Permalink : http://hdl.handle.net/2115/67355

KEYWORDS : oral cancer;jaw deformity;odontogenic tumors;post-surgical swallowing dysfunction;dentoalveolar surgery

In this paper we describe our strategies for treatment of oral cancer, jaw deformity, and odontogenic tumors. Details of the strategy for cleft palate is introduced in a separate report, by Professor Mikoya. Newly applied strategies for patients with post-surgical swallowing dysfunction and dentoalveolar surgery are also introduced. Oral cancer, jaw deformity, cleft, and odontogenic tumors are the main etiologies in the oral and maxillofacial region. Early stages of oral cancer (StageI and StageII) are mainly treated with surgery or radiotherapy alone, and the 5-year survival rate is 80 to 90%. With advanced oral cancer (StageIII and StageIV) a combination of chemotherapy and radiotherapy with or without surgery is the norm, but the 5-year survival rate is below 50% overall. Therefore, there is a need for an effective combination of therapies for advanced oral squamous cell carcinomas. The treatment goal for jaw deformities is to achieve a functional and desirable occlusion. To achieve desirable occlusion, treatment by the team approach is introduced, it includes oral and maxillofacial surgeons, orthodontists, and prosthodontists. A unique method, termed the “Dredging Method” is used in the treatment strategies of odontogenic tumors. The method was introduced to remove all of the tumor and restore the form and function of the jaw through bone generation. The Dredging Method involves four steps: Deflation, Enucleation, Dredging, and Follow up.　Tooth autotransplantation in our department stands out in comparison with other facilities in the field of dentoalveolar surgery. The annual number of cases exceeds 150, and up to December of 2015 the total number of cases reached 1,100. The 5-year survival rate for cases with transplanted third molars to the molar region is 86%. Post-surgical swallowing dysfunction is strongly dependent on the extent of the surgery and type of reconstruction. Here, post-surgical swallowing dysfunction can be accurately predicted prior to the surgery, and to develop plans for individual rehabilitation programs to overcome post-surgical swallowing dysfunction is crucial.