{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:06:38Z","timestamp":1787169998808,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diagnostic adjuncts such as toluidine blue have been investigated as screening tools that improve visual examination of potentially malignant disorders (PMD) and oral cancer. Acetic acid has been reported to be of value in the early detection of cervical cancers. This study assessed the utility of 5% acetic acid as a diagnostic adjunct in oral PMD and compared the accuracy of acetic acid with toluidine blue in the detection of dysplastic PMD and high-risk lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted at a dental hospital in a rural setting. Thirty-one patients with oral PMD formed the study group. Five percent acetic acid was applied to the lesions, followed by toluidine blue application and biopsy. Sensitivity, specificity, and positive and negative predictive values were computed considering true positives as stain uptake in dysplastic and high-risk PMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The sensitivity, specificity, and positive and negative predictive values of acetic acid for identifying dysplastic or malignant lesions were 100%, 13.3%, 51.2%, and 100%, respectively, and that for toluidine blue were 75%, 100%, 100%, and 78.9%, respectively. The corresponding values for identifying high-risk PMD (lesions with moderate and severe dysplasia) using acetic acid were 100%, 9.1%, 25.9%, and 100%, respectively, and for toluidine blue were 85.7%, 81.8%, 60%, and 94.7%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The utility of acetic acid in detecting dysplasia and high-risk PMD is severely limited due to its poor specificity. Compared with acetic acid, toluidine blue is a superior screening tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_42_21","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T03:30:51Z","timestamp":1696044651000},"page":"427-431","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Acetic acid versus toluidine blue as screening tools for oral potentially malignant disorders"],"prefix":"10.4103","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9256-2681","authenticated-orcid":false,"given":"San Rose","family":"Winton Kalluvelil","sequence":"first","affiliation":[{"name":"Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3759-4351","authenticated-orcid":false,"given":"Veena S.","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"319","DOI":"10.14219\/jada.archive.1983.0063","article-title":"Final evaluation of tolonium chloride rinse for screening of high-risk patients with asymptomatic squamous carcinoma","volume":"106","author":"Mashberg","year":"1983","journal-title":"J Am Dent Assoc"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1002\/hed.10309","article-title":"The utility of tolonium chloride rinse in the diagnosis of recurrent or second primary cancers in patients with prior upper aerodigestive tract cancer","volume":"25","author":"Epstein","year":"2003","journal-title":"Head Neck"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1067\/moe.2001.112949","article-title":"Reliability of toluidine blue application in the detection of oral epithelial dysplasia and in situ and invasive squamous cell carcinomas","volume":"91","author":"Onofre","year":"2001","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.oraloncology.2005.06.016","article-title":"Toluidine blue uptake in potentially malignant oral lesions in vivo:Clinical and histological assessment","volume":"42","author":"Gandolfo","year":"2006","journal-title":"Oral Oncol"},{"key":"R5-20240828","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1007\/s00784-015-1457-9","article-title":"Assessing the accuracy of autofluorescence, chemiluminescence and toluidine blue as diagnostic tools for oral potentially malignant disorders--a clinicopathological evaluation","volume":"19","author":"Awan","year":"2015","journal-title":"Clin Oral Investig"},{"key":"R6-20240828","first-page":"351","article-title":"Early detection of cervical cancer through acetic acid application--an aided visual inspection","volume":"42","author":"Singh","year":"2001","journal-title":"Singapore Med J"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/ijc.11245","article-title":"Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India","volume":"106","author":"Sankaranarayanan","year":"2003","journal-title":"Int J Cancer"},{"key":"R8-20240828","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.tripleo.2008.01.017","article-title":"The application of acetic acid in the detection of oral squamous cell carcinoma","volume":"106","author":"Bhalang","year":"2008","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4103\/0973-029X.164521","article-title":"Acetic acid as an adjunct vital stain in diagnosis of tobacco-associated oral lesions:A pilot study","volume":"19","author":"Vinuth","year":"2015","journal-title":"J Oral Maxillofac Pathol"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/j.1600-0714.2007.00582.x","article-title":"Nomenclature and classification of potentially malignant disorders of the oral mucosa","volume":"36","author":"Warnakulasuriya","year":"2007","journal-title":"J Oral Pathol Med"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1002\/1097-0142(197510)36:4<1386::AID-CNCR2820360430>3.0.CO;2-7","article-title":"Leukoplakia revisited. 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