Narrow-Band Imaging for the Detection of Oral Potentially Malignant Disorders and Early-Stage Oral Squamous Cell Carcinoma

Background: Early detection of oral potentially malignant disorders (OPMDs) and early-stage oral squamous cell carcinoma (OSCC) remains a major clinical challenge, as initial lesions often present with subtle or nonspecific findings during conventional white-light examination. Narrow-band imaging (NBI) enhances visualization of mucosal microvasculature and may improve the identification of dysplastic and malignant transformation. Methods: A narrative review of the literature was conducted in the PubMed, Scopus and Google Scholar databases. Studies published between January 2012 and January 2025 evaluating clinical applications of NBI in oral mucosal lesions, OPMDs, or OSCC were included. Results: NBI enhances visualization of intraepithelial papillary capillary loops (IPCLs), whose morphological alterations correlate with epithelial dysplasia and malignant transformation. Evidence suggests high diagnostic sensitivity (up to 87–100%) and specificity (approximately 83–96%) for detecting high-grade dysplasia and early OSCC. NBI also improves biopsy site selection, reduces sampling error, and supports surveillance of high-risk patients. Conclusions: NBI represents a valuable adjunctive diagnostic tool in oral medicine and dentistry. Although it does not replace histopathological examination, its integration into clinical assessment may enhance early cancer detection and improve management of patients with OPMDs.