Eradication of Pathologic Condition
The therapeutic goal of any extirpative surgical procedure is to remove the entire lesion and leave no cells that. could proliferate and cause a recurrence of the lesion. The methods used to achieve this goal vary tremendously and
depend on the nature of the pathologic condition of the lesion. Excision of an oral carcinoma necessitates an aggressive approach that must sacrifice adjacent structures in an attempt to thoroughly remove the lesion.
Using this approach on a simple cyst would be a tragedy. It is therefore imperative to identify the lesion histologically with a biopsy before undertaking any major surgical extirpative procedure. Only then can the appropriate surgical procedure be chosen to eradicate the lesion with as
little destruction of adjacent normal tissue as is feasible.
Functional Rehabilitation of Patient
As just noted the primary goal of surgery to’ remove a pathologic condition is total removal of the lesion. Although eradication of disease may be the most important goal of treatment, by itself it is frequently inadequate in the
comprehensive treatment of patients. The second goal of any treatment used for eradication of disease is an allowance for the functional rehabilitation Of the patient. After the primary objective of eradicating a lesion has been achieved, the most important consideration is dealing with
the residual defects resulting from ,he extirpative surgery. These defects can range from a mild obliteration of the labial sulcus secondary to the elimination of an area of denture epulis to a defect in the alveolus after removal of a benign odontogenic tumor or to a hemimandibulectomy defect resulting from carcinoma resection. The best results are
obtained when future reconstructive procedures are considered
before excision of lesions. 1 ‘cthods of grafting, fixation principles, soft tissue deficits, dental rehabilitation, and patient preparation must be thoroughly evaluated and . adequately handled preoperatively.