Oral cancer is the eighth most frequently diagnosed type of cancer in the world.

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1 Oral cancer is the eighth most frequently diagnosed type of cancer in the world. According to the American Cancer Society, every hour one citizen of America dies from oral and throat cancer. In 2008, this disease was the cause of 7590 deaths in the United States. In 2012, Poland was classified as one of the countries with the highest mortality rate as regards patients suffering from oral cancer. Only in 2010, more than 3600 cases of lip, oral cavity and throat cancer were diagnosed, out of which 75% concerned men. In 60% of cases in Poland, the malignant disease of the oral cavity is diagnosed at the last stage of development.

2 Do you want to confirm your patient in their belief that you do not only care for their ideal smile? You can achieve this in a simple way by going beyond standard procedures applied at a dental office. Fluorescence-based device enables to diagnose inflammatory and neoplastic changes of oral mucosa and tongue. An examination with the use of will be a proof of your commitment towards the patient, and what is most important in certain instances may save their life.

3 Spend 2 3 minutes to do this simple test, which is painless, non-invasive and completely safe for both you and the patient. The test does not require any preparations or applying special safety measures. Find out how important it is. Perhaps you will save someone s life... Try... it s so simple.

4 is the first Polish device, based on the phenomenon of fluorescence, designed for initial diagnosis of inflammatory changes as well as neoplastic and precancerous lesions of oral mucosa. In comparison with competitive equipment available in the market, provides greater comfort for both the patient and the operator. This light and mobile device, fixed on the operator s head allows the practitioner to examine the patient using both hands. Owing to the best optics available in the market worldwide, images of changes in oral mucosa ensure much higher contrast, hence facilitate evaluation of the lesions. At the same time, the images are free from any deformations which are not a part of the examination (e.g. resulting from the fluorescence of bacterial flora).

5 source of light is placed on the practitioner s head, which allows them to use both hands during an examination. This is particularly important in dentistry, as it enables the operator to visualise the entire oral cavity. The construction of special glasses with a filter makes it possible for the practitioner to wear additional correction glasses without any problems. The device can be plugged into the mains network (230 V) or use batteries as a source of power. When connected to the network, the equipment can be both charged and operated at the same time. is a one-time investment; there are no additional costs that the dental practitioner has to incur to deal with new patients.

6 The characteristic features of Oralitest: The use of special filters, which guarantee high contrast of observed tissue fluorescence. The filters have been designed to eliminate other types of fluorescence, e.g. caused by bacteria. Small dimensions owing to the application of the LED technology. Even lighting conditions on a narrow field due to a specially designed set of lenses. Possibility of operation without the need to use hands by the practitioner. Silent operation that ensures comfort during an examination for both the practitioner and the patient. Long time of operation on batteries, and if the batteries are low a possibility to operate during charging from a mains network. The application of state-of-the-art control of lamp temperature, which prevents from overheating of the device to a temperature that could cause discomfort. Test: non-invasive painless quick safe A test does not require the use of disposable hygienic pads or rinsing of the oral cavity with unpleasant chemical substances (which reduces operating costs practically to zero). Owing to the filters used separately in the diagnostic glasses, provides an opportunity to observe lesions in the oral mucosa by several practitioners simultaneously.

7 Oralitest is comprised of: head-mounted source of light with a filter, mains charger, diagnostic and protective glasses with a filter for the practitioner, protective glasses for the patient. The device allows for several hours of operation without the need to connect it to mains power, hence it enables conducting screening tests (an efficient and reliable test takes only about 2 3 minutes). During the test, the device operates silently and does not generate any types of hum or noise. The equipment can be operated in combination with a special medical camera to record the entire procedure, which allows the practitioner to monitor pathological lesions and consult with other specialists. Live preview on any computer screen using wireless technology of images transfer is of utmost importance for teaching purposes.

8 The principle of operation The source of light emits excitation radiation in the form Tissue epithelium: of blue light. An excitation filter is located behind the source of light and its objective is to cut off a part of the spectrum so it does not correspond with the light of tissue autofluorescence emission. The light that reaches a tissue causes tissue fluorescence, which can be observed with Superficial layer Intermediate layer Parabasal layer Basal layer FAD FAD FAD Stratified squamous epithelium Basement membrane the help of an emission filter that allows the emitted light and blocks the excitation light. Lymphatic capillary vessels Stroma As opposed to other devices based on the same method, the design of has been optimised to ensure maximum contrast between a healthy tissue and neoplastic or precancerous lesions, with simultaneous elimination of the influence of other fluorescent phenomena, such as bacterial plaque. Collagen fibre matrix Capillary blood vessels Stromal cell Changes in the distribution of fluorophores and accompanying alterations in the absorption and decomposition of light by tissues may be used to identify progressing dysplasia of oral tissues. FAD Flavin adenine dinucleotide Nicotinamide adenine dinucleotide

9 fluorescence drop of fluorescence FAD concentration of the cells affected by a disease is lower, hence they are characterised by smaller fluorescence discerned with the naked eye. The device does not excite fluorescence. In pathological tissues, epithelium is harder and changes Epithelium hardening Nuclear dysplasia FAD FAD take place in the morphology of the nucleus combined with progressing dysplasia, which reduces the amount of fluorescence exciting light reaching collagen. Therefore, the amount of fluorescence excited in collagen bonds in pathological tissues is smaller than in healthy tissues. As it grows bigger, new capillary vessels are created in stroma. Blood absorbs more excitation light, hence fluorescence decreases. Change of collagen structure in the course of a malignant disease Rich network of capillary blood vessels

10 Oralitest is a good investment is a one-time investment; there are no additional costs that the dental practitioner has to incur to examine new patients. does not require the use of disposable hygienic pads or rinsing of the oral cavity with unpleasant chemical substances (which reduces operating costs practically to zero).

11 Literature: 1. Svistun E., Alizadeh-Naderi R., El-Naggar A., Jacob R., Gillenwater A., Richards- Kortum R.: Vision enhancement system for detection of oral cavity neoplasia based on autofluorescence. Head Neck, 2004, 26, 3: Oral cavity autofluorescence can be examined easily with the naked eye in real time. Visual examination of autofluorescence enables better detection of contrast between normal oral mucosa and neoplastic lesions in a freshly cut out tissue. 2. Rahman M.S.: Low cost optical imaging systems for early detection of oral cancer. ProQuest, Ann Arbor 2011 The results collected during work with this system show that it can be used together with contrast agents to visualise tissues in high definition when diagnosing cancer and precancerous lesions. 3. Lane P.M., Gilhuly T., Zeng H., Poh C.F., Williams P.M., Zhang L., Rosin M.P., MacAulay C.E., Ng S., Whitehead P.: Simple device for the direct visualization of oral-cavity tissue fluorescence. J. Biomed. Opt., 2006, 11, 2: The authors of the article predict that the device will have practical applications during screening examinations, biopsies and marking borders before a surgical procedure. 4. Heintzelman D.L., Utzinger U., Fuchs U., Zuluaga A., Gossage K., Gillenwater A.M., Jacob R., Kemp B., Richards-Kortum R.R.: Optimal excitation wavelengths for in vivo detection of oral neoplasia using fluorescence spectroscopy. Photochem. Photobiol., 2000, 72, 1: The results suggest that fluorescence spectroscopy may be a simple and objective tool to facilitate identification of neoplastic changes inside the oral cavity in vivo. 5. Lane P.: Urządzenia wykorzystujące zjawisko fluorescencji do bezpośredniej wizualizacji błony śluzowej jamy ustnej. e-dentico, 2007, 1 (21): 8 18 VELscope is a simple device designed for fluorescence visualisation of the field of vision of oral mucosa. It was optimised to detect high-risk precancerous changes and planoepithelial carcinoma. It was proven that VELscope can be used to supplement traditional visualisation in white light during a routine dental examination. Fluorescence visualisation is an effective technique of visualisation, whereas techniques of spot measurement are very good diagnostic tools. 6. MacAulay C.: Zastosowanie diagnostyczne autofluoresenceji tkankowej. e-dentico, 2007, 1 (21): A diagnostic application of tissue fluorescence is highly promising both now and in the future. 7. Ng S.P., Poh C.F., Williams P.M., Zhang L., MacAulay C., Rosin M.P.: Zastosowanie bezpośredniej wizualizacji fluorescencyjnej do identyfikacji zmian przedrakowych wysokiego ryzyka w jamie ustnej w prowincji Kolumbia Brytyjska. e-dentico, 2007, 1 (21): Using tissue optics to detect neoplastic and precancerous lesions has a very long history. Among the available technologies, fluorescence visualisation is very popular, among others during oral examinations. Under the influence of blue light generated by the device healthy and pink mucosa emits pale green fluorescent light referred to as FVR (fluorescence visualisation retained), whereas pathological tissues are usually characterised by dark green autofluorescence or even its lack (black areas) (FVL fluorescence visualisation loss). More on