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A brief review of cytology in dentistry

British Dental Journal volume 236, pages 329–336 (2024)Cite this article

Abstract

Oral cytology is a non-invasive adjunctive diagnostic tool with a number of potential applications in the practice of dentistry. This brief review begins with a history of cytology in medicine and how cytology was initially applied in oral medicine. A description of the different technical aspects of oral cytology is provided, including the collection and processing of oral cytological samples, and the microscopic interpretation and reporting, along with their advantages and limitations. Applications for oral cytology are listed with a focus on the triage of patients presenting with oral potentially malignant disorders and oral mucosal infections. Furthermore, the utility of oral cytology roles across both expert (for example, secondary oral medicine or tertiary head and neck oncology services) and non-expert (for example, primary care general dental practice) clinical settings is explored. A detailed section covers the evidence-base for oral cytology as a diagnostic adjunctive technique in both the early detection and monitoring of patients with oral cancer and oral epithelial dysplasia. The review concludes with an exploration of future directions, including the integration of artificial intelligence for automated analysis and point of care ‘smart diagnostics', thereby offering some insight into future opportunities for a wider application of oral cytology in dentistry.

Key points

  • The major potential application for oral cytology is as a diagnostic adjunct in the triage of patients with oral potentially malignant disorders.

  • Oral cytology is recommended over fungal culture for the initial diagnosis of patients with possible oral candidosis.

  • There is potential for oral cytology to be incorporated into both general dental practice and across expert clinic settings.

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Funding

Funding for some sections of this work were provided by the National Institutes of Health (NIH) through the National Institute of Dental and Craniofacial Research (NIDCR) (Award Numbers R01DE031319-01, 5U54EB027690-04, 1RC2DE020785-01, 5RC2DE020785-02, 3RC2DE020785-02S1, 3RC2DE020785-02S2, 4R44DE025798-02, R01DE030169). The content of this paper is solely the responsibility of the authors and does not necessarily represent or reflect the official views of the NIH or the US Government.

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Authors and Affiliations

  1. Department of Molecular Pathobiology, New York University College of Dentistry, New York, 10010, USA

    Kritika Srinivasan Rajsri & John T. McDevitt

  2. Division of Oral and Maxillofacial Pathology, UT Health, The University of Texas Health Science Centre, Houston, Texas, 77054, USA

    Safia K. Durab, Ida A. Varghese & Nadarajah Vigneswaran

  3. Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York,, 10010, USA

    A. Ross Kerr

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Contributions

Kritika Srinivasan Rajsri: curation of literature, writing - original draft, reference editing and formatting. Safia K. Durab, Ida A. Varghese: curation of literature, writing - original draft. Nadarajah Vigneswaran: conceptualisation, review and editing, supervision and proofreading manuscript. John T. McDevitt: writing - review and editing, supervision, and proofreading manuscript. A. Ross Kerr: project management, conceptualisation, curation of literature, writing - review and editing, supervision, and proofreading manuscript.

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Correspondence to A. Ross Kerr.

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Kritika Srinivasan Rajsri and John T. McDevitt have patent applications pending. John T. McDevitt has an ownership position and an equity interest in OraLiva Inc. and serves on the advisory board. Nadarajah Vigneswaran serves as advisor to OraLiva Inc. All other authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

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Srinivasan Rajsri, K., K. Durab, S., A. Varghese, I. et al. A brief review of cytology in dentistry. Br Dent J 236, 329–336 (2024). https://doi.org/10.1038/s41415-024-7075-7

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