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Case Reports
. 2010 Dec;14(4):253-6.
doi: 10.1007/s10006-010-0208-y.

Removal of an oral squamous cell carcinoma including parts of osseointegrated implants in the marginal mandibulectomy. A case report

Gert J Meijer  1 , Francois J Dieleman, Stefaan J Bergé, Matthias A W Merkx
Affiliations
Case Reports

Removal of an oral squamous cell carcinoma including parts of osseointegrated implants in the marginal mandibulectomy. A case report

Gert J Meijer et al. Oral Maxillofac Surg. 2010 Dec.

Abstract

Purpose: The incidence of oral squamous cell carcinomas (OSCC) arising around dental implants will increase because of the rising popularity of dental implants. In this case, a novel surgical treatment of an OSCC in the vicinity of endosseous implants is reported.

Materials and methods: In a 69-year-old woman, a recurrent OSCC (cT₂N₀M₀) developed in the floor of the mouth extending to the attached keratinized peri-implant mucosa of both interforaminal-placed dental implants. Radiographically, no bone invasion could be observed.

Results: To radically remove the tumor, a marginal mandibulectomy was performed including the cranial parts of both dental implants by cutting them into two parts. Three years after tumor resection and one year after reimplantation, the patient is disease free and has a good oral function.

Conclusions: In case of an OSCC, traditional bone and soft margins for oncologic safety are 1.0 cm. If a dental implant is present within this safety zone, on condition, there is no massive bone invasion, and the original mandible has sufficient vertical height; a marginal mandibulectomy including part of the implants can be considered.

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Figures

Fig. 1
Fig. 1
a The carcinoma is positioned between the white arrows. b First, an incision is made, respecting a border (see arrows) of 1 cm around the tumor. c Intraoral view after removing the upper bone segment. Clearly, the apical parts of both implants are visible, as also d the cervical parts in the block resection (see arrows)
Fig. 2
Fig. 2
a Panoramic radiograph preoperatively showing both the implants with their interconnecting bar and b after resection. Notice the round edges of the osteotomy (white arrows). c Intraoral view 1 year after partial implant removal
Fig. 3
Fig. 3
a Situation after placement of three implants. The cut implants (white arrows) can be easily identified. b Panoramic radiograph postoperatively showing both the new and the cut implants (white arrows)
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