Table of Contents
List of Contributors
Preface
Acknowledgements
1. Introduction
General Introduction
Epidemiology
Prevention Treatment Strategies
Terminology
Summary
References
2. Structure and Function of Oral Mucosa
Introduction
Applied Anatomy of the Oral Cavity
Function of the Oral Mucosa
The Microanatomy of Oral Mucosa
Regional Variation of Oral Mucosa
Oral Epithelial Cell Kinetics
Oral Epithelial Cell Proliferative Activity
Anatomical Site Predilection for Oral Carcinogenesis
Summary
References
3. Oral Carcinogenesis
Introduction
Oral Cancer and Precancer
The ‘Progression Model’ for Oral Cancer
Aetiology and Risk Factors
Patient and Risk Factor Profiling
Summary
References
4. Clinical Presentation of Oral Precancer
Introduction
Clinical Terminology
Precancerous (Premalignant) Lesions
Precancerous (Premalignant) Conditions
Multiple Lesion Disease
Summary
References
5. Diagnostic Methods
Introduction
Screening
Clinical Examination Techniques
Vital Tissue Staining
Light Based Detection Systems
Brush Biopsy and Exfoliative Cytology
Clinical Diagnosis in Practice
Summary
References
6. Pathological Aspects of Oral Precancer
Introduction
Biopsy Techniques
The Role of the Pathologist
Histopathological Features of Oral Potentially Malignant Disorders
Grading of Dysplasia
Limitations in Conventional Pathological Techniques
Summary
References
7. Management of Oral Precancer
Introduction
Risk Factor Modification
Observation versus Intervention
Medical Treatment
Surgical Treatment
Interventional Laser Surgery
Combined Treatment Modalities
Patient Follow Up and Surveillance
Summary
References
8. Clinical Outcome
Introduction
Clinical Outcome Studies
Patient Cohort Studies
Definitions of Clinical Outcome
Newcastle Patient Cohort Studies
Patient Follow Up
Prediction of Clinical Outcome
Summary
References
9. Malignant Transformation and Oral Cancer Development
Introduction
The Risk of Progression to Oral Carcinoma
Malignant Transformation versus Oral Cancer Development
Interventional Laser Surgery and Oral Cancer Prevention
The Newcastle 10 Year Follow Up Study
High and Low Risk Patients
Clinical Signs of Oral Squamous Cell Carcinoma
Diagnosis and Management of ‘Unexpected Malignancy’
Prognosis for the ‘Transformed Patient’
Summary
References
10. The Future
Introduction
Prevention of Oral Precancer
Early Diagnosis of Potentially Malignant Disease
Interventional Management Strategies in the Future
Individualised Patient Treatments – Biomarkers and Targeted Chemoprevention
Future Research Directions
Summary
References
11. Case Histories
Introduction
Diagnosis of Unexpected Malignancy
Multiple Lesion Disease Responding to Conservative Management
Multiple Lesion Disease Requiring Repeated Laser Treatments
Proliferative Verrucous Leukoplakia
Localised Oral Lichenoid Reaction
Multiple Oral Lichenoid Reactions
Widespread Dysplastic Oral Lichenoid Reactions
An Immunosuppressed Patient
Chronic Hyperplastic Candidosis
Tobacco Associated Hyperkeratosis
Malignant Transformation in Longstanding Non-erosive Lichen Planus
Summary
12. Conclusions
Oral Cancer Potentially Malignant Disorders
Clinical Management
Patient Care Pathways
Public Health Strategies
Future Directions
Index
