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
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2.  Mesenchymal
 Epithelial
 Mixed
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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
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4. Anatomical subsites
 Lip
 Buccal mucosa
 Alveolus
 Retro molar trigone
 Tongue
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5. Aetiology
 Tobacco
 Alcohol
 Viruses
 Trauma
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6. Spread of malignancy
 Local infiltration
 Lymphatic
 Blood borne
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7. Precancer
 Premalignant lesion
 Premalignant condition
Treatment by medical or surgical methods
 Leukoplakia – stripping or excision
 OSMF – Local injections, surgical release
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8. Clinical features of oral ca.
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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
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9. Investigations
IMAGING
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Radiographs
CT
MRI
SPECT – Single photon emission computed
tomography
 PET – positron emission tomography
 Bone scan
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10.  Biopsy
 FNAC
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11. Staging
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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
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12. N- Lymph node metastasis
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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
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13. M- Distant metastasis
 Mx – cannot be assessed
 M0 – No distant metastasis
 M1 – metastasis present
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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
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15. Management
Depends on stage of presentation
 Surgery
 Radiotherapy
 Chemotherapy
 Combination
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16. Surgery
 Extent depends on the stage of presentation.
 Minimum 2 cm margin
Composite resection, Commando operation, En bloc
removal
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17. Neck dissection
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18. Radical neck dissection
Modified Radical neck dissection
Spinal accessory
Internal jugular vein
Sternocleidomastoid
(Functional neck dissection)
Selective neck dissection
Extended neck dissection
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19.  Radiotherapy – curative or palliative
 56- 7- gray/30 fractions/6wks
 Chemotherapy
Generally palliative
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20. Thank you
For more details please visit
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