AI for Classifying Oral Cancer and Precursor Lesions Using Visible-Light Photography

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Abstract

Artificial intelligence shows promise for oral cancer detection, yet clinical translation remains limited. This scoping review examined 134 studies (2015–2025) investigating AI applications for oral lesion classification using visible-light clinical photography. Searches across Scopus, Web of Science, Embase, and PubMed followed PRISMA-ScR guidelines. Methodological limitations exist among studies; 25.4% utilised a single 131-image Kaggle dataset without ground-truth histological labelling, 99.3% employed supervised learning, and 8.2% performed external validation. Binary classification tasks predominated (59.7%), while dysplasia grading was seldom explored (10.4%). Convolutional neural network architectures, such as ResNet, dominated study designs. Critical gaps include limited multi-modal and multi-model integration, absence of ordinal classification approaches - reflecting disease progression, and underexplored potential of novel deep-learning architectures such as graph-based mechanisms, and use of frontier techniques to address data scarcity such as synthetic image generation.

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