Consistent differences exist between the fluorescence spectra of abnormal and normal oral mucosa. Therefore, fluorescence spectroscopy has the potential to improve the noninvasive diagnosis of oral cavity neoplasia. Further studies will better define the role of this technique in the detection of premalignant and early oral cancer lesions.

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We reviewed the cases of 20 cancer patients (mean age 47.4 years) in whom osseointegrated implants were used for dental restoration after mandibular reconstruction between January of 1988 and December of 1994. Seventy-one implants were placed into bone flaps (n = 60) or native mandible (n = 11), an average of 3.55 per patient (range, 2 to 5). Successful integration occurred in 91.5 percent (65 of 71); there were five early failures and one late failure, with no significant difference between the number lost in microvascular flaps (5 of 60) and native mandible (1 of 11) (as determined by Fisher's exact test). Functional evaluation included assessments of diet, speech, and cosmesis. Based on our review, we concluded that (1) implants enhance dental restoration in selected patients, and (2) microvascular bone flaps, including the fibula and iliac crest, are well suited for dental implant restoration.

Background. Early detection of squamous cell carcinoma (SCC) in the oral cavity can improve survival. It is often difficult to distinguish neoplastic and benign lesions with standard white light illumination. We evaluated whether a technique that capitalizes on an alternative source of contrast, tissue autofluorescence, improves visual examination.Methods. Autofluorescence of freshly resected oral tissue was observed visually and photographed at specific excitation/ emission wavelength combinations optimized for response of the human visual system and tissue fluorescence properties. Perceived tumor margins were indicated for each wavelength combination. Punch biopsies were obtained from several sites from each specimen. Sensitivity and specificity were evaluated by correlating histopathologic diagnosis with visual impression.Results. Best results were achieved with illumination at 400 nm and observation at 530 nm. Here, sensitivity and specificity were 91% and 86% in discrimination of normal tissue from neoplasia. This compares favorably with white light examination, in which sensitivity and specificity were 75% and 43%.Conclusions. Oral cavity autofluorescence can be easily viewed by the human eye in real time. Visual examination of autofluorescence enhances perceived contrast between normal and neoplastic oral mucosa in fresh tissue resections.