Identafi 3000 ultra handpiece and disposable mirror cover.
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Over the last couple of decades, advances in semiconductor and fiber optic technology have made available inexpensive light sources and detectors for tissue visualization and evaluation. These help make conditions that are difficult to visualize under white light, easy to see. One such condition is oral cancer.

Realizing the oral care potential of advanced visualization technologies, Trimira LLC, a Houston-based startup, embarked upon a research and development effort that resulted in the development and launch of the Identafi 3000 ultra.

White light methods fall short

Viewing oral cavity tissues with white light is effective in detecting many lesions and conditions, however conditions such as some viral and bacterial infections, precancerous conditions, and subtle inflammatory conditions are difficult to visualize under white light. Two advancements—fluorescence visualization and narrowband illumination visualization—are addressing these challenges.

Identafi 3000 ultra fluorescence.
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Copyright: Trimira.

Fluorescence visualization works by illuminating tissues with light of a particular color and detecting the light emitted at other colors. For example, when normal oral cavity tissues are illuminated with violet light around 405 nm, they emit fluorescence that appears light blue. This is due to the response from chemicals in cells associated with the metabolic rate, as well as from some tissue structural components such as collagen and elastin. Fluorescence, while relatively dim compared with reflected light, is very sensitive to changes such as those caused by viral and bacterial infections and precancerous conditions.

Narrowband illumination is a form of reflectance visualization using only selected colors rather than white light. If the presence or absence of blood were to be emphasized, illuminating tissue with colors that are strongly absorbed preferentially by blood such as green light around 545 nm would be indicated. Under this illumination normal tissues look medium green while blood vessels look brown/black.

A tool is born

Ergonomically designed to feel as familiar as a dental handpiece or mirror in the hands of dentist or hygienist, much like a dental handpiece or mirror, the Identafi 3000 ultra enhances the providers’ visualization capabilities by incorporating additional fluorescence and narrowband reflectance illumination modes. It allows for quick and thorough examination of all areas of the oral cavity, including the base of the tongue, lingual and palatine tonsils, and the oropharynx.

The system has three components: a handpiece, a disposable sheath with a mirror, and special filtering glasses. The thin, long handpiece provides three illumination modes: bright white light for a conventional exam; violet light at 405 nm to excite tissue autofluroescence that provides optimum contras between normal and precancerous tissues; and green-amber illumination (dominant at 545 nm) that highlights the presence or absence of vascular features.

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