Management of oral pathologic lesions by Resection. 1. Marginal/ Segmental 2. Partial 3. Total 4. Composite

2. Resection
 Removal of a tumor by incising through uninvolved tissues
around the tumor, thus delivering the tumor without direct
contact during instrumentation.
 Also known as en bloc resection.

3. Types of Jaw tumors and primary treatment
modalities
Marginal or Partial resection Composite Resection
 Ameloblastoma
 Calcifying epithelial odontogenic
tumor
 Myxoma
 Ameloblastic odontoma
 Squamos odontogenic tumor
 Malignant ameloblastoma
 Ameloblastic fibrosarcoma
 Ameloblastic odontosarcoma
 Primary intraosseous
carcinoma

4. I. Marginal/Segmental Resection
 Resection of a tumor without disruption of the continuity of
the bone.
Surgical technique
Resected specimen should include the lesion and 1cm bony margins around the
radiographic boundaries of the lesion.
Reconstruction limited to replacing lost osseous structure (alveolus)

5. I. Marginal/Segmental Resection
Surgical technique
 Full thickness mucoperiosteal flap developed
from bone to be removed.
 Air driven surgical burs - section bone
 Determine if tumor has perforated the cortical plates and
invaded adjacent soft tissues .
• sacrificing tissue may be necessary
• supraperiosteal dissection of involved bone
 Send specimens to pathologists for histopathologic exam.

6. Marginal or Segmental resection of
ameloblastoma
Intraoral exposure of mandible and
osseous cuts made around lesion
leave inferior border intact.
Intraoral defect after
removal of lesion

7. …cont’d(Marginal/Segmental resection of
ameloblastoma)
Radiographic appearance of the
lesion.
Its relationship to inferior
border of mandible is
demonstrated.
Radiographic appearance
immediately after graft placement

8. II. Partial Resection
 Resection of a tumor by removing a full-thickness portion of
the jaw.
 In the mandible, this can vary from a small continuity defect to
a hemimandibulectomy
 Jaw continuity is disrupted.

9. Partial mandibular resection of Myxoma
Lesion after sectioning

10. III. Total Resection
 Resection of a tumor by removal of the involved bone.
 Example: Maxillectomy and Mandibulectomy

11. III. Total resection
Maxillectomy

12. IV. Composite resection
 Resection of a tumor with bone, adjacent soft tissues, and
contiguous lymph node channels.
 This is an ablative procedure used most commonly for malignant
tumors.
 Surgical approach for treating cancer of the oral cavity and
oropharynx, results in considerable functional and cosmetic
deformity.

13. Squamous cell carcinoma of left posterior
mandible.
Neck dissection and Segmental resection of cancer
has been completed, and a titanium reconstruction
bar placed.
The neck lymph nodes and left
mandible cancer specimen.