Skip to main content
SpringerLink
Log in

Oral Dysplasia

  • Chapter
  • First Online:
Advancements and Innovations in OMFS, ENT, and Facial Plastic Surgery

  • 308 Accesses

Abstract

Oral potentially malignant disorder (OPMD) is a broad term that encompasses anything that has a risk of progressing to oral cancer, including clinically normal oral mucosa. OPMDs includes both strictly clinical conditions (e.g., leukoplakia, erythroplakia, and erythroleukoplakia) and a variety of diagnoses that have well-established clinical and histologic characteristics (e.g., submucous fibrosis, dyskeratosis congentia, smokeless tobacco keratosis, chronic candidiasis lichen planus, discoid lupus erythematosus, syphilitic glossitis, and actinic keratosis). In contrast, dysplasia is a histological diagnosis that describes “abnormal growth” at the cellular level, as its name implies. The diagnostic criteria for epithelial dysplasia includes both architectural and cytological epithelial changes that serve as evidence of the cellular misbehavior that is thought to progress to oral squamous cell carcinoma (OSCC). However, although a plethora of grading scales, models, and biomarkers exist, no one has been able to reliably predict if and when epithelial dysplasia will traverse the basement membrane and invade the underlying connective tissue to progress to OSCC. This leaves clinicians with a difficult conundrum in the management and surveillance of these historically controversial conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Baillie S, Simms W. Queries and responses from the medical committee of the society for investigating the nature and cure of cancer. Edinb Med Surg J. 1806;2:382–9.

    Google Scholar 

  2. Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36:575–80.

    Article  CAS  PubMed  Google Scholar 

  3. Reibel J, Gale N, Hille J, et al. Oral potentially malignant disorders and oral epithelial dysplasia. In: El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PPJ, editors. WHO classification of head and neck tumours. 4th ed. Lyon: IARC; 2017. p. 112–5.

    Google Scholar 

  4. Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):612–27.

    Article  PubMed  Google Scholar 

  5. Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021;27(8):1862–80.

    Article  PubMed  Google Scholar 

  6. Nikitakis NG. Special focus issue on potentially premalignant oral epithelial lesions: introduction and perspective. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):575–6.

    Article  PubMed  Google Scholar 

  7. Van der Waal I. Historical perspective and nomenclature of potentially malignant or potentially premalignant oral epithelial lesions with emphasis on leukoplakia-some suggestions for modifications. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):577–81.

    Article  PubMed  Google Scholar 

  8. Chaturvedi AK, Udaltsova N, Engels EA, Katzel JA, Yanik EL, Katki HA, Lingen MW, Silverberg MJ. Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study. J Natl Cancer Inst. 2020;112(10):1047–54.

    Article  PubMed  Google Scholar 

  9. Axell T, Pindborg JJ, Smith CJ, et al. Oral white lesions with special reference to precancerous and tobacco related lesions: conclusions of an international symposium held in Uppsala, Sweden, May 18-21, 1994. J Oral Pathol Med. 1996;25:49–54.

    Article  CAS  PubMed  Google Scholar 

  10. Hogewind WFC, van der Kwast WAM, van der Wall I. Oral leukoplakia, with emphasis on malignant transformation. J Craniomaxillofac Surg. 1989;17:128–33.

    Article  CAS  PubMed  Google Scholar 

  11. Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, Di Maio P, Spriano G, Pardiñas López S, Shanti RM. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck. 2020;42(3):539–55.

    Article  PubMed  Google Scholar 

  12. Waldron CA, Shafer WG. Leukoplakia revisited. Cancer. 1975;36:1386–92.

    Article  CAS  PubMed  Google Scholar 

  13. Reddi SP, Shafer AT. Oral premalignant lesions: management considerations. Oral Maxillofac Surg Clin North Am. 2006;18:425–33.

    Article  PubMed  Google Scholar 

  14. Abadie WM, Partington EJ, Fowler CB, Schmalbach CE. Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature. Otolaryngol Head Neck Surg. 2015;153:504–11.

    Article  PubMed  Google Scholar 

  15. Goette DK. Review of erythroplasia of queyrat and its treatment. Urology. 1976;8(4):311–5.

    Article  CAS  PubMed  Google Scholar 

  16. Cawson RA, Langdon JD, Eveson JW. Ertyroplasia (‘ertyroplakia’). In: Cawson RA, editor. Surgical pathology of the mouth and jaws. Oxford: Wright; 1996. p. 180.

    Google Scholar 

  17. Pindborg JJ, Reichart PA, Smith CJ, et al. Histological typing of cancer and precancer of the oral mucosa. 2nd ed. Berlin: Springer; 1997.

    Book  Google Scholar 

  18. Shafer WG, Waldron CA. Erththroplakia of the oral cavity. Cancer. 1975;36:1021–8.

    Article  CAS  PubMed  Google Scholar 

  19. Slaughter DP, Southwick HW, Smejkal W. “Field cancerization” in oral stratified squamous epithelium: clinical implications of multicentric origin. Cancer. 1953;6(5):963–8.

    Article  CAS  PubMed  Google Scholar 

  20. Califano J, van der Riet P, Westra W, Nawroz H, Clayman G, Piantadosi S, et al. Genetic progression model for head and neck cancer: implications for field cancerization. Cancer Res. 1996;56:2488–92.

    CAS  PubMed  Google Scholar 

  21. Smith C, Pindborg JJ. Histologic grading of oral epithelial atypia by the use of photographic standards. Copenhagen: C. Hamburgers Bogtrykkeri; 1969.

    Google Scholar 

  22. Pindborg JJ, Reichart PA, Smith CJ, van der Waal I. World Health Organization: histological typing of cancer and precancer of the oral mucosa. Berlin: Springer; 1997.

    Book  Google Scholar 

  23. WHO, Collaborating Centre for Oral Precancerous Lesions. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1978;46:518–39.

    Article  Google Scholar 

  24. Brothwell DJ, Lewis DW, Bradley G, Leong I, Jordan RC, Mock D, Leake JL. Observer agreement in the grading of oral epithelial dysplasia. Community Dent Oral Epidemiol. 2003;31(4):300–5.

    Article  CAS  PubMed  Google Scholar 

  25. Ranganathan K, Kavitha L. Oral epithelial dysplasia: classifications and clinical relevance in risk assessment of oral potentially malignant disorders. J Oral Maxillofac Pathol. 2019;23(1):19–27.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Abbey LM, Kaugars GE, Gunsolley JC, Burns JC, Page DG, Svirsky JA, Eisenberg E, Krutchkoff DJ, Cushing M. Intraexaminer and interexaminer reliability in the diagnosis of oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(2):188–91.

    Article  CAS  PubMed  Google Scholar 

  27. Warnakulasuriya S, Reibel J, Bouquot J, Dabelsteen E. Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med. 2008;37:127–33.

    Article  CAS  PubMed  Google Scholar 

  28. Kujan O, Oliver RJ, Khattab A, Roberts SA, Thakker N, Sloan P, et al. Evaluation of a new binary system of grading oral epithelial dysplasia for prediction of malignant transformation. Oral Oncol. 2006;42:987–93.

    Article  PubMed  Google Scholar 

  29. Nankivell P, Williams H, Matthews P, Suortamo S, Snead D, McConkey C, et al. The binary oral dysplasia grading system: validity testing and suggested improvement. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115:87–94.

    Article  PubMed  Google Scholar 

  30. Lingen MW, Kalmar JR, Karrison T, et al. Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol. 2008;44(1):10–22.

    Article  PubMed  Google Scholar 

  31. Downer MC, Moles DR, Palmer S, Speight PM. A systematic review of test performance in screening for oral cancer and precancer. Oral Oncol. 2004;40(3):264–73.

    Article  PubMed  Google Scholar 

  32. Lane PM, Gilhuly T, Whitehead P, Zeng H, Poh CF, Ng S, et al. Simple device for the direct visualization of oral-cavity tissue fluorescence. J Biomed Opt. 2006;11(2):024006.

    Article  PubMed  Google Scholar 

  33. Rashid A, Warnakulasuriya S. The use of light-based (optical) detection systems as adjuncts in the detection of oral cancer and oral potentially malignant disorders: a systematic review. J Oral Pathol Med. 2015;44(5):307–28.

    Article  CAS  PubMed  Google Scholar 

  34. Mashberg A. Final evaluation of tolonium chloride rinse for screening of high-risk patients with asymptomatic squamous carcinoma. J Am Dent Assoc. 1983;106(3):319–23.

    Article  CAS  PubMed  Google Scholar 

  35. Portugal LC, Wilson KM, Biddinger PW, et al. The role of toluidine blue in assessing margin status after resection of squamous cell carcinomas of the upper aerodigestive tract. Arch Otolaryngol Head Neck Surg. 1996;122:517–9.

    Article  CAS  PubMed  Google Scholar 

  36. Field EA, McCarthy CE, Ho MW, Rajlawat BP, Holt D, Rogers SN, Triantafyllou A, Field JK, Shaw RJ. The management of oral epithelial dysplasia: the Liverpool algorithm. Oral Oncol. 2015;51(10):883–7.

    Article  CAS  PubMed  Google Scholar 

  37. Speight PM. Update on oral epithelial dysplasia and progression to cancer. Head Neck Pathol. 2007;1(1):61–6.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Awadallah M, Idle M, Patel K, Kademani D. Management update of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):628–36.

    Article  PubMed  Google Scholar 

  39. Kademani D, Dierks E. Surgical management of oral and mucosal dysplasias: the case for surgical excision. J Oral Maxillofac Surg. 2007;65(2):287–92.

    Article  PubMed  Google Scholar 

  40. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144:646–74.

    Article  CAS  PubMed  Google Scholar 

  41. Nikitakis N, Pentenero M, Georgaki M, Poh C, et al. Molecular markers associated with development of potentially premalignant oral epithelial lesions: current knowledge and future implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;125:650–69.

    Google Scholar 

  42. Smith J, Rattay T, McConkey C, Helliwell T, Mehanna H. Biomarkers in dysplasia of the oral cavity: a systematic review. Oral Oncol. 2009;45:647–53.

    Google Scholar 

  43. Bera K, Schalper KA, Rimm DL, Velcheti V, Madabhushi A. Artificial intelligence in digital pathology—new tools for diagnosis and precision oncology. Nat Rev Clin Oncol. 2019;16(11):703–15.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Hwang JT, Gu YR, Shen M, Ralhan R, Walfish PG, Pritzker KP, Mock D. Individualized five-year risk assessment for oral premalignant lesion progression to cancer. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(3):374–81.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Section of Oral Oncology, University of Alabama at Birmingham, Birmingham, AL, USA

    Lior Aljadeff & Anthony B. Morlandt

Authors
  1. Lior Aljadeff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony B. Morlandt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony B. Morlandt .

Editor information

Editors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA

    James C. Melville

  2. School of Medicine, New York University, New York, NY, USA

    Paulo G. Coelho

  3. Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Simon Young

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Aljadeff, L., Morlandt, A.B. (2023). Oral Dysplasia. In: Melville, J.C., Coelho, P.G., Young, S. (eds) Advancements and Innovations in OMFS, ENT, and Facial Plastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-32099-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32099-6_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32098-9

  • Online ISBN: 978-3-031-32099-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation