Several screening techniques based on light interaction with tissue have been described to aid clinicians in the detection of early oral cancerous lesions. One of the most studied techniques is chemiluminescence. This method has been used in different studies but always by Oral Medicine specialists. Objective: To evaluate the chemiluminescence system as a screening method in the detection of clinically suspicious cancerous and precancerous oral lesions when used by clinicians without an Oral Medicine Speciality. Study Design: A total of 100 patients attending the Oral Medicine Unit at the Dental School of the University of Seville were enrolled. All patients were current smokers and were above the age of 40. The clinical examination was performed by dental students who were instructed in the location and recognition of potentially malignant oral disorders, using visual examination and the chemiluminescence test ViziLite Plus  (Zila Pharmaceuticals, Phoenix, AZ, USA). To assess the validity of the chemiluminescence test as a screening method, a visual exam was performed by a specialist in Oral Medicine which was used as a gold-standard. Results: Conventional oral visual examination by the Oral Medicine Specialist found 13 lesions suspicious for malignancy, out of which 7 were also detected using the chemiluminescence test. Furthermore, 87 patients were diagnosed as lesion-free, of which 49 obtained negative results during the chemiluminescence test and 38 patients had some sort of lesion. With these results, the test yielded a sensitivity of 0.56 and a specificity of 0.56. These results indicate values similar to other studies, in fact lower sensitivity values, possibly due to the lack of experience of the clinician. Conclusions: The chemiluminescence test (ViziLite Plus) did not present any advantages in terms of cost-benefit compared to conventional examination as a screening method for cancerous and precancerous oral lesions.

El cáncer oral es un problema de salud con el que nos enfrentamos todos los días en nuestras consultas. Los dentistas formamos la primera línea de defensa ante una patología que no ha presentado una mejora de los índices de mortalidad y morbilidad en las últimas décadas. La principal arma con la que contamos es la del diagnóstico precoz de la enfermedad, y esto es mucho más complicado de lo que parece. Para ayudar a los dentistas en la visualización de lesiones de precáncer o cáncer temprano han aparecido algunas técnicas o dispositivos de screening de cáncer oral basadas en la interacción de los tejidos orales con la luz. La técnica más extendida y estudiada es la basada en la quimioluminiscencia, intentaremos poner en claro algunos aspectos analizando los estudios que hay en la literatura actual.

Introduction: Leukoplakia is the most frequent potentially malignant disorder. Management and diagnosis requires clinical and histopathogical monitorization. Conventional biopsy generates patient morbidity and is considered a complex procedure for general dentists, which can delay initial diagnosis. To solve these problems, we have proposed a novel procedure denominated Whole Tissue Microbiopsy (WTM). The aim of this study is to evaluate the samples obtained with the WTM procedure and to test their viability; to check if they are applicable in all anatomic locations and compare the results with those obtained with conventional biopsy. Methods: We studied 41 clinically compatible lesions with oral leukoplakia. A tissue sample was taken using the WTM technique, after which, a conventional biopsy was performed on the same location. Both samples were studied and compared in terms of viability and concordance. Results: 100% of the samples obtained using the WTM procedure were viable. 95% of the samples were useful to detect dysplasia, and in 85% of cases the basal membrane was retained. Coincidence with conventional biopsy as to detect cancer-dysplasia was 78% and showed a 53.8% sensitivity regarding the detection of dysplasia-Cancer. Discussion and Conclusion: The samples obtained by the WTM are viable for study. Conservation of all epithelial layers in the sample and the basement membrane in particular is not influenced by the anatomical area or by the clinical appearance of the lesion. The results that did not coincide with the conventional biopsy were due to the difference in size and not the quality of it.