Epithelial dysplasia as a predictor of malignant transformation in oral potentially malignant disorders: The concepts, controversies, and challenges

Oral potentially malignant disorders (OMPDs) are a group of precursor lesions with varied clinical manifestations which exhibit an increased risk of malignant transformation. Early diagnosis and prevention of oral cancer now focuses more on the early recognition of OPMDs and assessment of their risk of malignant transformation. Although epithelial dysplasia is being widely used as a yardstick to assess the malignant potential of OMPDs, the interobserver variability and lack of reproducibility observed in the interpretations had made their efficacy as a predictor of malignant transformation highly questionable. The aim of this paper is to discuss the concept, controversies, and challenges involved in the utility of epithelial dysplasia as a predictor of malignant transformation.