FARZANA FATIMA NAFI

CRI
• Lesion- whitish non scrapable on his right buccal mucosa

• Approx size - 1x1.5cm

• Extension-second premolar to molar

• Palpation - vertical fibrotic bands on palpation on both sides

• LEUKOPLAKIA WITH SUBMUCOUS FIBROSIS

• INVESTIGATIONS-

BIOPSY
 Linea alba
Leukoedema
Lichen planus
Hyperplastic candidiasis
White sponge nevus
Morsicato
 LESION FEATURES
LINEA ALBA ALONG OCCLUSAL PLANE

LEUKOEDEMA BILATERALLY
DISAPPEARS ON STRETCHING

LICHEN PLANUS BILATERAL WITH WICKAMS

STRIAE
MORSICATIO RAGGED SURFACE

HYPERPLASTIC CANDIDIASIS EASILY SCRAPABLE

WHITE SPONGE NEVUS HEREDITARY ORIGIN
 On histopathological examination-SEVERE
DYPLASTIC CHANGES with characteristic
appearance of bulbous rete ridges -suggestive of
VERRUCOUS CARCINOMA
ADVICED FOR THE CESSATION OF THE HABIT

ANTIOXIDANTS PRESCRIBED

PATIENT RECALLED FOR REVIEW AFTER EVERY 6

MONTHS
• Simple small non-alarming white lesion
 DYPLASIA
• TOLUIDINE BLUE TEST

• CHEMILUMINESCENCE- VIZILITE
 a w h i c h i s
g d y sp l a si
e m o n s t ra t in
ec ti v e i n d le
• Ef f e co g n i z a b ta te s
l ly r f a ci l i
not clinica p l a s ti c e p i th e l i um
I P LE - D y s
• P R IN C . n o t
n o f d y e ce l l s b u t
penetratio t e r ia l o fd y s p l a st ic
u c l ea r m a
• Stain s n
o r m a l c el ls
other n
BEFORE APPLICATION AFTER APPLICATION OF STAIN
 CHEMILUMINESCENCE
-VIZILITE
• Commercially available diagnostic tool
• Hand held , single use , deposable light
stick that emits 430 , 540 and 580 nm
wavelength

VIZILITE KIT consists of

 Vizilite1%acetic acid solution
Capsule retractor
 T-Blue 360 Oral lesion marking system
 CLINICAL STEPS
RINSE- 1% acetic acid sol 30-60sec
Bending of the light stick
Vigorously shake the contents
Dim the room light
Examine with eyewear
If abnormality detected , Reconfirm with Toluidine
Blue stain.
 VISUALIZATION WITH
LUMINESCENCE STICK
BEFORE APPLICATION AFTER APPLICATION
On visual examination Normal epithelium
absorbs light and appears dark
Hyper keratinized and dysplastic changes
appears white
 ADVANTAGES

• Non invasive , easy chair side test

• Easily storable , prevents cross contamination

• Highly acceptable

• Helps in patient education and motivation

• Helps in documenting clinical appearance

 RECENT ADVANCES

• VELSCOPE

• ORAL CDx BRUSH CYTOLOGY

• ORAL COHERENCE TOMOGRAPHY

• SALIVARY BIOMARKERS
CONCLUSION
 REFERENCES
• Advanced diagnostics aids in detection of oral cancer-Chaudhary R
et al
• Oral luminoscopy : an adjuvant in oral screening cancer-Anshul
agarwal
• Efficacy of oral luminoscopy
• Picture courtesy - www.vizilite.com