Suspicious Oral Lesions Research Articles

Dual Sec62/Ki67 immunocytochemistry of liquid-based cytological preparations represents a highly valid biomarker for non-invasive detection of head and neck squamous cell carcinomas.

Head and neck squamous cell carcinomas (HNSCC) are frequently diagnosed in advanced stages, which limits therapeutic options and results in persistently poor patient outcomes. The aim of this study was to use liquid-based swab cytology (LBC) in combination with dual immunocytochemical detection of migration and proliferation markers Sec62 and Ki67 in order to allow non-invasive early detection of HNSCC as well as to analyse the diagnostic validity of this method for predicting the malignancy of suspicious oral lesions. 104 HNSCC patients and 28 control patients, including healthy patients (n = 17), papilloma (n = 1) and leukoplakia patients (n = 10), were included in this study. For all patients, an LBC swab followed by simultaneous immunocytochemical detection of Sec62 and Ki67 was performed. Immunocytochemical as well as cytopathological results were correlated with histological diagnoses and clinical findings. All HNSCC patients (100%) showed dual Sec62/Ki67 positivity, and all control patients except for the papilloma patient were negative for Sec62/Ki67 (96.4%), resulting in a 100% sensitivity and 96.4% specificity of Sec62/Ki67 dual stain for non-invasive detection of HNSCC. The positive predictive value was 99% and the negative predictive value was 100%. Sec62 expression levels showed a positive correlation with tumour de-differentiation (p = 0.0489). Simultaneous immunocytochemical detection of Sec62/Ki67 using LBC represents a promising non-invasive and easy-to-apply tool for the early detection of HNSCC in routine clinical practice. This novel technique can help to avoid incisional biopsies and reduce the frequency with which general anaesthesia is used in diagnostic procedures in patients with suspicious oral lesions.

Oral manifestations of COVID-19 in unvaccinated patients: a cross-sectional study

BackgroundEarly studies have highlighted the possible development of dysgeusia and anosmia in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and these manifestations should be considered a potential indication of coronavirus disease 19 (COVID-19). As potential contributors to these symptoms, dentists should perform careful oral and oropharyngeal examinations and document suspicious oral lesions in patients with COVID-19, especially in those who complain of loss of taste and smell. The study’s objective was to assess the prevalence of oral manifestations among ambulatory unvaccinated symptomatic patients with suspected COVID-19 during the acute phase of the disease.MethodsThis cross-sectional study evaluated oral manifestations in adults (aged ≥ 18 years) with suspected and confirmed SARS-CoV-2 infection. Chi-square and Fisher’s exact tests were used to compare data between the groups (rRT-PCR-positive and rRT-PCR-negative patients).ResultsOne hundred thirty-six participants were included. Most were female (n = 79; 58.1%), with a mean age of 39.53 (± 14.17) years. Of these, 54 (39.7%) had a positive rRT-PCR test, and 82 (60.3%) had negative rRT-PCR results. Oral manifestations were observed in 40 participants (74.1%) in the rRT-PCR-positive group and 67 participants (81.7%) in the rRT-PCR-negative group. The most common oral manifestations were xerostomia (n = 85; 62.5%) and dysgeusia/ageusia (n = 57; 41.9%). Different rates of gingivitis (n = 12; 22.2% vs. n = 5; 6.1%; p = 0.005) and halitosis (n = 7; 13.0% vs. n = 1; 1.2%; p = 0.007) were observed between the rRT-PCR-positive and -negative groups, respectively. Mouth ulcers, glossitis, tongue coating, and petechiae were reported in both groups without significant differences.ConclusionsA high prevalence of oral manifestations was observed in symptomatic patients with suspected or confirmed COVID-19.Clinical RelevanceThis study highlights the importance of routine oral examinations by dentists as part of the multidisciplinary care of COVID-19 patients.

Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions.

Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study's results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions.

Histopathological and risk factor analyses of oral potentially malignant disorders and oral cancer in a proactive screening in northeastern Thailand

BackgroundLip and oral cavity cancer has been reported as the 10th most common cancer in Thailand. Recently, a screening program for oral potentially malignant disorders (OPMDs) and oral cancer was conducted in the northeastern Thailand which took into consideration a total of 371,911 people who resided in the provinces of Buriram, Chaiyaphum, Nakhon Ratchasima, and Surin.MethodsA total of 330,914 subjects were consecutively screened for risk factors of oral cancer by village health volunteers (VHVs) using a questionnaire (S1). Then, 186,710 subjects with one or more risk factors for oral cancer were referred for oral screening by dental auxiliaries or dentists at sub-district level hospitals (S2) where 86,941 subjects were subsequently screened. Afterwards, 1576 subjects with suspicious oral lesions for OPMDs or oral cancer attended local hospitals for further investigation and treatment. Oral medicine specialists, oral surgeons, and local dentists at the district level hospitals performed biopsies and the samples were sent for histopathological analysis. The objectives of the study were to report the histopathology findings from the biopsies obtained from these subjects and the associated risk factors.ResultsOut of 427 subjects who received biopsies, complete diagnostic results were obtained from 409 patients (462 specimens). The 5 most common histopathological results from these specimens were mild epithelial dysplasia (27.3%), fibroepithelial hyperplasia (14.5%), oral lichen planus/oral lichenoid reactions (11.5%), moderate epithelial dysplasia (8%), and acanthosis with or without hyperkeratosis (5%). Oral squamous cell carcinoma was detected in 14 subjects and 11 other forms of oral cancer were revealed. Among the analyzed risk factors, habitual betel quid chewing was established as a statistically significant risk factor associated with OPMDs and oral cancer.ConclusionThe most frequently observed histopathological results of clinically suspected oral cancer and OPMDs included mild epithelial dysplasia, fibroepithelial hyperplasia, oral lichen planus/oral lichenoid reactions, moderate epithelial dysplasia, and acanthosis with or without hyperkeratosis. Betel quid chewing habit was found to be associated with OPMDs and oral cancer.

Field validation of deep learning based Point-of-Care device for early detection of oral malignant and potentially malignant disorders

Early detection of oral cancer in low-resource settings necessitates a Point-of-Care screening tool that empowers Frontline-Health-Workers (FHW). This study was conducted to validate the accuracy of Convolutional-Neural-Network (CNN) enabled m(mobile)-Health device deployed with FHWs for delineation of suspicious oral lesions (malignant/potentially-malignant disorders). The effectiveness of the device was tested in tertiary-care hospitals and low-resource settings in India. The subjects were screened independently, either by FHWs alone or along with specialists. All the subjects were also remotely evaluated by oral cancer specialist/s. The program screened 5025 subjects (Images: 32,128) with 95% (n = 4728) having telediagnosis. Among the 16% (n = 752) assessed by onsite specialists, 20% (n = 102) underwent biopsy. Simple and complex CNN were integrated into the mobile phone and cloud respectively. The onsite specialist diagnosis showed a high sensitivity (94%), when compared to histology, while telediagnosis showed high accuracy in comparison with onsite specialists (sensitivity: 95%; specificity: 84%). FHWs, however, when compared with telediagnosis, identified suspicious lesions with less sensitivity (60%). Phone integrated, CNN (MobileNet) accurately delineated lesions (n = 1416; sensitivity: 82%) and Cloud-based CNN (VGG19) had higher accuracy (sensitivity: 87%) with tele-diagnosis as reference standard. The results of the study suggest that an automated mHealth-enabled, dual-image system is a useful triaging tool and empowers FHWs for oral cancer screening in low-resource settings.

Improving the Diagnostic Performance by Adding Methylation Marker to Conventional Visual Examination in Identifying Oral Cancer.

Background: Visual oral examination (VOE) is a conventional oral cancer screening method. This study aimed to evaluate the value of methylation marker to assist VOE in identifying oral epithelial dysplasia and oral squamous cell carcinoma (OED/OSCC) from non-cancerous lesions in a real-world situation. Methods: 201 patients with high-risk personal habits who self-perceived oral anomaly were VOE examined, ZNF582 methylation (ZNF582m) tested, and histologically diagnosed. Results: Among them, 132 patients (65.7%) were histologically diagnosed OED/OSCC. Using VOE, 56.1% OED/OSCC patients had possible oral cancer, whereas 37.7% non-OED/OSCC patients had leukoplakia. ZNF582m-positive was detected in 90.2% OED/OSCC patients and 44.9% non-OED/OSCC patients. Various logistic regression models were postulated to evaluate the diagnostic performance of conventional VOE and new strategies using ZNF582m. ROC analysis and its corresponding C-index demonstrated that either triage or co-testing models of VOE and ZNF582m could improve diagnostic performance and discriminative abilities compared with the VOE only approach. Conclusions: In conclusion, methylation marker test shows equivalent performance to an experienced judgment by oral maxillofacial surgeons and plays a significantly supplementary role in increasing the efficacy in identifying oral malignant lesions. ZNF582m may be an especially important tool for family physicians or general dentists to properly diagnose suspicious oral lesions.

Photodynamic Diagnosis Using 5-Aminolevulinic Acid with a Novel Compact System and Chromaticity Analysis for the Detection of Oral Cancer and High-Risk Potentially Malignant Oral Disorders.

Detecting early-stage oral cancer and precancerous lesions are critical to improving patient prognosis and quality of life after treatment. Photodynamic diagnosis using 5-aminolevulinic acid enables the detection of malignant lesions. This study aimed to improve the diagnostic accuracy of photodynamic diagnosis using an objective chromaticity analysis of fluorescence emitted from oral lesions. Sixty-seven patients with clinically suspicious oral cavity lesions underwent photodynamic diagnosis after topical application of 5-aminolevulinic acid solution, followed by imaging and histological evaluation of the lesions. Chromaticity red and green values were measured from the fluorescence images on the lesion, and the red-to-green ratio was calculated. The photodynamic diagnosis allowed for the visualization of oral cancer and high-risk dysplasia as red fluorescence. Compared to low-risk dysplasia and benign lesions, oral cancer and high-risk dysplasia areas had a significantly higher red value and red-to-green ratio. After setting the cutoff value, sensitivity and specificity were 83.3–88.7% and 83.3–83.9%, respectively, when discriminating between oral cancer or high-risk dysplasia and low-risk dysplasia or benign lesions. Photodynamic diagnosis combined with chromaticity analysis may be a valuable diagnostic tool for detecting oral lesions, with a high likelihood of malignant transformation.

Clinical Evaluation of the Optical Filter for Autofluorescence Glasses for Oral Cancer Curing Light Exposed (GOCCLES®) in the Management of Potentially Premalignant Disorders: A Retrospective Study.

Background: Any oral potentially malignant disorders (OPMDs) must be regularly monitored through clinical examination to detect any possible malignant transformation. Conventional intraoral exams, however, can be difficult because these conditions may resemble benign lesions. For this reason, several non-invasive diagnostic technologies have been developed to help the clinician in detecting and distinguishing between cancerous and benign lesions. Epithelial dysplasia can be considered the most important predictor of malignant evolution. Therefore, in this study we aim to evaluate the ability of an optical filter for autofluorescence Glasses for Oral Cancer Curing Light Exposed (GOCCLES®) and of toluidine blue staining in identifying dysplastic areas in patients with OPMDs. Methods: In this retrospective study, medical records, photographs and videos of 25 patients with oral lesions were analyzed. Forty-two biopsy samples in 25 patients with OPMDs and at least one suspicious oral mucosa lesion that were evaluated in white light, autofluorescence with optical filter GOCCLES®, toluidine blue staining and then biopsied with histopathological analysis were analyzed. Results: The sensitivity and specificity for the autofluorescence evaluation with GOCCLES® for identifying dysplasia or carcinoma were 66% and 48%, respectively. The positive and negative predictive values were 34% and 77%, respectively, and the accuracy was 53%. The sensitivity and specificity for toluidine blue staining were 91% and 68%, respectively. The positive and negative predictive values were 55% and 95%, respectively, and the accuracy was 75%. Conclusions: The optical filter for autofluorescence (GOCCLES®) and toluidine blue staining are simple, inexpensive, rapid and non-invasive procedures that can assist the clinician in distinguishing OPMDs from healthy mucosa but they are not able to distinguish benign and malignant lesions.

To Evaluate the Efficacy of Tissue Autofluorescence (Velscope) in the Visualization of Oral Premalignant and Malignant Lesions among High-Risk Population Aged 18 Years and Above in Haroli Block of Una, Himachal Pradesh.

ABSTRACTIntroduction:Visually enhanced lesion scope (Velscope) that identifies reduction in tissue fluorescence in dysplasia can prove to be effective in screening for potentially malignant lesions. The objective of the present study was to evaluate the effectiveness of device that utilizes the principles of tissue autofluorescence (Velscope) in the detection of dysplastic and/or neoplastic changes in oral mucosal lesions using biopsy and histopathology as “gold standard.”Materials and Methods:Out of nine hundred fifty patients with suspicious oral mucosal lesions, 250 patients were subjected to conventional oral examination followed by Velscope examination. The autofluorescence characteristics of 250 patients were compared with the results of histopathology. Biopsies were obtained from all suspicious areas identified on examination. The sensitivity, specificity, positive and negative predictive values were calculated for Velscope examination.Results:The Velscope examination showed sensitivity and specificity values of 75.00% (95% CI: 69.63%-80.37%) and 61.39% (95% CI: 55.35%–67.42%) respectively while the positive and negative predictive values were 31.58% (95% CI: 25.82%-37.34%) and 91.18% (95% CI: 87.66%-94.69%) respectively.Conclusion:The definite diagnosis of the presence of dysplastic tissue changes in the oral lesions cannot be made alone with the Velscopic examination. The high number of false-positive results limits its efficiency as an adjunct despite its reasonable sensitivity. However, It can serve to alleviate patient anxiety regarding suspicious mucosal lesions in a general practice setting due to high negative predictive value. Also, a combined approach of Velscope examination and conventional oral examination may prove to be an effective diagnostic tool for early detection of malignant oral mucosal lesions.

Screening and Diagnosis of Oral Precancerous Lesions/precancerous conditions for General Practitioners

Brief Background Oral cancer has a tendency to be detected always at a later stages which is very dangerous to the patients because of its higher mortality rates. Early detection of oral cancer is therefore very important to prevent its progression to later stages. General practitioners are well suited to providing head and neck examinations, and to screening for the presence of suspicious oral lesions. This is a review article on screening and diagnosing the precancerous lesions or conditions which are now termed as oral potentially malignant disorders(OPMDs). Key Words Early detection, Malignant potential, Pre cancerous lesions

Identification of candida albicans and nonalbicans candida resistant species in tobacco users and oral squamous cell carcinoma patients: Comparison of HiCrome agar and automated VITEK 2 system.

Introduction:Candida is most common fungal pathogen in the immunocompromised and medically ill patients. Higher prevalence of Candida albicans has been reported in tobacco users and oral squamous cell carcinoma (OSCC) patients which may be due to immunosuppression. Recently, emergence of nonalbicans candida (NAC) species resistant to conventional antifungal treatment has been observed that requires accurate identification of organisms at species level for reduction of progression of suspicious oral lesions toward malignancy.Aims and Objectives:To detect and compare the prevalence of C. albicans and NAC species smokeless tobacco chewers, histopathologically confirmed oral squamous cell carcinoma patients and the normal individuals. Effectiveness of automated Vitek 2 system in comparison to HiCrome agar color media in the identification of the candida species was also evaluated.Methodology:One hundred and fifty patients (90 males, 60 females) aged between 20 and 76 years were divided into three groups: Group I individuals with habit of chewing Gutka, and betel quid/pan masala with or without tobacco, Group II individuals with clinically and histopathologically confirmed oral squamous cell carcinoma and Group III comprised of controls. Salivary samples were cultured on HiCrome agar color media and results were compared with those of Vitek 2 system in the accurate identification of candida species. Data were statistically analyzed and Chi-square test was used to estimate the effectiveness of color and Vitek method in the identification of candida species in all the three groups. P < 0.05 was considered to be statistically significant.RESULTS:HiCrome agar color method identified six candida isolates C. albicans, Candida tropicalis, Candida krusei and Candida glabrata isolates in all the three groups, with 0.00 unidentified organisms (P = 0.00001) whereas VITEK 2 system identified five isolates of candida; C. albicans, Candida famat, Candida ciferri, Candida gulleri, C. tropicalis, unidentified organisms were observed in 26% of subjects. Further confirmation by supplemental tests indicated the presence of two or three organisms of different species/or subspecies with low reactivity biopattern. Higher incidence of opportunistic infections was seen in Group II OSCC patients (P = 0.00001).Conclusion:The results suggested that there is shift toward NAC species, with higher species diversity in OSCC patients followed by gutka, betel quid/pan masala with or without tobacco users. Conventional agar media culture methods of species identification should be used in conjunction with automated Vitek 2 method for better control of candida-associated oral cancer.

Velscope guided oral cancer screening

Context:Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope.Aims:Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder.Settings and Design:A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India.Materials and Methods:Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed.Statistical Analysis Used:Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome.Results:The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity.Conclusions:The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.

Impact of Narrow Band Imaging in Pre-Operative Assessment of Suspicious Oral Cavity Lesions: A Systematic Review.

Introduction:Narrow band imaging (NBI) is a powerful tool that allows visualizing the mucosal and submucosal vasculature. Among the available diagnostic techniques, NBI is one of the most valid for early detection of oral squamous cell carcinoma (OSCC).Materials and Methods:We carried out a bibliographic search in PubMed, Scopus and Web of Science databases using relevant keywords. Articles selected were screened by two independent authors based on inclusion and exclusion criteria. Nine papers were singled out according to the eligibility criteria and included in this review. We investigated the articles for pooled sensitivity, specificity, accuracy, positive predictive value and negative predictive value of pre-operative NBI.Results:The use of NBI examination in the oral cavity revealed higher specificity, sensitivity, positive and negative predictive values and accuracy compared to white light examination for the diagnosis of oral squamous cell cancer (OSCC). In addition, NBI has proved great utility in detecting malignancy features in oral pre-malignant lesions.Conclusions:This review shows that NBI is a powerful tool for examining oral suspicious lesions. Most of the articles examined revealed high values of sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of oral malignant and pre-malignant lesions. Therefore, the use of NBI is highly recommended for the early detection of oral cancer and potentially malignant disorders. Future studies should seek to affirm the validity of NBI and in particular to standardize NBI classification.

Comparing the efficacy of chemiluminescence with lugol's iodine versus toluidine blue in the diagnosis of dysplasia in tobacco associated oral lesions - A diagnostic study

Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light-based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non-invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair-side marker for delineating normal and dysplastic oral mucosal tissues. To compare the efficacy of chemiluminescence with Lugol's iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions. A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol's iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol's iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively. The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco-associated oral lesions when compared to the group of chemiluminescence with Lugol's iodine.

Evaluation of the Role of Toluidine Blue Paint as an Adjunctive Method to Biopsy in Suspicious Oral Lesion: A Hospital Based Study.

Early detectionisamajorstep in thesuccessof cancer therapy.Histopathology report is considered as the gold standard in theformulationof management protocol of anymalignancyworldwide. Butunfortunately, there is adelayin thedetectionof oral cancer very often due to inconclusive histopathology reports.Themainreason behind it isobtaininga biopsy specimen from the non-representativearea of thelesion.A hospital-basedevaluationof theroleofToluidine Blue dye, used as an adjunctive methodprior tobiopsywasconductedin a tertiary carehospitalon 200patientspresentingwith oral lesions persistent for more than 3weeks. Theparticipantsweredividedinto two equal groups by alternate sampling.In onegroupbiopsywastakenby clinical judgment and inothers,Toluidine Bluewas usedprior toobtainingabiopsytodecidetheareato bebiopsied.Datawascollectedusinga predesigned proforma and wasanalyzedwith thehelpofSPSSversion 20.Resultsin twogroupswerecomparedwithrespecttosensitivity,specificity,positiveandnegative predictive values,falsepositiveandfalsenegativepercentages. The Sensitivity, Specificity, PositivePredictiveValueand NegativePredictiveValueof wedge biopsy without staining were 73.68, 58.14, 70.00, and 62.50% respectively.Thesevalueswere 95.08, 82.05, 89.23, and 91.43% respectively when Toluidine Blue staining wasdoneas an adjunctive before thebiopsyprocedure.Theseresultsindicatethe promising role of Toluidine blue staining before thebiopsytodiagnoseoralmalignancymore efficiently than obtainingbiopsyspecimens on clinical assessment only and inavoidingthedelayininitiatingthetreatmentincaseoforalmalignant lesions.

Recent Advances in Cytology-A Review

In olden days, specificity and sensitivity of oral cytology is poor. Utilizing traditional oral cytology for theconclusive diagnosis of malignancyand premalignant lesions. But with the recent cytological techniquespaves cytology to conclude a final diagnosis. This reestablished interest is somewhat because of thepresentation of a specific brush that gathers a full-thickness epithelial sample and not simply sloughed cells,just as examination of that sample with computer support and analysis. There is an assortment of adjunctivestrategies have been acquainted with possibly upgrade the finding of the cytologic examples including DNAexamination, immunocytochemistry, molecular analysis, and liquid based preparations. An expansion insensitivity (&gt;96%) and specificity (&gt;90%) of the oral brush biopsy with computer support, diagnosis hasbeen accounted for detection of malignant and premalignant lesions. Brush cytology is significant to forestallmisdiagnosing suspicious oral lesions.

Early detection of oral cancer and potentially malignant disorders: Experiences, practices, and beliefs of prosthodontists practicing in Saudi Arabia

Statement of problemData on the oral cancer screening skills and beliefs of prosthodontists practicing in Saudi Arabia are lacking. PurposeThe purpose of this survey was to assess the beliefs, experiences, and practices of prosthodontists practicing in Saudi Arabia regarding the early detection of oral cancer and potentially malignant disorders. Material and methodsA cross-sectional, questionnaire-based survey was conducted on prosthodontists practicing in Saudi Arabia. A 26-item questionnaire was sent to all eligible prosthodontists (N=250). The collected data were analyzed with a statistical software program. ResultsThe response rate was 57.2% (N=143). The majority of participants (79%) reported that they routinely examined all new patients for mucosal pathologies. However, only 58% reported that they examine their patients at recall visits, and only 61.5% stated that they provide tobacco use or smoking cessation advice. With regard to the respondents’ experiences with suspicious mucosal lesions, the majority said that they had detected a suspicious lesion (79.7%) and had referred affected patients (83.2%) during their career. Most prosthodontists (65%) believed that they were able to detect oral cancer on their own, and 40% believed that they could influence their patients to stop smoking. A lack of training, confidence, time, and financial incentives were reported as barriers to oral cancer screening. ConclusionsMost of the prosthodontists surveyed in this study appeared motivated to perform routine oral mucosal screening. However, more efforts are needed to help improve the attitudes, confidence, and skills of prosthodontists when it comes to identifying and referring suspicious oral mucosal lesions.

A Prospective Study to Evaluate the Role of Narrow Band Imaging and Toludine Blue in the Screening of Premalignant and Malignant Lesions of the Oral Cavity in a Tertiary Referral Centre.

In India cancer patients come at a very advanced stage with many of them being crossed the stage of resection. A wide range of non invasive techniques like toludine blue staining, methylene blue staining, Narrow band imaging have been developed for the early detection of malignant and premalignant lesions in the mucosa including oral cavity and gastrointestinal tract. However it is difficult for the clinicians to decide which diagnostic tool is most appropriate and useful for screening, resulting in failure to pick up the lesions at an early stage. Various online journals have been reviewed and no journal was found to support this point. This study here by describes Toludine blue and narrow-band imaging (NBI), diagnostic tools already proven independently as a useful screening method in many fields, and demonstrate its usefulness in the early detection of premalignant and malignant lesions of the oral cavity, as reported by previous studies in the otolaryngologic literature and compare both screening tools which has not been done till now. This study was done in a tertiary referral centre in middle India from March 2018 to August 2019 in order to evaluate the role of different screening tools (NBI and Toludine blue).44 patients with suspicious oral cavity lesions (premalignant and malignant) who had given consent for both NBI and toludine blue screening techniques were selected from the suspected (premalignant and malignant lesions) who had visited the OPD during the study period. Patients with proven malignancy were excluded from the study. A detailed history of the patient taken and standard Ear, nose, throat, oral cavity and neck examination of patient carried out. After subjecting the patients to screening tools like NBI and toludine blue, the efficacy of these techniques in helping us to take a representative biopsy was evaluated. In present study the sensitivity (to correctly identify all patients with disease), specificity (to correctly reject healthy patients without disease) of older technique toludine blue in detecting premalignant lesion was 66.6%, 87.8% while for NBI was 66.6%, 95%. For malignant lesion sensitivity and specificity of toludine blue was 94.3%, 100%, while the same for NBI was 100%, 88.8% respectively. Both NBI and toludine blue staining can be adopted for screening and the accurate detection of biopsy site and in the follow up of premalignant lesions to look for malignant transformation. Time tested is Toludine blue which is cheap and easily available. But being a better tool and having an upper hand in evaluating the lesions, NBI should be made available in all the secondary and tertiary care centres as a screening method.

Mouth Self-Examination for Prevention and Control of Oral Cavity Cancer.

Oral cavity cancer is one of the most common preventable cancers in the world. The burden of the disease is high in South Asia. Therefore, public health strategies such as creating awareness and disease screening should be advocated for its prevention and early detection. Mouth self-examination serves both the purposes. It is easy to perform, non-invasive, and low-cost methods. It not only helps in the early detection of suspicious oral lesions but also helps people to quit their high-risk behaviors such as consumption of tobacco and alcohol.

Virtual assistance in oral medicine for prioritizing oral cancer diagnosis during the COVID-19 pandemic

Oral cancer has been considered an important health problem in many parts of the world.1 In Brazil, it is one of the top 10 most frequent malignancies accounting for about 15,000 new cases per year.2 In addition, the majority of the cases are diagnosed at advanced clinical stages, significantly worsening the prognosis.3 In the last decades, many strategies have been used in an attempt to modify this scenario. Educational campaigns targeted at the general population regarding risk factors, main clinical features, and what to do when a suspicious oral lesion is observed are among the most emphasized topics.