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Toluidine blue color perception in identification of oral mucosal lesions

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Abstract

The objective of this study is to examine observer agreement on the rank of the color tones after toluidine blue staining of a mucosal lesion. Cohort study with repeated measures is the design of the study. Twenty observers ranked and scored 8 specified areas on the color images of a lesion before and after toluidine blue application in two sessions. Inter and intra-observer variations were analyzed with Cohen’s kappa. The L* (the black-white axis), a* (red-green axis), and b* (yellow-blue axis) values were measured and set as the gold standards. Intra and inter-observer agreements were к = 0.86 and к = 0.854. All color parameters were effective on the color ranking order (pL* = 0.00, pa* = 0.007, pb* = 0.00), although L* and b* were more effective on the ranking of the samples than a*. Areas that appeared pale blue visually had a significant blue component, but the observers were confused with the effect of whiteness of the area in clinical decision making.

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Authors and Affiliations

  1. School of Dentistry, Department of Oral Diagnosis and Radiology, Ege University, Bornova, 35100, İzmir, Turkey

    Pelin Güneri & Selin Ergün

  2. Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois, Chicago, IL, USA

    Joel B. Epstein

  3. Department of Otolaryngology/Head and Neck Surgery, Chicago Cancer Center, College of Medicine, University of Illinois, Chicago, IL, USA

    Joel B. Epstein

  4. Faculty of Science, Department of Statistics, Ege University, İzmir, Turkey

    Hayal Boyacioğlu

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  1. Pelin Güneri
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  2. Joel B. Epstein
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Correspondence to Pelin Güneri.

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Güneri, P., Epstein, J.B., Ergün, S. et al. Toluidine blue color perception in identification of oral mucosal lesions. Clin Oral Invest 15, 337–345 (2011). https://doi.org/10.1007/s00784-010-0398-6

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