Sonodynamic inactivation of gram-negative and gram-positive bacteria in the presence of phenothiazine compounds toluidine blue and azurin A.

BACKGROUND: Sonodynamic antimicrobial chemotherapy (SACT) is an effective antimicrobial treatment that can avoid the production of drug-resistant bacteria. Design and development of new high-efficiency sonosensitizers play a key role in the practical application of SACT. METHODS: The bacteriostatic effects of two phenothiazine compounds, toluidine blue (TB) and azure A (AA) combined with ultrasonic (US) on Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) were studied, and the sonodynamic antibacterial activities of TB and AA were compared. The reactive oxygen species (ROS) and the types of ROS produced in the sonodynamic system were detected and the sonodynamic mechanisms of TB and AA were proposed. RESULTS: The sonodynamic bacteriostasis mediated by TB and AA increased with the increasing concentration of sonosensitizer, the extension of sonication time and the increase of reaction temperature. The production of ROS was the main reason that TB and AA had excellent sonodynamic antibacterial performance. Singlet oxygen (1O2) and hydroxyl radical (•OH) were the main ROS types in the sonodynamic antibacterial system. The ROS produced by the combined action of AA and US was higher than that of TB. CONCLUSION: Both TB and AA displayed excellent sonodynamic antibacterial activities. Moreover, AA had a higher sonodynamic activity than TB. The electron donation effect and steric hindrance effect of the methyl group of phenothiazine parent nucleus of TB might be the cause of the decrease of its sonodynamic activity. These results would provide a valuable reference for the further study of phenothiazines sonosensitizers and their clinical application in SACT.

Solitary Cutaneous Mastocytoma in an Adult Diagnosed on Cytology: A Rare Case Report.

Mastocytosis is characterized by the proliferation of neoplastic mast cells in various organs, which can have either cutaneous or systemic presentation. Solitary cutaneous mastocytomas are most commonly seen in the pediatric age group but rarely present in adults. Histopathology of cutaneous mastocytoma is well described in the literature but only a few studies are available describing the cytomorphological features. We present a case of a 19-year-old female who presented with a 6-month history of a right supraclavicular single, 0.5 × 0.5 cm, well-defined, reddish-brown round nodule. The fine needle aspiration cytology (FNAC) smears were highly cellular showing monomorphic cells, predominantly dispersed singly and occasionally in small clusters. The cells were round to oval, with moderate cytoplasm containing coarse metachromatic granules. Toluidine blue stain and CD117 immunocytochemical stain confirmed the presence of mast cell granules. Based on the cytomorphology, staining, clinical history, and examination, a diagnosis of solitary cutaneous mastocytoma was rendered. FNAC plays a pivotal role in diagnosing mast cell tumors and even obviates the need for tissue biopsy in selected cases.

Facile coupling of plasmonic Au-NPs on ZnS NFs as a robust SERS substrate for toluidine blue detection and degradation.

BACKGROUND: The robustness and sensitivity of the surface-enhanced Raman spectroscopy (SERS) technique heavily relies on the development of SERS active materials. A hybrid of semiconductor and plasmonic metals is highly effective as a SERS substrate, which enables the trace level detection of various organic pollutants. RESULTS: This approach demonstrates the photodeposition of plasmonic gold nanoparticles (Au-NPs) on the surface of semiconductor-zinc sulfide nanoflowers (ZnS NFs), grown via the hydrothermal route. The synergistic contribution of the charge-transfer phenomenon and localized surface plasmon resonance of the Au-NPs/ZnS NFs makes it an ideal SERS substrate for the detection of organic pollutants, toluidine blue (TB). The proposed material has a high SERS enhancement factor (109), low limit of detection (10-11 M), good reproducibility, selectivity and strong anti-interference ability. Furthermore, the practicability of the Au-NPs/ZnS NFs is explored in real-time water samples, which are obtained with the satisfactory recovery rates. Additionally, the UVC light illumination on the Au-NPs/ZnS NFs has efficiently degraded TB within a time period of 150 min. SIGNIFICANCE AND NOVELTY: These finding demonstrate the significance of the proposed Au-NPs/ZnS NFs for SERS based detection and degradation of organic pollutants in real-time samples, highlighting their potential in monitoring and treating water pollutants in wastewater.

Labeled sandwich-type electrochemical immunosensor based on Ti3C2Tx/AuNP and Ti3C2Tx/HKUST-1/TB composites for early liver cancer detection.

A novel sandwich-type electrochemical immunosensor for the detection of the liver cancer marker alpha-fetoprotein (AFP) in human serum is proposed. The two-dimensional MXene material Ti3C2Tx was first prepared using etching and ultrasonic stripping, and then Ti3C2Tx was used to reduce chloroauric acid to form Ti3C2Tx/AuNP composites which were modified on the surface of the glassy carbon electrodes to form probe-type sensors. The Ti3C2Tx/AuNPs provide a large number of binding sites for the AFP capture antibody (Ab1) and increase the electrochemical reaction active site. The Ti3C2Tx/copper metal-organic frameworks HKUST-1 composite was also prepared by solvothermal method and combined with toluidine blue (TB) and AFP detection antibody (Ab2) to form a labeled sandwich-type electrochemical immunosensor. The sensor achieved trace detection of AFP from 0.1 to 100 ng/mL with a detection limit of 0.073 pg/mL and possesses good selectivity, stability, and reproducibility. The sensor performs well in clinical samples and has good potential for clinical applications.

Destruction of cariogenic biofilms by antimicrobial photodynamic therapy mediated by phycocyanin and toluidine blue along with sodium fluoride varnish or titanium tetrafluoride.

OBJECTIVE: Evaluation of the effect of phycocyanin (PC) and toluidine blue (TBO) along with sodium fluoride varnish (FV) or titanium tetrafluoride (TiF4) under the conditions of antimicrobial photodynamic therapy (PDT) on a dual-species cariogenic biofilm and on remineralization process. DESIGN: After the development of Streptococcus mutansStreptococcus mutans and Lactobacillus acidophilus dual-species biofilms on the human enamel disks, they were divided into 11 groups (n = 9): Control (0.9 % saline), PC, TBO, FV, and TiF4 alone, PC and TBO in combination with a 635 nm diode laser (PDT treatment), PC-PDT+ (PC + FV or TiF4 + 635 nm diode laser), and TBO-PDT+ (TBO + FV or TiF4 + 635 nm diode laser). After the treatment, crystal violet assay was performed to determine the reduction of cariogenic biofilms. Enamel remineralization changes were analyzed using energy dispersive X-ray spectroscopy (EDX) and field emission scanning electron microscopy (FESEM) for the calcium and phosphorus (Ca/P) ratio. RESULTS: Only TBO-PDT+ showed superior antibiofilm activity when TiF4 was applied. Furthermore, the highest Ca/P ratio was found after treatment of enamel surfaces with TiF4-TBO-PDT+. The FESEM images showed that the enamel disks treated with TiF4 plus TBO-mediated PDT exhibited surface coating. However, TiF4 plus PC-mediated PDT cannot repair demineralized enamel. CONCLUSIONS: These data suggest that TBO-PDT along with TiF4 can effectively reduce cariogenic biofilms and significantly remineralize enamel disks, opening new avenues in caries prevention.

A mammalian model reveals inorganic polyphosphate channeling into the nucleolus and induction of a hyper-condensate state.

Inorganic polyphosphate (polyP) is a ubiquitous polymer that controls fundamental processes. To overcome the absence of a genetically tractable mammalian model, we developed an inducible mammalian cell line expressing Escherichia coli polyphosphate kinase 1 (EcPPK1). Inducing EcPPK1 expression prompted polyP synthesis, enabling validation of polyP analytical methods. Virtually all newly synthesized polyP accumulates within the nucleus, mainly in the nucleolus. The channeled polyP within the nucleolus results in the redistribution of its markers, leading to altered rRNA processing. Ultrastructural analysis reveals electron-dense polyP structures associated with a hyper-condensed nucleolus resulting from an exacerbation of the liquid-liquid phase separation (LLPS) phenomena controlling this membraneless organelle. The selective accumulation of polyP in the nucleoli could be interpreted as an amplification of polyP channeling to where its physiological function takes place. Indeed, quantitative analysis of several mammalian cell lines confirms that endogenous polyP accumulates within the nucleolus.

Brain structure alterations following neonatal exposure to low-frequency electromagnetic fields: A histological analysis.

Nitric oxide (NO) and electromagnetic fields (EMF) have been extensively studied for their roles in neurobiology, particularly in regulating cerebral functions and synaptic plasticity. This study investigates the impact of EMFs on NO modulation and its subsequent effects on neurodevelopment, building upon prior research examining EMF exposure's consequences on Wistar albino rats. Rats were exposed perinatally to either tap water, 1 g/L of L-arginine (LA) or 0.5 g/L of N-methylarginine (NMA). Half of the rats in each group were also exposed to a 7-Hz square-wave EMF at three separate intensities (5, 50 and 500 nT) for 2-14 days following birth. Animals were allowed to develop, and their brains were harvested later in adulthood (mean age = 568.17 days, SD = 162.73). Histological analyses were used to elucidate structural changes in key brain regions. All brains were stained with Toluidine Blue O (TBO), enabling the visualization of neurons. Neuronal counts were then conducted in specific regions of interest (e.g. hippocampus, cortices, amygdala and hypothalamus). Histological analyses revealed significant alterations in neuronal density in specific brain regions, particularly in response to EMF exposure and pharmacological interventions. Notable findings include a main EMF exposure effect where increased neuronal counts were observed in the secondary somatosensory cortex under low EMF intensities (p < 0.001) and sex-specific responses in the hippocampus, where a significant increase in neuronal counts was observed in the left CA3 region in female rats exposed to EMF compared to unexposed females (t(18) = 2.371, p = 0.029). Additionally, a significant increase in neuronal counts in the right entorhinal cortex was seen in male rats exposed to EMF compared to unexposed males (t(18) = 2.216, p = 0.040). These findings emphasize the complex interaction among sex, EMF exposure and pharmacological agents on neuronal dynamics across brain regions, highlighting the need for further research to identify underlying mechanisms and potential implications for cognitive function and neurological health in clinical and environmental contexts.

A mechanistic study on the toluidine blue/ photodynamic therapy inhibition of lipopolysaccharide-induced inflammatory response in rat gingival fibroblasts.

The purpose of this research was to investigate the effect of toluidine blue (TB) mediated photodynamic therapy (PDT) on the inhibition of lipopolysaccharide (LPS)-induced inflammation in rat gingival fibroblasts through in vitro experiments. Rat gingival fibroblasts were divided into five groups: (1) control, (2) LPS treatment, (3) laser treatment, (4) TB treatment (1.0 µg/mL), and (5) PDT treatment (TB plus laser irradiation at 320 mW/cm2 for 240 s). After 24 h, cell growth activity was measured using MTT assay. The levels of receptor activator for nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) in the cell culture supernatant were measured using enzyme-linked immunosorbent assay (ELISA). Nuclear proteins were extracted and the phosphorylation levels of phosphorylated nuclear factor-κB/p65 (p-p65) and phosphorylated inhibitor of nuclear factor-κB (p-IκBα) were determined using Western Blot. MTT results showed no significant difference in cell viability between the groups (P > 0.05). After LPS induction, OPG expression decreased, RANKL expression increased, and the OPG/RANKL ratio decreased, which was different from the control group (P < 0.05). After PDT treatment, OPG expression increased, RANKL expression decreased (P < 0.05), and the OPG/RANKL ratio increased (P < 0.05). Compared to the control group, there was no significant difference in OPG and RANKL expression or the OPG/RANKL ratio (P > 0.05). The activation of NF-κB was closely related to the phosphorylation levels of p-p65 and p-IκBα. LPS significantly up-regulated p-p65 and p-IκBα expression (P < 0.05), while PDT treatment decreased their phosphorylation levels (P < 0.05). TB-PDT treatment can inhibit NF-κB signaling pathway activation, decrease RANKL and OPG expression, and reduce the OPG/RANKL ratio, thereby reducing inflammation and playing a role in periodontitis treatment.

Community-based early detection of oral precancerous lesion, accessibility and utilization of oral healthcare services among Irular tribes residing at union territory of Pondicherry.

Background: The present study was conducted to estimate the prevalence of oral carcinoma and precancerous lesion, oral healthcare seeking behaviour and identify accessible areas of tobacco cessation centres and oral healthcare facilities among Irular adult tribes residing in Pondicherry. Objectives: 1. To estimate the prevalence of oral carcinomas and precancerous lesion by using toluidine blue solution. 2. To determine their oral healthcare seeking behaviour in terms of utilizing oral healthcare facilities. 3. To identify accessible tobacco cessation centres and oral healthcare centres for prevention of oral cancer. Materials and Methods: A cross-sectional study is designed to identify oral carcinomas, oral health-care seeking behaviour among Irular tribes of Pondicherry. 1% toluidine blue solution prepared for detection of oral precancerous lesion. Data was collected using a questionnaire and clinical examination. The collected data was subjected to statistical analysis. Results: Out of 587 study population, oral mucosal lesion among the study population was 46 (7.8%) leukoplakia and 18 (3.1%) candidiasis. Positive health seeking behaviour 24 (41.7%) was observed. Conclusion: The study concluded that low prevalence of oral precancerous lesion and oral healthcare seeking behaviour is poor.

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial.

BACKGROUND: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). METHODS: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. RESULTS: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). CONCLUSIONS: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.

Rapid on-site evaluation and cell blocks: getting the most from the least invasive method in cytopathology.

INTRODUCTION: Fine needle aspiration cytology (FNAC) sampling is a minimally invasive procedure done to identify the pathology behind superficial and deep-seated lesions. Rapid on-site evaluation (ROSE) can be an adjunct to the FNACs. Our study aimed to identify the role of ROSE in diagnostic adequacy and to check the benefit of cell block (CB)/cell buttons prepared from the ROSE samples. MATERIAL AND METHODS: A prospective study was conducted where all patients referred for FNAC were included. ROSE using 1% aqueous toluidine blue stain and CB/cell button preparations were done for the identification of various cytological lesions. RESULTS: Among 600 cases included in the study most common age group was third and fourth decades with a mean age of 41.6 years and M: F ratio of 1:1.7. Ultrasound-guided procedures were done in 20% of cases. CB preparation was available in 14% of cases. Most CBs were from the cases wherein ROSE was performed 81% (77 out of 86), with CB helping in making an accurate diagnosis in 17% of cases. Lymph nodes 26%, and thyroid 23% were the most common sites for sampling with the highest number of repeat procedures from non-ROSE cases (14%). The non-diagnostic rate for non-ROSE cases was 7.7% (23/300) even after the repeat procedures as compared to 1.3% (4/300) for ROSE. Three slides on average were consumed in ROSE-performed procedures, as compared to an average of 5 slides in non-ROSE. The average turnaround time was 1.7 days for non-ROSE cases and 1.05 for ROSE cases respectively. Cyto-histopathological correlation was available in 40% of cases with a sensitivity of 98.1%, specificity of 96.7%, positive predictive value of 90%, negative predictive value of 99.4%, and diagnostic accuracy of 97%. The correlation of CB, number of slides consumed, and turnaround time among the 2 groups were statistically significant (P value < 0.001). CONCLUSIONS: ROSE is a method used to assess material aspirated at the time of FNAC procedures to determine the adequacy and to an extent to identify whether the lesion is neoplastic or non-neoplastic. CBs have helped in increasing diagnostic accuracy apart from the fact that the paraffin-embedded tissue material can be used for further studies.

Enhancing Phototoxicity in Human Colorectal Tumor Cells Through Nanoarchitectonics for Synergistic Photothermal and Photodynamic Therapies.

Phototherapies are promising for noninvasive treatment of aggressive tumors, especially when combining heat induction and oxidative processes. Herein, we show enhanced phototoxicity of gold shell-isolated nanorods conjugated with toluidine blue-O (AuSHINRs@TBO) against human colorectal tumor cells (Caco-2) with synergic effects of photothermal (PTT) and photodynamic therapies (PDT). Mitochondrial metabolic activity tests (MTT) performed on Caco-2 cell cultures indicated a photothermal effect from AuSHINRs owing to enhanced light absorption from the localized surface plasmon resonance (LSPR). The phototoxicity against Caco-2 cells was further increased with AuSHINRs@TBO where oxidative processes, such as hydroperoxidation, were also present, leading to a cell viability reduction from 85.5 to 39.0%. The molecular-level mechanisms responsible for these effects were investigated on bioinspired tumor membranes using Langmuir monolayers of Caco-2 lipid extract. Polarization-modulation infrared reflection-absorption spectroscopy (PM-IRRAS) revealed that the AuSHINRs@TBO incorporation is due to attractive electrostatic interactions with negatively charged groups of the Caco-2 lipid extract, resulting in the expansion of surface pressure isotherms. Upon irradiation, Caco-2 lipid extract monolayers containing AuSHINRs@TBO (1:1 v/v) exhibited ca. 1.0% increase in surface area. This is attributed to the generation of reactive oxygen species (ROS) and their interaction with Caco-2 lipid extract monolayers, leading to hydroperoxide formation. The oxidative effects are facilitated by AuSHINRs@TBO penetration into the polar groups of the extract, allowing oxidative reactions with carbon chain unsaturations. These mechanisms are consistent with findings from confocal fluorescence microscopy, where the Caco-2 plasma membrane was the primary site of the cell death induction process.

Evaluation of Usage of Different Diagnostic Aids for Oral Cancer by Oral and Maxillofacial Surgeons: An Original Research.

Objective: The purpose of this study was to assess how oral and maxillofacial surgeons used various diagnostic tools for oral cancer. Materials and Methods: A cross-sectional methodology was used, and a standardized questionnaire was given to oral and maxillofacial surgeons randomly chosen sample. The questionnaire gathered information on demographics and the use of diagnostic tools. Data analysis methods included Chi-square testing and descriptive statistics. Results: The study included 200 oral and maxillofacial surgeons in total. The most often used diagnostic tool (95%) was visual inspection, followed by toluidine blue staining (48%) and brush biopsy (32%). Less frequently used were newer methods like optical coherence tomography (12.5%) and autofluorescence imaging (15%). No significant correlations between demographic factors and patterns of use of diagnostic tools were found by Chi-square tests. Conclusion: The results show that oral and maxillofacial surgeons frequently use brush biopsy, toluidine blue staining, and ocular evaluation. However, there is a need for more widespread adoption of cutting-edge technologies. By removing obstacles and offering training opportunities, one can increase the use of diagnostic tools, improving patient outcomes and the diagnosis of oral cancer.

The Biosorption Capacity of the Marine Microalga Phaeodactylum tricornutum for the Removal of Toluidine Blue from Seawater.

A wide variety of dyes, such as toluidine blue (TB), are used daily for a multitude of purposes. After use, many of these compounds end up in aqueous effluents, reaching natural environments, including marine environments. The removal of these pollutants from marine environments must be considered a priority problem. The search for natural techniques, such as biosorption, is a preferred option to eliminate pollution from natural environments. However, biosorption studies in seawater are scarce. For this reason, the living biomass of the marine microalga Phaeodactylum tricornutum was studied to determine its ability to remove TB from seawater. The kinetics of the biosorption process, the isotherms, and the effect of light and pH were determined. This biomass showed a maximum TB removal capacity of 45 ± 2 mg g-1 in the presence of light. Light had a positive effect on the TB removal capacity of this living biomass. The best fitting kinetics was the pseudo-second order kinetics. The efficiency of the removal process increased with increasing pH. This removal was more effective at alkaline pH values. The results demonstrated the efficacy of P. tricornutum living biomass for the efficient removal of toluidine blue dye from seawater both in the presence and absence of light.

Mast cell distribution and prevalence in the murine urinary bladder.

BACKGROUND: Mast cells have been implicated in the pathology of various urinary bladder disorders. However, the distribution of mast cells throughout urinary bladder tissue remains uncertain despite mast cell prevalence being relatively well-defined. Using a mouse tissue model, this study aims to characterise the prevalence and distribution of mast cells throughout the urinary bladder. METHODS: Bladder tissues were collected from six C57BL/6J female mice. Mast cell prevalence was quantified by flow cytometry, based on the expression of the following characteristic markers: CD45, CD117 and FcɛRIα. The toluidine blue stain assessed mast cell distribution, size, and proximity to vasculature. A repeated measures one-way ANOVA was used to evaluate the density of mast cells between the discrete layers of the urinary bladder, and an ordinary one-way ANOVA was used to assess potential differences between mast cell size across the urinary bladder wall. RESULTS: It was determined that mast cells compose less than 4% of all live leukocytes in the urinary bladder. They were also found to be more prominent in the lamina propria and detrusor muscle layers, compared to the urothelium and adventitia. In addition, 20.89% of mast cells were located near vasculature, which may be an important factor in consideration of their function and potential to contribute to various bladder pathologies, such as cystitis or overactive bladder. CONCLUSION: These findings provide a baseline understanding of mast cell prevalence and distribution throughout the urinary bladder.

Phenolic Determination in Proembryogenic Cell Complexes of Buckwheat Morphogenic Cell Culture with Osmium Tetroxide, Toluidine Blue O Dye, and Iron Chloride.

The study of the localization of secondary metabolites in both plants and the cell cultures on the intravital sections is hampered by the difficulty of obtaining thin, correctly oriented sections. Techniques for fixing tissues in resins allow these difficulties to be overcome. Properly selected tissue fixation techniques allow using different dyes to identify the compound of interest. In addition, some components of tissue fixation can act as fixatives and as a dye for identifying secondary metabolites. For example, osmium tetroxide, which fixes lipids in tissues, stains phenolic compounds black. This paper describes methods for the detection of phenolic compounds in morphogenic callus culture of buckwheat using osmium tetroxide, Toluidine Blue O dye, and ferric chloride as dyes in epoxy resin-embedded cell culture with double fixation of the material and when material fixed in Karnovsky's fixative.

Evaluate the Effectiveness of Toluidine Blue for Obtaining Safe Margins in Resection of Oral Squamous Cell Carcinoma.

Aims: To evaluate the effectiveness of toluidine blue for obtaining safe margins in oral squamous cell carcinoma. Materials and methods: Intra-operatively irrigation of the lesion and its surrounding areas was done with toluidine blue solution for 20 s. Followed by irrigation with 1% acetic acid to remove all the mechanically retained stain. The unstained margins were demarcated using incision placed by no 15 BP blade. The lesion was resected with a safe margin of 1 cm away from the stained tissue. Neck dissection was done according to the nodal status. The tumor along with the resected margins was sent for histopathological examination. Statistical analysis was performed to calculate specificity of the vital stain. The cross tabulation between epithelium of the stained and unstained margins was done and subjected to Chi-square test to calculate the significance. Results: The toluidine blue vital stain has a sensitivity of 93.33%. Out of 15 cases, 2 patients recorded positive excision margins leading to recurrence at primary site; 1 patients recorded positive excision margins leading to recurrence at secondary site; 1 patient recorded free excision margins but had recurrence at secondary site; remaining 11 patients recorded free excision margins and did not have recurrence. Conclusion: Vital staining with toluidine blue is concluded to be specific in demarcating the dysplastic tissue adjacent to the carcinomatous lesion, which when excised along with the adjacent dysplastic tissue leads to a decrease in the recurrence in oral squamous cell carcinoma cases. Furthermore, it is inexpensive, easily available and does not add significantly to the operating time. Moreover, it provides a gross visualization of dysplasia surrounding the lesion especially in cases where in the margins are not well defined. Hence, toluidine blue can be a useful and inexpensive adjunct to identify margins intra-operatively in the current scenario where intra-operative frozen sections are not available.

Effectiveness of adjunctive screening tools for potentially malignant oral disorders and oral cancer: A systematic review.

Background and objectives: To enhance the abilities of healthcare professionals to make informed treatment decisions and establish accurate diagnoses, it is essential to assess the diagnostic reliability of different adjunctive aids. This systematic review aimed to compare the accuracy of various adjunctive methods for diagnosing suspected oral cancer (OC) or potentially malignant oral disorders (OPMD) in adults against histopathological investigative results. Materials and methods: The review protocol registered in the PROSPERO database (CRD42023463525) was developed in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Diagnostic Test Accuracy checklist. A comprehensive electronic search was conducted to identify relevant research articles published between January 2014 and April 2023 using the PubMed and EBSCO databases. The research question was meticulously structured following the participants' index test, reference standard, target condition, and study setting framework. To evaluate methodological quality and assess the risk of bias (RoB), the Quality Assessment for Diagnostic Accuracy Studies-2 tool was used. Results: An initial search yielded 483 publications, which were reduced to 278 after removal of duplicates. Finally, 85 publications underwent full-text review by two investigators, which lead to 29 studies that met the inclusion criteria. Among these, 7% had a low RoB, 72% had an unclear RoB, and 21% had a high RoB. Applicability concerns were expressed in 59% of the studies with low concern, 31% with unclear quality evidence of concern, and 10% with high concern. Conclusion: The review findings support the use of these diagnostic methods as valuable adjuncts to biopsy for the early detection of various OPMD and OC. They also highlight the importance of regular screening and awareness in reducing the global burden of OC, while acknowledging that they cannot replace the gold standards of surgical biopsy and histopathological evaluation.

Comparative study of the effect of different exposure parameters of 635nm diode laser and toluidine blue O in eliminating Aggregatibacter actinomycetemcomitans biofilm from titanium implant surfaces.

BACKGROUND: The aim of this study was to investigate the effects of antimicrobial photodynamic therapy (PDT) using 635 nm diode laser irradiation with an energy density of 6 to 30 J/cm2 and toluidine blue O (TBO) as a photosensitizer on the viability of Aggregatibacter actinomycetemcomitans attached to the surface of titanium implants. MATERIALS AND METHODS: Titanium implants contaminated with A. actinomycetemcomitans were treated with TBO alone or in combination with different exposure parameters (light doses of 6 - 30 J/cm2 at 635 nm) and 0.2 % chlorhexidine (CHX). After treatment, colony forming units (CFUs)/ml were determined to assess PDT efficacy. The structure of the biofilm of A. actinomycetemcomitans was analyzed by field emission scanning electron microscopy (FESEM). RESULTS: Under optimal conditions, the colony count was reduced by ∼90 %. Treatment with CHX was somewhat more effective (colony formation was reduced by ∼95 %), but this agent has adverse effects that can be avoided with PDT. CONCLUSION: This study confirms the efficacy of PDT against A. actinomycetemcomitans depending on the light dose. Treatment with TBO + 635 nm diode laser has an effect that may be equivalent to that of CHX, but perhaps with fewer adverse effects.