Huber Michaell A
Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, Dental School, San Antonio, Texas 78229, USA.
Tex Dent J. 2012 May;129(5):471-80.
During the past decade, several adjunctive aids have been introduced to the marketplace with the promoted goal of improving the dental practitioner's ability to screen for and identify oral premalignant and malignant lesions (OPMLs). These products include the OralCDx Brush Test, ViziLite Plus with TBlue, Microlux, VELscope Vx, Sapphire Plus, Identafi, and the DOE Oral Exam System. They are all marketed as aids for the clinician to use in addition to, not in lieu of, the accomplishment of a conventional oral examination (COE). Studies addressing the efficacy of these products when used in the general practice setting to screen for OPMLs are limited and conflicting. The ability to discriminate between truly dangerous OPML against the milieu of benign mucosal lesions remains a concern and further research is necessary to determine the true value of these products as marketed to the general practitioner. The attainment of a complete history and the accomplishment of a thorough and disciplined COE remains the foundation upon which the practitioner assesses the patient for OPMLs. Findings deemed suspicious or equivocal should be referred to an expert for further assessment or undergo immediate biopsy, while findings deemed innocuous should be re-evaluated within 2 weeks and referred to an expert for further assessment or undergo biopsy if still present.
在过去十年中，市场上推出了几种辅助工具，其宣传目标是提高牙科从业者筛查和识别口腔癌前病变和恶性病变（OPMLs）的能力。这些产品包括OralCDx Brush Test、ViziLite Plus with TBlue、Microlux、VELscope Vx、Sapphire Plus、Identafi和DOE口腔检查系统。它们都作为辅助工具进行销售，供临床医生在完成传统口腔检查（COE）之外使用，而非替代COE。关于这些产品在一般临床环境中用于筛查OPMLs时的疗效研究有限且相互矛盾。在良性黏膜病变背景下区分真正危险的OPMLs的能力仍然是一个问题，需要进一步研究以确定这些面向全科医生销售的产品的真正价值。获取完整病史并完成全面且规范的COE仍然是从业者评估患者是否患有OPMLs的基础。被认为可疑或模棱两可的发现应转诊给专家进行进一步评估或立即进行活检，而被认为无害的发现应在2周内重新评估，若仍然存在则转诊给专家进行进一步评估或进行活检。
