Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Periodontology

Oral keratotic lesions are not uncommon in the population. More concern should be directed towards these lesions as some of these lesions are already considered of the most important OPMDs as leukoplakia and lichenplanus. Being asymptomatic in most of cases, these lesions can be diagnosed at later stages after development of dysplastic changes. In the last decades, research has been directed towards early detection of oral cancer and OPMDs in order to achieve better prognosis for these patients and decrease the high mortality rates of oral cancer. Many adjunctive diagnostic techniques have been introduced in order to increase the ability of the clinicians to detect dyplastic lesions and help in the decision of taking a sample from the suspicious lesions. In this study, the diagnostic accuracy of two of these techniques which are the VELscope and TB in detecting dysplastic changes within the oral keratotic lesions was assessed through comparing the results of both techniques with the histopathological results of the same patient as it is considered the gold standard in detecting and grading of dysplasia. Our study showed that TB is more accurate than VELscope in detecting dysplasia having higher sensitivity(75% for TB versus 62.5% forVELscope) and higher specificity (85% for TB versus 68.4% for VELscope). Positive and negative predictive values of TB were 66.6% and 89.4% respectively. While positive and negative predictive values of VELscope were 45.5% and 81.3% respectively. These results of the VELscope regarding sensitivity were attributed to two reasons. One was that the hyperkeratinization in oral keratotic lesions increase the autofluorescence and mask the deep changes occurring in the epithelial and sub epithelial tissues

Issued also as CD