Prospects for Narrow Band Imaging Magnification Endoscopy in Oral Lesions -Recommendations from Oral and Maxillofacial Surgeons and Gastroenterologist

Narrow band imaging (NBI) magnification endoscopy for the diagnosis of early-stage oral cavity-related cancer and precancerous lesions can recognize oral lesions as brownish areas, and can observe intraepithelial papillary capillary loops (IPCL) in the mucosa and submucosa to make a qualitative diagnosis of the lesion and highlighting of the mucosal surface microstructure to facilitate appropriate diagnosis and early treatment. IPCL is classified from Type 0 to IV, Type 0 being normal mucosa or no blood vessels are observed e.g. in keratinisation, Type I being mainly normal mucosa, Type II being mainly inflammatory sites or non-neoplastic lesions, Type III being mainly neoplastic lesions, and Type IV being neoplastic lesions. NBI magnification endoscopy is a useful noninvasive method for identifying malignant transformation of oral potentially malignant disorders (OPMDs), and oral lesions classified as IPCL Type II or higher would be atypical epithelial or oral squamous cell carcinoma (OSCC), oral biopsy is recommended for early and accurate diagnosis, and is an indicator of the appropriate biopsy site in the follow-up of OPMDs. In the future, the accuracy of NBI magnification endoscopy for malignant transformation of OPMDs and OSCC will be further confirmed. It is then expected that NBI magnification endoscopy will be widely used by dentists in hospitals and general dental clinics.