Jaw carcinomas:
- Introduction (epithelioma):
Epithelial tumors:
► Either primary (with an intraosseous or mucosal starting point)
► Or secondary, metastatic.
In most cases they originate from a lining mucosa (gingival, palatine, sinus or nasal) which infiltrates and invades the underlying bone.
- General characteristics:
Rapid growth
Symptomatic
Blurred boundaries
Invasive and destroys neighboring tissues
Recurrent and metastatic
- Clinical semiology
Maxillofacial deformation (depending on the evolution)
Epistaxis, gingivorrhagia
Dental mobility, late dental movement (of great value)
Pain, hypoesthesia, skin anesthesia
Bone swelling: hard, painless (alarm sign)
Relatively early pain
Early satellite adenopathy
- Radiological semiology
- Bone lysis image: Lacunar image surrounded by bone in the process of destruction, often with teeth appearing to be suspended in the lacuna.
- Boring image: rarer, hollow image; the bone takes on a moth-eaten or striped appearance. There is therefore diffuse decalcification leaving a porous bone with irregular spots or areas without clear limits.
- Clinical aspects:
- Mandibular carcinomas:
- Primary mandibular carcinomas:
- Ulcerative form: Ulceration resting on an indurated base, 5 extensive with irregular raised and sometimes everted edges.
- Vegetative or exophitic form: where the bud is thicker, protruding from the healthy mucosa. The invasion of neighboring noble structures is very symptomatic.
- Boring form: characterized by dental mobility and hyperesthesia with a radiological appearance of diffuse rarefaction (porous bone + mirrored appearance)
- Pseudo-osteitis form: this is a picture of sub-acute osteitis (painful tooth, pus at the neck, congested and sometimes ulcerated mucosa, early chin hypoesthesia).
- Pseudo-pyorrhoeic form: Recent mobility which worsens rapidly followed by spontaneous loss
- Mandibular carcinomas secondary to metastases:
Associate:
>A lip-chin anesthesia.
>The two bone tables are blown.
- Radiography: often reveals a small decalcified area with blurred boundaries and irregular contours
- Maxillary carcinomas:
- Carcinoma with oral origin:
- Either it is born from the platinum mucosa causing a characteristic vegetative lesion .
- Either it is born from the gingival mucosa causing an ulceration which is sometimes vegetative.
- The teeth move and the extraction does not lead to healing.
- An ulceration surrounded by a small hard ridge with homolateral or bilateral adenopathy
- Carcinoma with sinus starting point:
- A palatal or alveolar arch.
- Dental mobility giving a pseudo-osteitic, pseudo-pyorrhoeic appearance
- Tooth loss
- Toothache, sometimes facial neuralgia
- Suborbital pain or anesthesia.
- Facial deformation
- Erasure of the internal angle of the orbit
- Arching of the nasal bones.
- Erasure of the nasolabial furrow
- Nasal obstruction and epistaxis
- Diplopia, exophthalmos, tearing and lower eyelid edema.
- Facial paralysis
1. A visit to the dentist every 6 months is recommended. Untreated cavities can damage the pulp.
Orthodontics aligns teeth and jaws.
Implants replace missing teeth permanently.
Dental floss removes debris between teeth.
A visit to the dentist every 6 months is recommended.
Fixed bridges replace one or more missing teeth.