Fifty‐six cases of osteosarcoma of the maxilla or mandible are analyzed for clinical, roentgenographic and histologic character, therapy and prognosis. The mean age at the onset of symptoms for osteosarcoma of the jaws is about a decade later than for osteosarcoma of other bones. Pain is less often associated with osteosarcoma in the jaws than it is in the long bones. Roentgenographic evidence of a symmetrically widened periodontal membrane space may be a significant early finding. There is no correlation between the histologic character of the tumors and prognosis but prognosis does appear to vary depending upon the specific site of origin within the bones. The worst prognosis is associated with maxillary antral osteosarcomas and mandibular symphysis osteosarcomas have the best prognosis. Radical surgery is the treatment of choice. Approximately one third of the patients had biopsy‐proved metastasis, with the lung being the most common site.
Analysis was made of 37 cases of Chondrosarcoma of the maxilla or the mandible. The most common complaint at initial presentation was the presence of a mass. Pain was a presenting symptom in less than half of the patients. The usual roentgenographic appearance was an ill‐defined radiolucency with mottled areas of calcification. When teeth were involved, some cases showed a widened periodontal membrane space on periapical dental radiographs. Histologically, the tumors usually showed recognizable cartilage and a lobular growth pattern, but cellular evidence of malignancy was often subtle. Radical surgery was the treatment of choice. Prognosis appears best when such surgery is performed soon after the onset of symptoms. Also, patients presenting with mandibular tumors and with tumors of the better differentiated histologic grades enjoy a better survival time. Neck dissection is probably not warranted for Chondrosarcoma of the jaws. Contrary to the relationship between these two tumors in other skeletal sites, the overall prognosis for Chondrosarcoma of the jaws does not appear to be as good as that for osteosarcoma of the jaws.
More than 200 articles and texts relating to Chondrosarcoma in the general skeleton, in the head and neck area, and in extraskeletal soft tissues, were reviewed and summarized. In the interest of space conservation and avoidance to the extent possible, of distracting referential interjections in the text, the entire list of materials reviewed has not been referenced. For example, articles that contribute essentially nothing more than single case reports are not included in the list of references. Effort has been made, however, to include articles of historical significance, articles reporting series of cases, and articles exploring ideas and concepts. The authors believe this review to be a comprehensive summary of the Chondrosarcoma literature. An analysis of 37 cases of Chondrosarcoma of the jaws will be published as Part II.
Metals and polymers have received considerable attention with respect to their potential use in human implantation. Serious study of the ceramics for this purpose has only recently begun. Materials for implantation in any body site must meet certain requirements. Each class of material has been found to have some highly desirable properties as well as some undesirable characteristics. Materials for use in dental implantation, particularly for the replacement of individual teeth, are subjected to environmental factors not generally existent in other implantation sites. Preliminary studies of the ceramics have suggested that, from the physiologic standpoint, they may be the best implantable substitute for hard tissues (bones and teeth) yet achieved. There are, however, many questions remaining to be answered concerning the selection of the most suitable material, its fabrication, and the reaction of tissues to it. These questions should serve to indicate future areas of exploration.
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