Dr.5th🦷🎓

Photodynamic therapy Applies light over a tissue absorbed exogenous sensitizer<|>The sensitizing agent may be delivered systemically or topically and accumulates in target tissue<|>Cellular destruction<|>Due to the focused cellular destruction, the complications are small

Oral cancer treatment Complete surgical excision Lymph node dissection (when lymph nodes are involved) Radiation therapy (adjunct to surgery) Chemotherapy (palliative therapy) Either surgery or radiation may be used for T1 and T2 lesions; however, combined radiation and chemotherapy with or without surgery is usually employed for more advanced disease Photodynamic therapy

TNM staging system stages Stage 0 Tis N0 M0 Stage I T1 N0 M0 Stage II T2 N0 M0 Stage III T3 N0 M0, T1 N1 M0, T2 N1 M0, T3 N1 M0 Stage IV T4 N2 M1

TNM staging system Reflects the prognosis, and for the treatment strategy<|>T is the size of the primary tumor<|>N indicates the presence of regional lymph nodes<|>M indicates distant metastasis

Oral conditions with potential to transform into oral cancer Lichen planus Leukoplakia (proliferative verrucous leukoplakia has a high risk of progression to SCC) Erythroplakia Actinic cheilitis Submucous fibrosis

Presenting signs and symptoms of oral cancer A red, white, or mixed red-and-white lesion surface texture producing a smooth, granular, rough, or crusted lesion The presence of a mass or ulceration Dysphagia, and limited movement, oral bleeding, neck masses, and weight loss may occur with advanced disease Loss of function involving the tongue can affect speech, swallowing, and diet Involves the submandibular and digastric nodes, and the upper cervical nodes

Risk factors for oral cancer Age Tobacco products Alcohol, including, wine, and beer Nutritional factors Betel (Areca) Nut Human Papilloma Virus

The lips, gingiva, dorsal tongue, palate, and salivary glands are less common sites

The high-risk sites for oral carcinoma include the lower lip, the anterior floor of the mouth, and the lateral borders of the tongue

Other malignant diseases include tumors of the salivary glands, lymph nodes, bone, and soft tissue

The majority of oral cancers are squamous cell cancers

Squamous cell carcinoma Almost invariably non-painful, and thus patients do not know they have a lesion Early lesions are Carcinoma in situ Primary squamous cell carcinoma (SCC) of bone is rare; however, a tumor may develop from epithelial rests and from epithelium of odontogenic lesions, including cysts and benign lesions

Squamous cell carcinoma The most common malignant neoplasm of the oral cavity

Carcinoma in situ Most commonly persistent red plaque (erythroplakia) or a mixed white and red plaque Some are white plaque When completely removed, the prognosis is excellent

Carcinoma in situ Cancer of the oral epithelium which is confined to the epithelial layer

Epithelial dysplasia Clinically asymptomatic white, rough, areas, red patches (erythroplakia), or both red and white areas Some lesions will progress to squamous cell carcinoma, while others will resolve (impossible to determine) Treatment is complete surgical excision and follow-up

Epithelial dysplasia Microscopic atypical or abnormal growth of the stratified squamous epithelium

Hyperkeratosis Clinically white, rough, non-painful patches that do not rub off Keratinized surfaces usually resolve if the irritant is removed Nonkeratinized surface more serious and should be biopsied if they do not resolve

Etiology of hyperkeratosis Chronic irritation, such as biting, tooth irritation, or tobacco use

Hyperkeratosis (focal keratosis) Microscopic increased thickness of the keratin layer of stratified squamous epithelium