Study Year of
publication 		Study design Sample size Gender distribution Age
(years) 		Type of oral lesions Diagnostic context Type of IF Specific antibodies used
Hasler et al. [8] 1972 Case series 4 patients 3 males, 1 female
(case 1: one black woman; case 2 to 4: one Caucasian man in each case) 		Case 1: 40; case 2: 59; case 3: 34; case 4: 65 DG, erosive and ulcerative lesions of the oral cavity PV and bullous pemphigoid IIF Intercellular space antibodies in PV, antibodies against BMZ antigen in bullous pemphigoid
Donatsky et al. [9] 1974 IF study 24 patients with simple type of RAS,
24 controls without RAS 		- - Unkeratinized buccal human oral mucosa from a RAS patient, unkeratinized buccal human oral mucosa from a control, adult human skin, adult human smooth muscle, adult guinea-pig oral mucosa Humoral immunity to adult human oral mucosa in RAS of the simple type Double-layer IF staining method Humoral antibodies
Torabinejade et al. [10] 1979 Cross-sectional 25 dental periapical lesions - - Dental periapical lesions Patients undergoing periapical surgery Anti-complement IF Fluorescein-conjugated goat anti-guinea pig complement (C3 fraction)
Acosta et al. [11] 1981 Observational, comparative study 36 (10 active oral lesions, 3 in remission, 7 recurrent oral ulceration [aphthous ulcers], 2 MMP, 3 erosive lichen planus, 1 erythema multiforme, 10 clinically healthy oral mucosa) PV: 7 males, 6 females 48 to 82 PV, aphthous ulcers, MMP, erosive lichen planus - erythema multiforme, clinically healthy oral mucosa Diagnosis of PV DIF FITC-conjugated sheep anti-human IgG, IgA, IgM
Daniels et al. [12] 1981 Retrospective analysis 130 cases of chronic or recurrent ulcerative/erosive oral mucosal diseases - 64.9 Chronic or recurrent ulcerative/erosive diseases of the oral mucosa Diagnosis based on history, clinical features, histopathology, and clinical follow-up (DIF results not used to establish diagnosis) DIF Goat antisera against human IgG, IgA, IgM, C3 (complement), and fibrinogen
Fine et al. [13] 1984 Descriptive study 10 patients 6 males, 4 females 36 to 84 Cicatricial pemphigoid Examination of IF and immunoelectron microscopy in diagnosing cicatricial pemphigoid DIF Specific antibodies against human IgG, IgA, and C3
Firth et al. [14] 1990 Observational study 165 biopsy specimens - - OMLP To assess the value of DIF microscopy in diagnosing OMLP DIF microscopy Anti-fibrinogen, anti-C3, anti-Clq, anti-IgA, anti-IgG, anti-IgM
Lodi et al. [15] 1997 Cross sectional study 67 patients - - Non-erosive OLP Diagnosis of OLP based on WHO criteria IIF Circulating antibodies against epithelial antigens
Yih et al. [16] 1998 Observational study 72 cases of DG - 26 to 83 Erosive lichen planus or lichenoid mucositis, benign MMP, linear IgA disease, PV, bullous pemphigoid, paraneoplastic pemphigus (7 cases could not be defined) Diagnosis of chronic DG using DIF in conjunction with histology DIF IgG, IgM, IgA, C3c, fibrinogen
Bhol et al. [17] 2001 Immunological study 20 patients - - Oral pemphigoid Sera from untreated patients with active pemphigoid disease, limited to the oral cavity IIF assay Monoclonal antibodies to human α6 integrin were used to detect the presence of autoantibodies in the sera of patients
Nakano et al. [18] 2002 IF study 2 ameloblastoma samples - - Ameloblastoma Distinguish ameloblastoma from other lesions, assess tumour progression IIF Rat monoclonal antibodies against collagen IV α1, α2, α3, α4, α5, α6 chains
Kolde et al. [19] 2003 Retrospective study 30 diagnostic biopsies from 27 patients 7 males, 20 females Mean 54 Biopsies were taken from the buccal or gingival mucosa Differentiating OLP from other immunologically mediated oral mucosal diseases like pemphigoid, PV, and LE DIF testing FITC-conjugated polyclonal rabbit antibodies against IgG, IgA, IgM, complement C3, and fibrinogen
Musa et al. [20] 2005 Retrospective study 392 consecutive cases - 30 to 60 OLP Clinical diagnosis by contributing clinicians, histologic examination by 3 oral pathologists, DIF diagnosis DIF Fibrin, immunoglobulins, and C3
Kulthanan et al. [21] 2007 Retrospective study 72 patients 36 males, 36 females 6 to 76 Lichen planus Differentiation of LP from other conditions, especially LE, in cases with no specific clinical or histologic characteristics or ambiguous features DIF IgG, IgA, IgM, C3, fibrin
Suresh et al. [22] 2012 Retrospective analysis 239 consecutive cases of gingival biopsy with clinical diagnosis of DG 49 males, 190 females 16 to 95 OLP, pemphigoid clinical associations of DG and utility of DIF for definitive diagnosis DIF Humoral antibodies
de Freitas Silva et al. [23] 2014 Experimental study 30 oral leukoplakia, 20 OSCC, 10 normal oral mucosa specimens 41 males, 19 females - Oral leukoplakia, OSCC Evaluation of Twist and E-cadherin expression in the development and progression of OSCC Double IF Anti-Twist, anti-E-cadherin
Rameshkumar et al. [24] 2015 Retrospective and prospective analysis Retrospective: 70 (20 OLP, 20 DLE, 20 PV; 10 MMP). Prospective: 12 (chronic/recurrent ulcerative, erosive or vesiculobullous oral lesions) - - OLP, DLE, PV, MMP, chronic/recurrent ulcerative, erosive or vesiculobullous oral lesions Clinical features, histopathology and DIF DIF Not specified
Hashimoto et al. [25] 2015 Retrospective study 12 cases (granular C3 deposition seen in 10 cases) 2 males and 8 females 52.4 Erythemas, reticular lace-like whitish coating, erosions and ulcers on oral mucosae and lips Suspected autoimmune bullous diseases DIF IgG, IgA
Montague et al. [26] 2015 Retrospective study 164 cases of oral premalignant lesions and squamous cell carcinoma 59 males, 105 females 64.9 Premalignant lesions (verrucous hyperplasia, low-grade dysplasia, high-grade dysplasia) and squamous cell carcinoma DIF testing to differentiate OLP from other immune-mediated diseases, oral dysplasia, and squamous cell carcinoma DIF Fibrinogen reactivity at the BMZ

ACIF = anti-complement immunofluorescence; ANA = antinuclear antibody; BMZ = basement membrane zone; C3 = complement component 3; DIF = direct immunofluorescence; DLE = discoid lupus erythematosus; DG = desquamative gingivitis; FITC = fluorescein isothiocyanate; H&E = hematoxylin and eosin; IIF = indirect immunofluorescence; IgG = immunoglobulin G; IgA = immunoglobulin A; IgM = immunoglobulin M; LE = lupus erythematosus; MIF = multiplexed immunofluorescence; MMO = maximum mouth opening; OLDR = oral lichenoid dysplasia; OLL = oral lichenoid lesions; OLP = oral lichen planus; OMLP = oral mucosal lichen planus; OSCC = oral squamous cell carcinoma; OSF = oral submucous fibrosis; PV = pemphigus vulgaris; RAS = recurrent aphthous stomatitis; T1 = tumour size classification (smallest); T4 = tumour size classification (largest); WHO = world health organization; IF = immunofluorescence.