Toluidine Blue And Acetic Acid Experiment

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ABSTRACT
Objective:
The purpose of the study is to compare and evaluation of the diagnostic efficiency of Toluidine Blue, Lugol’s iodine and Acetic acid in the detection of potentially malignant disorders (PMD’S).
Materials and methods: The study population consisted of 30 patients with clinically suspicious PMD’S. The lesions were stained consecutively with toluidine blue, lugol’s iodine & acetic acid depending on the retention of the dyes, the biopsy site was determined and sent for histological confirmation.
Statistical Analysis Chi-square test was used to compare between Toluidine blue, Lugol’s iodine and Acetic acid. Diagnostic efficiency was calculated by sensitivity and specificity test to determine the utility of the test results.
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In the present study, among the 30 potentially malignant lesions, 7(23.3%) were homogenous leukoplakia, 16 (53.3%) were non homogenous leukoplakia and 7(23.34%) were erosive lichen planus. All patients with leukoplakia had the habit of smoking, alcoholic and pan chewing, whereas patients with lichen planus had no history of Tobacco abuse.

On performing comparative analysis between different staining modalities with Histopathological grades, non-significant results were reported. The sensitivity and specificity for Acetic acid was 83.3% and 8.3% respectively and for Toluidine blue, the sensitivity and specificity was 57.6% and 25% respectively. This was in agreement with previous results. [10,16] DISCUSSION
The concept of initial presence of a precursor lesion subsequently developing into cancer is well established and an early detection of oral mucosal epithelial dysplasia could halt the progression of these lesions into malignant transformation.[9] Thus, the establishment of adjunctive techniques is useful to clinical
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The literature on Toluidine blue is large and a recent systematic review 50 identified 77 publications. However, only 14 of these evaluated the ability of the dye to identify oral cancers that would not otherwise have been diagnosed by unaided clinical examination. Unfortunately these studies are of limited relevance to the use of the dye as a screening test, because none were randomized controlled trials, none were conducted in a primary care setting and most studies were case series conducted by specialists on high-risk populations often with known

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