Oral squamous cell carcinoma and the mandible

Of the various oral carcinoma subsites, the carcinomas related to the mandibular region (alveolar ridge, floor of mouth, lower retromolar area, lower buccal sulcus) are among those with the highest rate of recurrences. Neoplastic invasion of the mandible is one of the factors promoting the recurrences. Determining the presence and extent of bony involvement is therefore critical in the management of patients. The surgeon has several methods to aid in the determination of margins of invasion: radiology, gross clinical inspection, and intraoperative frozen section. Each has its deficiences and in the end, it is a combination of the methods, tempered by clinical judgment, that produces the best results.