Value of the ViziLite Plus System as a diagnostic aid in the early detection of oral cancer/premalignant epithelial lesions

The aim of the study was to assess the value of the chemiluminescent light and 1% tolonium chloride as a diagnostic aid in the early detection of oral cancer/premalignant epithelial lesions. Thirty consecutive patients with 41 visually identified oral lesions suggestive of being premalignant underwent chemiluminescence and tolonium chloride examination followed by incisional biopsy with histopathologic evaluation. The biopsies of 34 lesions (82.92%) revealed no dysplasia, 3 lesions (7.32%) revealed mild dysplasia, 3 lesions (7.32%) demonstrated severe dysplasia, and 1 lesion (2.44%) was malignant (squamous cell carcinoma). The chemiluminescent examination improved the brightness (58.54% of the cases), sharpness (56.1% of the cases), texture (60.98% of the cases), and size of the lesion (53.66% of the cases). With references to serious pathologies, 7 cases (100.0%) were brighter, and size was more visualized in 6 cases (85.71%) when using chemiluminescence examination than under incandescent light. Twenty-five (73.53%) of nonserious pathology and 7 (100.0%) of serious pathology (6 dysplasias, 1 squamous cell carcinoma) were positively stained by toluidine blue. Three (8.82%) of nonserious pathology and 0 (0.0%) of serious pathology lesions were identified as true negatives when toluidine blue staining was used. The overall toluidine blue sensitivity and specificity were 81.8% and 37.5%, respectively. Chemiluminescent light demonstrates better visualization (brightness, size) of serious pathology lesions in comparison with conventional clinical oral examination under incandescent light. Toluidine blue demonstrates 100% sensitivity in staining serious pathology. The ViziLite Plus system may help the practitioner to visualize oral pathologies that are not readily detectable with conventional incandescent lighting.