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Utilisation of antimicrobial photodynamic therapy as an adjunctive tool for open flap debridement in the management of chronic periodontitis: A randomized controlled clinical trial

Background: Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature. Aim: This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis. Materials and method: Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 mum fibre, to provide a fluence (energy density) value of 0.0125 J/cm2 per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively. Results: Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05). Conclusion: Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis. Interested yet? Keep reading other articles of !, Application In Synthesis of 1-Chloro-10H-phenothiazine

Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Photodynamic therapy in the control of endodontic infections

Introduction: Effective decontamination of the root canal system is key to the success of endodontic treatment. Photodynamic Therapy (PDT) may be an important tool in the reduction of root canal pathogens. Objectives: This study aimed to review the literature on the use of this therapy in Endodontics, and which clinical protocol has been used. Methods: A literature search was carried out using the following databases: PubMed and Scielo, and the following key-words: endodontics; photodynamic therapy; photodynamic therapy endodontics; light-activated disinfection root canal; light activated disinfection endodontics; photo-activated disinfection endodontics; photo-activated disinfection. Results: We selected 18 articles which fit the inclusion criteria: original and relevant articles, clinical and laboratory research, in permanent human teeth, as well as articles reporting the use of photodynamic therapy as a single or adjunct treatment to root canal disinfection, in addition to its efficacy in bacterial reduction. Conclusions: PDT has been shown to be an effective method in microbial reduction of root canals; however, it should be used as an additional method to conventional treatment.

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Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Photodynamic therapy in the treatment of periodontal diseases: A literature review

Aim: Periodontal diseases remain a challenging clinical condition and hence existing literature showed no consensus on the best treatment option for disease control. The aim of this review was to provide a comprehensive overview of exciting clinical evidence on the effect of photodynamic therapy (PDT) in the treatment of periodontal diseases. Materials and Method: A literature review was performed using MEDLINE, PubMed, Wiley, ScienceDirect, and Scopus using the terms PDT, periodontal disease, laser, scaling and root planning, chronic periodontitis, and aggressive periodontitis. Results: Of a total of 149 articles appeared from various sources, 147 articles were screened and 36 were related to the research objective. Adjunctive therapy with PDT may promote additional clinical and microbiological outcomes. Conclusion: Little information is available with regard to PDT photosensitizers, wavelength, number of sessions, and duration. Therefore, large randomized control trials with longer follow-up are needed to assess the potential of PDT in the treatment of periodontal disease.

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Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: A systematic review and meta-analysis

Background: The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. Methods: Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Results: Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD?=??0.61, 95% CI?=??1.22 to ?0.016, P?=.044) and PD reduction (WMD?=??1.79, 95% CI?=??3.44 to ?0.14, P?=.034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD?=?0.02, 95% CI?=??0.75 to 0.79, P?=.95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD?=?0.23, 95% CI?=??0.09 to 0.55, P?=.159, Figure 3A), PD reduction (WMD?=?0.31, 95% CI?=??0.67 to 1.31, P?=.52, Figure 3B) and GR depth (WMD?=??0.34, 95% CI?=??2.47 to 1.78, P?=.74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. Conclusion: With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.

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Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Antimicrobial efficacy of photodynamic therapy on dental implant surfaces: A systematic review of in vitro studies

Background: To systematically review the literature regarding the antimicrobial effects of photodynamic therapy (PDT) on multi-bacterial species and the possible surface alterations of dental implants as a result of PDT. Methods: The addressed focused question was: ?Does PDT show antimicrobial efficacy against multi-bacterial species colonization and result in surface alteration on dental implants?? Electronic databases including MEDLINE and EMBASE up to and including December 2018 were searched. Results: Seven studies were included. Two studies used a total of 110 titanium dental implants, while 1 study included a total of 72 zirconia dental implants. Three studies investigated the antimicrobial PDT effects on titanium discs, while 1 study used titanium plates with germanium prisms. All in-vitro studies used diode laser. Energy fluence was reported only in 2 studies. Power output and density were 100 mW (mW) and 150 mW cm?2, respectively. All in-vitro studies reported the multibacterial species outcomes after the application of antimicrobial PDT. All studies showed a significant reduction in the bacterial load. Only two studies reported the outcomes of microstructural changes on the titanium surface, in which both studies did not report any significant alterations on the titanium implants or discs with the application of PDT. Conclusion: This systematic review demonstrated significant reduction in the bacterial load but inconclusive findings regarding structural alterations on the titanium surface with the use of PDT. The results of this review should be considered preliminary and further in-vitro studies with standardized laser parameters are needed to obtain strong conclusions.

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Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: A systematic review and Bayesian network meta-analysis

Background: Glycemic control is vital in the care of type 2 diabetes mellitus (T2DM) and is significantly associated with the incidence of clinical complications. This Bayesian network analysis was conducted with an aim of evaluating the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycemic control in chronic periodontitis (CP) and T2DM patients, and to guide clinical practice. Methods: We searched the Pubmed, Embase, Cochrane Library and Web of Science databases up to 4 May 2018 for randomized controlled trials (RCTs). This was at least three months of the duration of study that involved patients with periodontitis and T2DM without other systemic diseases given SRP. Patients in the control group did not receive treatment or SRP combination with adjuvant therapy. Outcomes were given as HbA1c% and levels fasting plasma glucose (FPG). Random-effects meta-analysis and Bayesian network meta-analysis were conducted to pool RCT data. Cochrane’s risk of bias tool was used to assess the risk of bias. Results: Fourteen RCTs were included. Most were unclear or with high risk of bias. Compared to patients who did not receive treatment, patients who received periodontal treatments showed improved HbA1c% level, including SRP (the mean difference (MD) -0.399 95% CrI 0.088 to 0.79), SRP + antibiotic (MD 0.62, 95% CrI 0.18 to 1.11), SRP + photodynamic therapy (aPDT) + doxycycline (Doxy) (MD 1.082 95% CrI 0.13 to 2.077) and SRP + laser (MD 0.66 95% CrI 0.1037, 1.33). Among the different treatments, SRP + aPDT + Doxy ranked best. Regarding fasting plasma glucose (FPG), SRP did not show advantage over no treatment (MD 4.91 95% CI – 1.95 to 11.78) and SRP with adjuvant treatments were not better than SRP alone (MD -0.28 95% CI -8.66, 8.11). Conclusion: The results of this meta-analysis seem to support that periodontal treatment with aPDT + Doxy possesses the best efficacy in lowering HbA1c% of non-smoking CP without severe T2DM complications. However, longer-term well-executed, multi-center trails are required to corroborate the results.

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Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Adjunctive application of antimicrobial photodynamic therapy in the prevention of medication-related osteonecrosis of the jaw following dentoalveolar surgery: A case series

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication strongly associated to antiresorptive agents. The present study aimed to describe the use of antimicrobial photodynamic therapy (aPDT) in the prevention of MRONJ. Methods: The sample consisted of 11 non-oncologic osteoporotic subjects in therapy with non-intravenous antiresorptive agents, requiring tooth extractions and/or implant removal. After minimally invasive surgical extractions, each alveolar socket was debrided and bony edges were smoothened. At this point, aPDT was performed using methylene blue-based phenothiazine chloride dye irradiated with a hand-held 100 mW diode laser with a wavelength of 660 ¡À 10 nm. Flaps were sutured to achieve first intention closure. Soft tissue healing was promoted with weekly applications of low-level laser therapy for 6 weeks. Recall visits were scheduled weekly for the first two months and monthly thereafter up to 6 months. At the 6-month appointment, healing was assessed clinically and radiographically. Results: A total of 62 surgical extractions were performed in both jaws, including 51 natural elements and 11 dental implants. No intraoperative complications were observed. Immediate post-operative period was generally uneventful except for mild pain and ecchymosis that occurred rarely and resolved spontaneously. Healing proceeded uneventfully, with no clinical or radiological prodromal manifestations of MRONJ up to the latest follow-up visit. Conclusions: aPDT might constitute a promising preventive treatment to reduce the risk of MRONJ in non-oncologic osteoporotic patients treated with non-intravenous antiresorptive agents that underwent dentoalveolar surgery.

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Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Antimicrobial efficacy of photodynamic therapy and light-activated disinfection on contaminated zirconia implants: An in vitro study

Background: We aimed to evaluate the antimicrobial efficacy of photodynamic therapy (PDT) and light-activated disinfection (LAD) on zirconia dental implants contaminated with three bacterial species and investigate if the PDT and LAD cause implant surface alterations. Methods: Seventy-two zirconia dental implants were contaminated with a bacterial suspension of Prevotella intermedia, Actinomyces actinomycetemcomitans, and Porphyromonas gingivalis. The implants were subsequently randomly divided into four groups (n = 12 dental implants/each) according to the decontamination protocol: Group 1 (PDT1) ? PDT (660 nm, 100 mW) with toluidine blue; Group 2 (PDT2) ? PDT (660 nm, 100 mW) with phenothiazine chloride dye; Group 3 (LAD) ? light emitting diode (LED) with toluidine blue; and Group 4 (TB) ? toluidine blue without the application of light. Implants in the positive control (PC) group were treated with a 0.2% chlorhexidine-based solution, and implants assigned to the negative control (NC) group did not undergo any treatment. Each implant was then placed in tubes containing phosphate buffered saline (PBS) and vortexed for 60 s to remove the remaining bacteria from the implant surface. After 10-fold serial dilutions, 30 mul of the suspension was plated on Brucella agar plates. After 72 h, the colony forming units (CFU) were counted. Distinctive colonies were confirmed with MALDI Biotyper. The implants were analyzed using scanning electron microscope (SEM) to evaluate the possible surface alterations due to PDT or LAD. Results: All study groups had significant reductions in the number of CFUs compared with the NC (p < 0.05). PDT1, the PDT2, and the LAD groups had the largest bacterial reduction with respect to each bacterial species separately and the total bacterial count, and they were more efficient compared with the TB group (p < 0.05). SEM analysis did not reveal any alterations of the implant surface after the treatment procedures. Conclusion: Both PDT protocols and LAD showed high and equal effectiveness in decontamination of zirconia dental implants. Sometimes chemists are able to propose two or more mechanisms that are consistent with the available data. Recommanded Product: 1-Chloro-10H-phenothiazine, If a proposed mechanism predicts the wrong experimental rate law, however, the mechanism must be incorrect.Welcome to check out more blogs about 1910-85-6, in my other articles.

Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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Synthesis and Biological Investigation of Phenothiazine-Based Benzhydroxamic Acids as Selective Histone Deacetylase 6 Inhibitors

The phenothiazine system was identified as a favorable cap group for potent and selective histone deacetylase 6 (HDAC6) inhibitors. Here, we report the preparation and systematic variation of phenothiazines and their analogues containing a benzhydroxamic acid moiety as the zinc-binding group. We evaluated their ability to selectively inhibit HDAC6 by a recombinant HDAC enzyme assay, by determining the protein acetylation levels in cells by western blotting (tubulin vs histone acetylation), and by assessing their effects on various cancer cell lines. Structure-activity relationship studies revealed that incorporation of a nitrogen atom into the phenothiazine framework results in increased potency and selectivity for HDAC6 (more than 500-fold selectivity relative to the inhibition of HDAC1, HDAC4, and HDAC8), as rationalized by molecular modeling and docking studies. The binding mode was confirmed by co-crystallization of the potent azaphenothiazine inhibitor with catalytic domain 2 from Danio rerio HDAC6.

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Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem

 

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REACTION OF CHLORO DERIVATIVES OF 10-BENZYL- AND 10-(4′-FLUOROBENZYL)PHENOTHIAZINES WITH NITRILES AND AMINES UNDER ARYNE-FORMING CONDITIONS

2-Chloro-10-benzylphenothiazine (1) and 2-chloro-10-(4′-fluorobenzyl)phenothiazine (2) react with aliphatic nitriles (3 and 4) and LDA to yield typical 2-substituted aryne products (9a,b and 9g,h, respectively).However, treatment of 1 with aromatic nitriles (5-8) and LDA supplies 2-(arylmethyl)-1-cyano rearranged nitriles (10c-f), whereas 2, when treated similarly, affords both rearranged nitriles (10i-l) and typical 2-arylated nitrile products (9i-j).An explanation in terms of the effect of substituents on the competing aryne and tandem addition-rearrangement pathways is presented.The crystal structure of one of the rearranged 1-cyanophenothiazines (10c) was obtained and reveals that the molecule adopts the “extra” conformation in which the 10-benzyl group is in the pseudo axial position.The reaction of 1 and 2 with various lithium amides in the corresponding free amine solvents gives the corresponding 2-aminated products (11) and (12) in excellent yields.Both 1-chloro-10-benzylphenothiazine (18) and 1 supply the same product, 10-benzyl-2-N,N-diisopropylaminophenothiazine (11a), when made to react with LDA in diisopropylamine solvent, indicating that each of these reactions proceeds via the same aryne intermediate, and not through the SRN1 mechanism.

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Reference£º
Thiazine – an overview | ScienceDirect Topics,
Thiazine | C4H5NS – PubChem