RELIABILITY OF TOLUIDINE BLUE VITAL STAINING AS A DIAGNOSTIC ADJUNCT IN THE EARLY DETECTION OF POTENTIALLY MALIGNANT AND MALIGNANT DISORDERS

The first and foremost duty of an Oral Pathologist or any general dentist is to detect a potentially malignant and malignant lesion sufficiently early to prevent their progress to invasive carcinoma and metastasis. Prognosis of oropharyngeal squamous cell carcinoma (oral cavity and pharynx) depends on early diagnosis, despite advanced surgical techniques and adjuvant treatment. Their early detection may help to identify high-risk subjects thus allowing the clinician to initiate appropriate intervention measures to reduce the risk of later malignancy. Several adjunctive diagnostic clinical aids and agents are now available to facilitate both the visualization of oral cancers and the detection of potentially malignant disorders. Among these, the toluidine blue test is the most comprehensively studied method. Toluidine blue vital staining can serve as an important chair side investigation in detecting prompt premalignant lesion. Its feasibility rate is high since it is simple, inexpensive and sensitive in nature. Chemically Toluidine blue is a basic thiazine metachromatic dye having high affinity for acidic tissue components like DNA and RNA thus serves in detecting tissues rich in former mentioned proteins. Its metachromatic property leads its wide applications both as vital staining in living tissues and as a special stain. So it is being used often in vivo to identify dysplasia and carcinoma of the oral cavity. Its aim is to highlight components, such as mast cells granules, mucins, and cartilage. The study included 60 patients visiting the under routine OPD, of which 21 %( n=13) were females and 79 %( n=47) males. The age of the subjects ranged from 31-75 years, with a mean age of 53.83 years. Clinically a provisional diagnosis of homogeneous Leukoplakia, speckled Leukoplakia, Erythroplakia & Erosive lichen planus (Based on the criteria proposed by WHO 2005) was established after a detailed history of the lesion and through oral examination.