Velscope Presentation (Short)


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  • Pre-cancerous epithelial lesions typically start below the surface of the tissue, at the basement membrane, and can remain unseen until they reach the surface. The most appropriate timing for discovery and intervention is during the earliest stages of dysplastic progression, before the disease has reached the surface. The VELscope helps identify of clinically unseen oral abnormalities.
  • The VELscope Handpiece emits a safe blue light into the oral cavity, which excites the tissue from the surface of the epithelium through to the basement membrane (where premalignant changes typically start) and into the stroma beneath causes the naturally occurring fluorophores in the tissue to fluoresce. The clinician is then able to see this excitation immediately and view the different fluorescence responses to help differentiate between normal and abnormal tissue. Under VELscope examination, abnormal tissue typically appears as irregular, dark areas that stand out against the otherwise normal, green fluorescence pattern of surrounding healthy tissue.
  • VELscope Indications for Use… What this Means to You VELscope is the only adjunctive oral cancer screening system cleared to help clinicians detect, and surgeons remove, precancerous and cancerous lesions that may not be visible under white light examination.
  • A definition of fluorescence visualization is “ A Bite Wing for the Oral Mucosa.” Like a bite wing radiograph which detects decay not readily visible, the VELscope allows for detection of abnormal tissue in the epithelium.
  • This case that shows a region under white light examination in which a scar is observed, but no oral lesion is apparent otherwise. Keep in mind that this is under magnification and not as it would appear under normal examination.
  • Now, when viewing this same area with VELscope, you can again see the lesion appearing as a dark area. This lesion was subsequently confirmed by biopsy to be CIS. Without VELscope, the area may not have been discovered by the clinician.
  • This is another case where you can plainly see the small growth.
  • With VELscope you can see the area very clearly. Again, this was confirmed by biopsy to be CIS while the polyp was benign indicated by the white appearance under the VELscope.
  • This leukoplakia was in observation mode. In the image on the right, you can see that the lesion appears as an irregular, dark area. This area was biopsied and was found to be severe dysplasia.
  • The difference from the previous slide is that in the slide on the right you can see that the lesion is VELscope Negative. This area was biopsied and found not to be dysplasia but a benign lesion (hyperplasia).
  • This is a clinical presentation that might present in a typical GP’s office and might on cursory examination be considered an example of denture trauma. Under white light areas of erythema (redness) in the vestibule and hyperkeratosis on the alveolar ridge are evident. Under fluorescence, the hyperkeratotic area on the alveolar ridge demands our attention with an intense loss of fluorescence. This particular patient was examined in the Oral Medicine department at the University of Washington – the clinician involved relieved the denture and examined the patient again approximately 2 weeks later: the areas of erythema and corresponding darkness under fluorescence in the vestibule were gone, the intense loss of fluorescence on the ridge remained and was found to contain severe dysplasia after an excisional biopsy was performed.
  • There is over 10 Years of Research in Peer Reviewed Journal articles proving the efficacy of the VELscope. Many studies, including the ones listed here demonstrate the ability of the VELscope to detect lesions that are not readily visible and it gives the ability to a surgeon to be used as a tool to determine where and how much tissue to excise.
  • LED Dental believes that the American Dental Association’s decision to provide a CDT Fee Code for screening will have a tremendous impact on ensuring that these enhanced-screening devices are being utilized by the dental community, which will in turn help save lives. This reimbursement code is only valid in the U.S. and it will be different for other countries.
  • Velscope Presentation (Short)

    2. 2. 7Image courtesy of the British Columbia Oral Cancer Prevention Program Patient DPatient D Abnormal Tissue?
    3. 3. 8 Images courtesy of the British Columbia Oral Cancer Prevention Program Patient DPatient D Clinical Appearance Irregular, Dark Area Biopsy confirmed Carcinoma in situ
    4. 4. 9Image courtesy of the British Columbia Oral Cancer Prevention Progra Patient EPatient E Where Is The Abnormal Tissue? Polyp
    5. 5. 10 Mild dysplasia CIS Clinical Appearance Suspicious region is now clearly visible. Confirmed CIS. Polyp Images courtesy of the British Columbia Oral Cancer Prevention Program Patient EPatient E (continued)(continued) Polyp (white)
    6. 6. 11 Oral Lesions May Show as Irregular, Dark Areas Images courtesy of the British Columbia Oral Cancer Prevention Program Observe or Refer? Severe Dysplasia
    7. 7. 12 An Oral Lesion that Shows No Change in Autofluorescence Appearing Pale Green Images courtesy of the British Columbia Oral Cancer Prevention Program Hyperplasia Observe or Refer?
    8. 8. 14 Pre-clinical discovery Left palate : low-grade mucoepidermoid carcinoma
    9. 9. 15 EXTENSIVE CLINICAL SUPPORT 10+ Years of Research in the Oral Cavity • 2009 General Dentistry – K. Huff, et al • 2007 Head & Neck – P.M. Williams, et al. • 2006 Clinical Cancer Research – C.F. Poh, et al • 2005 Oral Oncology – deVeld, et al. Proven Efficacy
    10. 10. 16 Reimbursement Code (US) D0431 Adjunctive Mucosal ScreeningAdjunctive Mucosal Screening An adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including pre-malignant and malignant lesions. Not to include cytology or biopsy. Note: This reimbursement code is only valid in the U.S. and it will be different for other countries.