Oral mucosal disease in an Australian urban Indigenous community using autofluorescence imaging and reflectance spectroscopy.

BACKGROUND: The aim of this study was to document the oral mucosal burden in an urban Indigenous community and to evaluate the efficacy of an adjunctive optical device (Identafi(™) ) in a general dental practice. METHODS: Three hundred and forty-two patients who presented to an urban Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) were examined using conventional oral examination (COE) and with a multispectral device (Identafi(™) ). Loss of autofluorescence (LAF) and the visibility of diffuse vasculature were noted. RESULTS: The urban Indigenous community assessed did not display significantly higher rates of smoking, alcohol consumption or lesion prevalence compared to non-Indigenous counterparts. The white and violet light functions of Identafi(™) provided excellent lesion visibility in 84.5% and 77.9% of cases respectively compared to 75% with COE, and were capable of highlighting new lesions not seen during COE. CONCLUSIONS: The urban Indigenous community does not appear to display a significantly higher prevalence of risk factors such as smoking and alcohol consumption compared to their non-Indigenous counterparts living in the same region, nor are they more likely to have oral mucosal lesions. The incidence of intraoral pigmentation has the potential to complicate use of autofluorescence screening devices, emphasizing the importance of skill and training when using this technology.

Diagnostic accuracy of Narrow Band Imaging for the detection of oral potentially malignant disorders.

OBJECTIVE: To determine the clinical diagnostic accuracy of Narrow Band Imaging(™) for the detection of oral potentially malignant disorders in a prospective series of patients. MATERIALS AND METHODS: New and existing patients referred to an oral medicine and pathology specialist clinic for assessment of at least one white, red or red-white oral mucosal lesion underwent conventional oral examination, followed by examination with the white light mode and then narrow band imaging mode of a Narrow Band Imaging(™) system. The clinical presentation, microvascular architecture and relevant histopathology of all lesions were recorded. RESULTS: A total of 272 lesions from 95 patients were observed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the detection of oral potentially malignant disorders or worse by Narrow Band Imaging(™) were 100%, 74.63%, 92.38%, 100% and 93.77%, respectively, when compared with conventional oral examination. Narrow Band Imaging(™) aided the detection of 24 lesions undetected by conventional oral examination and 13 lesions undetected by white light endoscopy. CONCLUSION: Narrow Band Imaging(™) demonstrates great utility as a visualisation adjunct for detecting and monitoring oral potentially malignant diseases, particularly lesions not identified by conventional oral examination or white light examination alone.