Historical Development of Oral Cytology

The seminal work by Papanicolaou and Traut in studying the cells from precancerous and cancerous lesions of the cervical mucosa paved the way for oral cytology. Their work proved an effective tool for screening gynecologic malignant disease [ 1 ] . Initially, the use of oral cytology was limited to comparative studies of oral and cervical cytology, describing cytomorphological changes depending on the menstrual cycle. Interestingly, buccal smears also have been reported to show marked cyclic fl uctuation in keratinization during the normal menstrual cycle [ 2– 4 ] . In the second half of the nineteenth century, the morphology of malignant cells in sputum was fi rst described from an oropharyngeal carcinoma [ 5 ] . This was followed by work of Morrison et al. in which they used Papanicolaou staining to diagnose nasopharyngeal carcinomas [ 6 ] . But it was Montgomery and von Haam who were the fi rst to examine the usefulness of cytology in the oral cavity [ 7 ] . Some further studies showed the application of oral cytology by animal experiments [ 8, 9 ] . Oral cytology has been used effectively as a research tool for the evaluation of experimentally induced carcinomas in hamster cheek pouches and in healing of gingivectomy wounds [ 10 ] . Much later, Sandler, through his series of reports on Veterans Administration studies of oral cytology, focused attention on the potential of the technique as an aid to early detection of oral cancer [ 11 ] . These landmarks in the development of oral exfoliative cytology are listed in Table 2.1 .