70.1% (47 of 67). The prevalence was 85.7% (42 of 49) in patients with medullary invasion, but it was 27.8% (5 of 18) in patients with only cortical invasion, indicating a significant increase in the prevalence of underlying bone sclerosis in patients with medullary invasion (P<.05). Aggressive patterns of bone invasion were associated with increases in the degree and extent of the underlying bone sclerosis(P<.05). Conclusion: More than two-thirds of OSCC cases with bone invasion showed underlying bone sclerosis. On CT images, reactive sclerosis in the remaining margin of the alveolar bone should not be used as the primary means to differentiate periodontal inflammatory lesions from those resulting from OSCC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.133-138
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• 2016

Objectives: To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI). Materials and Methods: Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies. Results: Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles. Conclusion: This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.105-108
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• 2000

Odontogenic myxoma is one of rare tumors in oral and maxillofacial region and it is thought to be mesenchymal or ectomesenchymal origin. Its characteristics are benign and non-metastatic but it has the potential of local invasion and high recurrence rate. It originally occurs in atrium of heart and in central case, my xoma is located mainly in the maxilla and mandible. Most odontogenic myxoma develops in 2nd or 3rd decades of life and rarely occurs in child or older persons over fifty. The distribution of reported cases between the sexes is similar and the maxilla and mandible are equally affected or slightly higher in mandible. Clinically it is usually asymptomatic, however it can cause pain and paresthesia is complained in the advanced stages. Displacement and mobility of teeth have also been reported. Odontogenic myxoma is not a frequent tumor, but in case of slow and painless growing tumor it must be considered as a differential diagnosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.41-47
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• 1999

The route of bony invasion and spread pattern of tumor in the mandible are important in management of gingival cancer. Ten patients with gingival cancer involving mandibular body region were operated by composite resection. The radiographic and histopathologic features of the mandibular invasion and spread were analysed and compared. Our results showed that histopathologic extent of tumor invasion were greater than the radiographic prediction, especially in width of the tumor. And the pattern of bony invasion in the body area was mostly found in transmedullary spread rather than perineural spread. The vertical involvement in the mandibular body with tumor was evaluated. It indicated that if a oncologic surgeon was to ensure an adequate safety margin for extirpation of tumor, in most cases, the maintenance of the mandibular continuity is difficult. If the mandibular involvement by gingival cancer was identified radiographically and clinically, segmental mandibulectomy was required for the adequate safety margin, in consideration of the spread pattern in the body area.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.1
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• pp.357-365
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• 1999

Desmoplastic fibroma is a rare. benign intraosseous fibroblastic tumor. which is locally aggressive. It is osseous counterpart of soft tissue fibromatosis. The authors experienced the patient who complained persistent mouth opening limitation with mild swelling on the left mandibular angle area. After careful analysis of clinical. radiological and histopathological findings. we diagnosed as desmoplastic fibroma of the mandible. The results were as follows: 1. Main clinical symptoms were mouth opening limitation which had been persistent for 9 months and mild swelling on the left mandibular angle area. 2. Radiographs showed the radiolucent lesion and expansion of lingual cortex. CT finding is homogeneous soft tissue mass with expansion of left mandibular ramus. Destruction of medial wall of ramus and invasion to adjacent soft tissue is also seen. 3. Histopathologically, plump spindle shaped fibroblasts arranged in bundles or fascicles are observed. The cells of tumor are infiltrating into muscle fiber with destruction of bony trabeculae and merged with surrounding salivary gland.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.100-104
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• 2023

Autogenous bone grafts from the mandibular ramus are a known source of inadequate bone volume scenarios of the residual alveolar ridge. However, the conventional block-type harvesting technique cannot prevent bone marrow invasion, which can cause postoperative complications such as pain, swelling, and inferior alveolar nerve injury. This study aims to suggest a complication-free harvesting technique and present the results of bone grafting and donor sites. One patient received two dental implants with a complication-free harvesting technique that involves creation of ditching holes with a 1 mm round bur. Sagittal, coronal, and axial osteotomies produced grid-type cortical squares using a micro-saw and a round bur to confirm the cortical thickness. The grid-type cortical bone was harvested from the occlusal aspect, and the harvesting was extended through an additional osteotomy on the exposed and remaining cortical bone to prevent bone marrow invasion. The patient did not suffer postoperative severe pain, swelling, or numbness. After 15 months, the harvested site exhibited new cortical bone lining, and the grafted area had healed to a cortico-cancellous complex with functional loading of the implants. Our technique, grid-type cortical bone harvesting without bone marrow invasion, allowed application of autogenous bone without bone marrow invasion to achieve acceptable bone healing of the dental implants and to regenerate the harvested cortical bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.315-322
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• 2003

Background : Important factors to determine treatment method and prognosis of oral cancer are anatomical site, tumor size, metastatic lesion, histologic cell differenciation and microvascular invasion. Anatomical site has great effect to oral cancer patient's survival rate because each site's accessibility and lymph node metastasis is different but this factor was't studied much than other factors. Patients and Methods : 228 patients with squamous cell carcinoma of common primary sites(Mandible, Maxilla, Floor of Mouth and Tongue) in oral cavity who were diagnosed in the Korea Cancer Center Hospital from January 1989 to December 1999, were clinically studied and analyzed on survival rate. Results : 1. Survival rates of each anatomical sites were Tongue(36.8%), Mandible(33.3%), Maxilla(28.7%) and Floor of Mouth(24.5%). Survival rates difference between Tongue and Floor of Mouth has significance(p<0.05). 2. Survival rates for early cancer of each site were Maxilla(100%), Mandible(57.1%), Tongue(54.2%) and Floor of Mouth(46.7%). Survival rates difference between Maxilla and Floor of Mouth has significance(p<0.05). 3. Survival rates by surgery method of each site were Maxilla(60.6%), Tongue(56.9%), Mandible(44.8%) and Floor of Mouth(26.3%). Survival rates difference between Maxilla and Floor of Mouth has significance(p<0.05). 4. Survival rates by radiation or chemo method of each site were Floor of Mouth(23.5%), Mandible(20.0%), Maxilla(9.5%), and Tongue(9.1%). Survival rates difference between each site doesn't have significance(p>0.05). 5. In advance stage, Survival rates by single therapy of each site were Tongue(33.6%), Mandible(23.5%), Floor of Mouth(16.7%), Maxilla(0%), and Survival rates difference between Maxilla and Tongue has significance (p<0.05). Survival rates by combination therapy of each site were Mandible(38.1%), Maxilla(30.0%), Floor of mouth(18.2%), Tongue(12.5%), and Survival rates difference between Mandible and Tongue has significance(p<0.05). Conclusion : Survival rate of tongue is higher than the other sites, early detection of oral cancer can increase survival rate at any site and combination therapy is the most effetive method, especially at maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.435-446
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• 2001

Natural Killer/T-cell(NK/TC) lymphoma is a rare disease of oral and maxillofacial region with an aggressive clinical course, showed unusual clinical manifestations. Prognosis is generally poor and the disease is invariably fatal after systemic dissemination. A case of nasal NK/TC non-Hodgkin's lymphoma in the left maxilla that showed unusual clinical manifestations and a fulminant course of disease, are described with literature reviews. A 81-year-old female patient presented with rapidly growing ulceration and general malaise after extraction of right upper second premolar NK/TC lymphoma was subsequently detected by biopsy. rapid and wide invasion from maxilla to mandible developed within 10 days and multiple metastasis to whole body was after a few weeks. Although the time relationship is not clear, local invasion and multiple metastasis could be dissemination from localized disease of NK/TC. As seen in my case, the course can be excessively aggressive and fulminant even though it first appeared as a localized ulceractive lesion. She is expired 2 months after biopsy. Positivity of immunohistochemical stain (CD56, LCA, UCHL-1, CD3), which is a specific characteristic of NK/TC, may serve as a factor showing a poor prognosis of a malignant lymphoma