Perioral Marginal Mandibulectomy

Oral cavity cancers involving the mandibular gingiva can become a significant dilemma for the ablative surgeon with respect to the correct amount of mandibular bone required for surgical resection and achievement of appropriate surgical margin. Marginal mandibulectomy is defined as the partial resection of the mandible. It is generally reserved for cases in which a gingival cancer has involved only the alveolar bone adjacent the teeth or the cortical bone has not been violated by tumour infiltration. Marginal mandibulectomy can be performed both in the sagittal plane or the horizontal plane (rim resection). Although both techniques have been described the sagittal resection is fraught with more complications, removes the ability to wear a removable dental prosthesis, the inability to place dental implants without significant bone grafting and significantly weakens the mandibular bone increasing the risk of mandibular fracture. This chapter will focus on the technique of the marginal rim mandibulectomy.