Efficacy of Tissue Autofluorescence and Tissue Vital Staining in Evaluation of Potentially Malignant Oral Disorders - A Comparative Pilot Study

Background: The malignant transformation rate of oral potentially malignant disorders (OPMDs) is estimated to range from 1.4% to 36% and 17% to 35% of oral squamous cell carcinomas (OSCC) develop from pre-existing leukoplakic lesions. Therefore, early recognition of these precursor lesions would make OSCC a preventable disease. Tissue Autofluorescence can be an essential chairside screening tool for dysplasia along with other traditional investigations like vital staining. Objective: To compare the reliability of tissue Autofluorescence (VELscan(TM)) and vital staining (toluidine blue) as a valuable screening tool in the detection of dysplasia as compared to histopathological diagnosis. Methods: The study consisted of 40 patients within the age group of 18-60 years of either gender with clinically diagnosed OPMDs. All patients were subjected to a VELscan examination, followed by 1% toluidine blue staining, and finally, a biopsy which is the gold standard. Results: The study revealed a 55% prevalence of dysplastic lesions. VELscan(TM) showed 100% sensitivity and 94.4% specificity. Toluidine blue staining showed 86.3% sensitivity and 100% specificity. The positive predictive value (PPV) for VELscan and toluidine blue staining was 95.65% and 100% respectively. The negative predictive value (NPV) is 100% for VELscan(TM) and 85.72% for toluidine blue staining. Conclusion: VELscan(TM) is a light-based, simple, chairside screening tool for the diagnosis of OPMDs.