title: In vivo confocal microscopy for the oral cavity: Current state of the field and future potential.
abstract: Confocal microscopy (CM) has been shown to correlate with oral mucosal histopathology in vivo. The purposes of this review are to summarize what we know so far about in vivo CM applications for oral mucosal pathologies, to highlight some current developments with CM devices relevant for oral applications, and to formulate where in vivo CM could hold further application for oral mucosal diagnosis and management. Ovid Medline® and/or Google® searches were performed using the terms 'microscopy, confocal', 'mouth neoplasms', 'mouth mucosa', 'leukoplakia, oral', 'oral lichen planus', 'gingiva', 'cheilitis', 'taste', 'inflammatory oral confocal', 'mucosal confocal' and 'confocal squamous cell oral'. In summary, inclusion criteria were in vivo use of any type of CM for the human oral mucosa and studies on normal or pathological oral mucosa. Experimental studies attempting to identify proteins of interest and microorganisms were excluded. In total 25 relevant articles were found, covering 8 main topics, including normal oral mucosal features (n=15), oral dysplasia or neoplasia (n=7), inflamed oral mucosa (n=3), taste impairment (n=3), oral autoimmune conditions (n=2), pigmented oral pathology/melanoma (n=1), delayed type hypersensitivity (n=1), and cheilitis glandularis (n=1). The evidence for using in vivo CM in these conditions is poor, as it is limited to mainly small descriptive studies. Current device developments for oral CM include improved probe design. The authors propose that future applications for in vivo oral CM may include burning mouth syndrome, intra-operative mapping for cancer surgery, and monitoring and targeted biopsies within field cancerization.
authors.affiliation: The Melanoma Institute Australia, Sydney, Australia; The University of Sydney, Sydney, Australia.
authors.forename: N G
authors.initials: NG
authors.lastname: Maher
authors.affiliation: Hospital Universitari, Germans Trias i Pujol, Badalona (Barcelona), Spain.
authors.forename: H
authors.initials: H
authors.lastname: Collgros
authors.affiliation: Department of Dermatology, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: P
authors.initials: P
authors.lastname: Uribe
authors.affiliation: The Melanoma Institute Australia, Sydney, Australia; The University of Sydney, Sydney, Australia; Institute of Academic Surgery at Royal Prince Alfred Hospital, University of Sydney, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Ch'ng
authors.affiliation: Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, USA.
authors.forename: M
authors.initials: M
authors.lastname: Rajadhyaksha
authors.affiliation: The Melanoma Institute Australia, Sydney, Australia; The University of Sydney, Sydney, Australia; Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address: pascale.guitera@melanoma.org.au.
authors.forename: P
authors.initials: P
authors.lastname: Guitera
mesh_terms: D006801:Humans; D000069416:Intravital Microscopy / Q000295:instrumentation / Q000379:methods; D018613:Microscopy, Confocal / Q000295:instrumentation / Q000379:methods; D009055:Mouth / Q000473:pathology*; D009059:Mouth Diseases / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology*
keywords: Confocal; Melanoma; Melanosis; Microscopy; Mouth mucosa; Mouth neoplasms