Tolonium Chloride

甲氯铵
  • 文章类型: Journal Article
    光动力疗法(PDT)是一种有效的控制牙根管细菌感染的方法,具有广谱的抗菌活性。然而,由于其在低氧条件和牙本质染色下的效率低下,其在根管治疗中的应用受到限制。TritonX-100(TX)在通过改善细菌膜渗透性来提高抗微生物剂的效率方面显示出巨大的潜力。本研究采用甲苯胺蓝O(TB)介导的PDT与TX的组合来靶向粪肠球菌(E.粪肠),一种对各种抗菌剂具有很强抵抗力的细菌,主要在受感染的根管中检测到。PDT与TX组合显示对浮游细胞和粪肠球菌生物膜两者的增强的抗菌效率。同时,TX增强了牙本质小管中的抗菌作用并减少了孵育时间。机理研究表明,TX通过增加TB单体的比例来改善活性氧(ROS)的产生。此外,还观察到膜渗透性和润湿性增加。结果表明,PDT联合TX可作为一种高效的牙齿根管消毒方法。
    Photodynamic therapy (PDT) is an effective method for bacterial infection control in root canals of teeth with a broad-spectrum antibacterial activity. However, its application in root canal treatment is limited due to its inefficiency under hypoxic conditions and dentin staining. Triton X-100 (TX) shows great potential in enhancing the efficiency of antimicrobial agents through improving bacterial membrane permeability. The present study employed a combination of toluidine blue O (TB)-mediated PDT with TX to target the Enterococcus faecalis (E. faecalis), a bacterium with strong resistance to various antibacterial agents and mostly detected in infected root canals. PDT combined with TX showed enhanced antibacterial efficiency against both planktonic cells and biofilms of E. faecalis. At the same time, TX enhanced the antibacterial effect in dentinal tubules and reduced the incubation time. Mechanism studies revealed that TX improved reactive oxygen species (ROS) production through increasing the proportion of TB monomers. Additionally, increased membrane permeability and wettability were also observed. The findings demonstrated the PDT combined with TX could be used as a highly effective method for the root canal disinfection of teeth.
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  • 文章类型: Journal Article
    背景:牙齿变色是使用各种光敏剂(PS)的抗微生物光动力疗法(aPDT)中的常见问题。甲苯胺蓝(TB),亚甲蓝(MB),酞菁(Pc),研究了2-巯基吡啶取代的酞菁锌(TM-ZnPc),但它们对牙齿变色的相对影响尚不清楚。
    目的:本研究旨在比较结核病的影响,MB,PC,和TM-ZnPc在aPDT中对牙齿变色的影响,利用受控的实验装置。
    方法:该研究包括75个带有根管的单根门牙。经过精心准备,在表冠表面上指定了一个标准化区域进行检查,并记录初始牙齿颜色的精确测量。将样品随机分为5组:阴性对照,MB,TM,PC,和TM-ZnPc。使用LED灯进行光活化,在长达90天的多个时间点进行颜色测量。数据转换为CIELab*颜色系统的Lab*颜色值(国际照明委员会,维也纳,奥地利),并计算ΔE值。使用双向ANOVA和Post-HocTukey检验进行统计学分析(p<0.05)。
    结果:在第7天和第30天,与MB和TB相比,TM-ZnPc和Pc引起的变色较少。与Pc相比,TM-ZnPc引起更多的牙齿变色(p<0.05)。与基线相比,MB和TM-ZnPc在30天时引起更多的牙齿变色,并且TB在90天时引起更多的牙齿变色(p<0.05)。在Pc施用后评价的所有时期,在牙齿变色方面没有观察到显著差异(p>0.05)。在研究中测试的所有光敏剂都导致牙齿着色。
    结论:所有PS诱导临床可检测的牙齿变色,与Pc和TM-ZnPc相比,TB和MB在某些时间点引起更显著的变色。随着时间的推移,TM-ZnPc和Pc显示出更稳定的着色水平,表明它们在aPDT应用中的潜在可靠性。这项研究强调了在aPDT中选择合适的PS以最大程度地减少牙齿变色的重要性,PC在这方面表现出了希望。
    BACKGROUND: Tooth discoloration is a common concern in antimicrobial photodynamic therapy (aPDT) using various photosensitizers (PS). Toluidine Blue (TB), Methylene Blue (MB), Phthalocyanine (Pc), and 2-mercaptopyridine-substituted zinc phthalocyanine (TM-ZnPc) are among those studied, but their relative impacts on tooth discoloration remain unclear.
    OBJECTIVE: This study aimed to compare the effects of TB, MB, Pc, and TM-ZnPc in aPDT on tooth discoloration, utilizing a controlled experimental setup.
    METHODS: The study comprised seventy-five single-rooted incisors with root canals. Following meticulous preparation, a standardized area on the crown surface was designated for examination, and precise measurements of the initial tooth colors were recorded. Samples were randomly divided into five groups: Negative control, MB, TM, Pc, and TM-ZnPc. Photoactivation was performed using LED light, and color measurements were taken at multiple time points up to 90 days. Data were converted to Lab* color values of the CIE Lab* color system (International Commission on Illumination, Vienna, Austria), and ΔE values were calculated. Statistical analysis was performed using Two-way ANOVA and Post-Hoc Tukey tests (p < 0.05).
    RESULTS: At day 7 and 30, TM-ZnPc and Pc caused less discoloration compared to MB and TB. TM-ZnPc caused more tooth discoloration compared to Pc (p < 0.05). Compared to baseline, MB and TM-ZnPc caused more tooth discoloration at 30 days and TB caused more tooth discoloration at 90 days (p < 0.05). No significant difference was observed in terms of tooth discoloration at all periods evaluated after Pc application (p > 0.05). All photosensitizers tested in the study caused tooth coloration.
    CONCLUSIONS: All PS induced clinically detectable tooth discoloration, with TB and MB causing more significant discoloration compared to Pc and TM-ZnPc at certain time points. TM-ZnPc and Pc demonstrated more stable coloration levels over time, suggesting their potential reliability in aPDT applications. This study highlights the importance of selecting appropriate PS to minimize tooth discoloration in aPDT, with Pc showing promise in this regard.
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  • 文章类型: Journal Article
    通过建立糖尿病大鼠口腔义齿炎(DS)模型,研究基于PADTMPlus的光活化消毒(PAD)治疗糖尿病大鼠口腔义齿炎(DS)的疗效。
    通过随机选择2月龄雄性Sprague-Dawley大鼠并将其分为四组来建立糖尿病大鼠DS模型。PAD组大鼠的腭和义齿表面与1mg/mL甲苯胺蓝O孵育,每次1分钟,然后暴露于750mW的发光二极管光中1分钟。PAD-1组接受1次放射治疗,PAD-2组在5天内接受三次放射治疗,间隔1天。制霉菌素(NYS)组接受了5天的治疗,NYS的悬浮液为100,000IU。感染组未接受任何治疗。在每一组中,评估包括上颚的炎症评分,真菌负荷测试,组织学评估,治疗结束后1天和7天进行白细胞介素-17(IL-17)和肿瘤坏死因子(TNF-α)的免疫组织化学检测。
    治疗后一天,上颚和假牙上的真菌负荷,以及IL-17和TNF-α的平均光密度值,发现感染组高于其他三个治疗组(P<0.05)。治疗后第7天,感染组的这些值显着高于PAD-2和NYS组(P<0.05)。重要的是,感染和PAD-1组之间以及PAD-2和NYS组之间均无差异(P>0.05)。
    PAD可有效降低糖尿病性DS大鼠腭和义齿的真菌负荷和IL-17和TNF-α的表达。多光治疗的疗效优于单光治疗,与NYS相似。
    UNASSIGNED: To study the efficacy of PADTM Plus-based photoactivated disinfection (PAD) for treating denture stomatitis (DS) in diabetic rats by establishing a diabetic rat DS model.
    UNASSIGNED: The diabetic rat DS model was developed by randomly selecting 2-month-old male Sprague-Dawley rats and dividing them into four groups. The palate and denture surfaces of rats in the PAD groups were incubated with 1 mg/mL toluidine blue O for 1 min each, followed by a 1-min exposure to 750-mW light-emitting diode light. The PAD-1 group received one radiation treatment, and the PAD-2 group received three radiation treatments over 5 days with a 1-day interval. The nystatin (NYS) group received treatment for 5 days with a suspension of NYS of 100,000 IU. The infection group did not receive any treatment. In each group, assessments included an inflammation score of the palate, tests for fungal load, histological evaluation, and immunohistochemical detection of interleukin-17 (IL-17) and tumor necrosis factor (TNF-α) conducted 1 and 7 days following the conclusion of treatment.
    UNASSIGNED: One day after treatment, the fungal load on the palate and dentures, as well as the mean optical density values of IL-17 and TNF-α, were found to be greater in the infection group than in the other three treatment groups (P < 0.05). On the 7th day after treatment, these values were significantly higher in the infection group than in the PAD-2 and NYS groups (P < 0.05). Importantly, there were no differences between the infection and PAD-1 groups nor between the PAD-2 and NYS groups (P > 0.05).
    UNASSIGNED: PAD effectively reduced the fungal load and the expressions of IL-17 and TNF-α in the palate and denture of diabetic DS rats. The efficacy of multiple-light treatments was superior to that of single-light treatments and similar to that of NYS.
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  • 文章类型: Journal Article
    CA125(糖类抗原125)是卵巢癌的重要生物标志物,因此开发有效的检测方法具有重要意义。在目前的工作中,通过制备纳米带样Ti3C2TxMXenes(Ti3C2TxNR)来固定CA125和UIO-66-NH2MOFs结构的第一抗体(PAb),以固定第二抗体(SAb)和电活性甲苯胺蓝(Tb)探针,构建了一种新型的CA125夹心样电化学免疫传感器(STEM)。在这个设计的STEM分析中,制备的Ti3C2TxNR纳米杂化物具有大表面积和作为载体的导电性等优点,和UIO-66-NH2提供了一个理想的平台来容纳SAb和大量的Tb分子作为信号放大器。在存在CA125的情况下,来自所形成的STEM结构的Tb的峰值电流随着CA125水平的增加而增加。优化相关控制条件后,CA125的线性范围(0.2-150.0UmL-1)和检测限(0.05UmL-1)很低。因此,预计开发的STEM策略对于CA125的检测具有重要的应用。
    CA125 (carbohydrate antigen 125) is an important biomarker of ovarian cancer, so developing effective method for its detection is of great significance. In the present work, a novel sandwich-like electrochemical immunosensor (STEM) of CA125 was constructed by preparing nanoribbon-like Ti3C2Tx MXenes (Ti3C2TxNR) to immobilize primary antibody (PAb) of CA125 and UIO-66-NH2 MOFs structure to immobilize second antibody (SAb) and electroactive toluidine blue (Tb) probe. In this designed STEM assay, the as-prepared Ti3C2TxNR nanohybrid offers the advantages in large surface area and conductivity as carrier, and UIO-66-NH2 provided an ideal platform to accommodate SAb and a large number of Tb molecules as signal amplifier. In the presence of CA125, the peak currents of Tb from the formed STEM structure increase with the increase of CA125 level. After optimizing the related control conditions, a wide linear range (0.2-150.0 U mL-1) and a very low detection limit (0.05 U mL-1) of CA125 were achieved. It\'s thus expected the developed STEM strategy has important applications for the detection of CA125.
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  • 文章类型: Journal Article
    在植物和活体切片上的细胞培养物中的次生代谢物定位的研究受到难以获得的阻碍,正确定向的部分。用于将组织固定在树脂中的技术允许克服这些困难。适当选择的组织固定技术允许使用不同的染料来鉴定感兴趣的化合物。此外,组织固定的某些成分可以用作固定剂和鉴定次级代谢产物的染料。例如,四氧化锇,将脂质固定在组织中,将酚类化合物染成黑色。本文介绍了使用四氧化锇检测荞麦形态发生愈伤组织培养物中酚类化合物的方法。甲苯胺蓝O染料,和氯化铁作为染料在环氧树脂包埋的细胞培养中进行双重固定,并将材料固定在Karnovsky的固定剂中。
    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.
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  • 文章类型: Journal Article
    背景:从受感染的根管系统中消除牙髓生物膜仍然是牙髓学的主要关注点。在这项研究中,研究了能量密度参数在通过635nm二极管激光(DL)激活的甲苯胺蓝O(TBO)和藻蓝蛋白(PC)对抗根管模型中粪肠球菌生物膜的抗菌光动力疗法(PDT)疗效中的作用。
    方法:用不同剂量的光能(600、900、1200和1500J/cm2)的TBO和PC处理根管中的粪肠球菌生物膜。未处理的生物膜代表对照组。治疗后,基于每毫升菌落数分析生物膜。
    结果:用能量密度为1500J/cm2的635nmDL激活的TBO和PC比能量密度为600J/cm2的TBO和PC更有效地去除根管内的粪肠球菌生物膜(p=0.00)。
    结论:光能量剂量优化了根管空间中粪肠球菌生物膜的细菌减少。这些结果提供了对肛门内生物膜进行PDT的决定性参数的信息。
    BACKGROUND: Eradication of endodontic biofilms from the infected root canal system is still the main concern in endodontics. In this study, the role of the power density parameter in the efficacy of antimicrobial photodynamic therapy (PDT) with toluidine blue O (TBO) and phycocyanin (PC) activated by a 635 nm diode laser (DL) against Enterococcus faecalis biofilm in the root canal model was investigated.
    METHODS: The E. faecalis biofilm in the root canal was treated with TBO and PC with different power densities (636, 954, 1273, and 1592 W/cm2). The untreated biofilm represented the control group. After the treatments, the biofilms were analyzed based on the number of colonies per milliliter.
    RESULTS: TBO and PC activated with 635 nm DL with a power density of 1592 W/cm2 were more efficient in removing E. faecalis biofilms within the root canals than those with a power density of 636 W/cm2 (p = 0.00).
    CONCLUSIONS: The light power density optimized the bacterial reduction of E. faecalis biofilms in the root canal spaces. These results provide information on the decisive parameters for performing PDT on intracanal biofilms.
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  • 文章类型: Journal Article
    甲胎蛋白(AFP)的高表达与肝细胞癌(HCC)密切相关。在这里,提出了一种基于壳聚糖-二茂铁甲醛-纺锤体金(Chit-Fc-SAu)和Co/Fe金属-有机骨架-甲苯胺蓝/聚多巴胺(Co/FeMOF-TB/PDA)的双信号比率电化学免疫传感器,用于定量分析AFP。具体来说,Chit-Fc-SAu用作底物以捕获更多的从Fc产生第一电化学信号的初级抗体(Abl)。由于比表面积大,Co/FeMOF纳米片的协同效应和电子效应,以及PDA丰富的功能组,Co/FeMOF-TB/PDA可以加载更多的二级抗体(Ab2)和信号分子(TB),提供另一个放大的电化学信号。在法新社面前,Ab1-AFP-Ab2形成了三明治结构,随着AFP浓度的增加,TB与Fc的峰值电流比(ITB/IFc)也增加。双信号比率策略可以避免环境信号干扰,实现信号自校准,从而提高检测的准确性和再现性。经过一系列的探索,这种自校准的比率免疫传感器表现出很宽的线性范围(0.001-200ngmL-1),低检测限(0.34pgmL-1),和良好的重复性。当应用于临床血清样本的测定时,比率传感器的检测结果与商业电化学发光(ECL)免疫分析的结果一致,明显优于非比率传感器。基于比率传感器的自校准策略有助于提高AFP在临床诊断中的准确性。
    The high level of alpha-fetoprotein (AFP) expression is closely related to hepatocellular carcinoma (HCC). Herein, a dual signal ratiometric electrochemical immunosensor based on chitosan-ferrocenecarboxaldehyde-spindle gold (Chit-Fc-SAu) and Co/Fe metal-organic framework-toluidine blue/polydopamine (Co/Fe MOF-TB/PDA) was proposed for quantitative analysis of AFP. Specifically, Chit-Fc-SAu worked as a substrate to trap more primary antibodies (Ab1) generating the first electrochemical signal from Fc. Thanks to the large specific surface area, the synergistic and electronic effects of Co/Fe MOF nanosheets, and the rich functional groups of PDA, Co/Fe MOF-TB/PDA could load more secondary antibodies (Ab2) and signal molecules (TB) providing another amplified electrochemical signal. In the presence of AFP, Ab1-AFP-Ab2 formed a sandwich structure, and as the AFP concentration increased, the peak current ratio of TB to Fc (ITB/IFc) also increased. The dual signal ratiometric strategy can avoid environmental signal interference and achieve signal self-calibration, thereby improving the accuracy and reproducibility of detection. After a series of exploration, this self-calibrated ratiometric immunosensor exhibited a wide linear range (0.001-200 ng mL-1), a low detection limit (0.34 pg mL-1), and good repeatability. When applied to the assay of clinical serum samples, the detection results of ratiometric sensor were consistent with that of commercial electrochemiluminescence (ECL) immunoassay, significantly superior to that of non-ratiometric sensor. The self-calibrated strategy based on ratiometric sensor helps to improve the accuracy of AFP in clinical diagnosis.
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  • 文章类型: Journal Article
    使用多信号放大方法开发了一种用于检测潜在抑郁症生物标志物载脂蛋白A4(Apo-A4)的新型电化学免疫传感器。首先,传感器使用了一种改进的电极材料,NG-PEI-COF,结合联吡啶官能化共价有机骨架(COF)和聚乙烯亚胺官能化氮掺杂石墨烯(NG-PEI),为电信号传导的第一级放大提供高表面积和优异的电子转移能力。随后,金纳米粒子(AuNP)进一步电沉积到电极上,提供良好的生物相容性和丰富的结合位点来固定靶抗原,从而在靶标识别和结合中实现第二阶段扩增。为了解决抗原缺乏氧化还原特性的问题,通过加载AuNPs形成示踪探针,抗Apo-A4和甲苯胺蓝(TB)相继到COF上,导致信号转换的第三级放大。构建的电化学免疫传感器TB/Ab/AuNPs/COF-Apo-A4/AuNPs/NG-PEI-COF/GCE对Apo-A4具有良好的检测性能,线性范围为0.01至300ngmL-1,检测下限为2.16pgmL-1(S/N=3)。此外,生物传感器重现性好(RSD=2.31%),稳定性,以及对其他抑郁症生物标志物的显着抗干扰性能。该传感器已成功用于血清中Apo-A4的定量检测,为临床上检测Apo-A4提供了潜在的应用,并为构建基于COF的传感方法提供了参考。
    A novel electrochemical immunosensor for detecting potential depression biomarker Apolipoprotein A4 (Apo-A4) was developed using a multi-signal amplification approach. Firstly, the sensor utilized a modified electrode material, NG-PEI-COF, combining bipyridine-functionalized covalent organic framework (COF) and polyethyleneimine-functionalized nitrogen-doped graphene (NG-PEI), providing high surface area and excellent electron transfer capability for the first-stage amplification in electrical signal conduction. Subsequently, gold nanoparticles (AuNPs) were further electrodeposited onto the electrode, providing good biocompatibility and abundant binding sites for immobilizing the target antigen, thus achieving the second-stage amplification in target recognition and binding. To address the lack of redox properties of the antigen, a tracer probe was formed by loading AuNPs, anti-Apo-A4, and toluidine blue (TB) successively onto COF, leading to the third-stage amplification in signal conversion. The constructed electrochemical immunosensor TB/Ab/AuNPs/COF-Apo-A4/AuNPs/NG-PEI-COF/GCE exhibited excellent detection performance against Apo-A4 with a linear range of 0.01 to 300 ng mL-1 and had a low detection limit of 2.16 pg mL-1 (S/N = 3). In addition, the biosensor had good reproducibility (RSD = 2.31%), stability, and significant anti-interference performance toward other depression biomarkers. The sensor has been successfully used for the quantitative detection of Apo-A4 in serum, providing potential applications for detecting Apo-A4 in the clinic and serving as a reference for constructing sensing methods based on COF.
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  • 文章类型: Journal Article
    支气管肺泡灌洗液(BALF)细胞学检查用于诊断非感染性下气道炎症。当在人和马两者中使用不同的染色方法时,已经报道了差异细胞计数。这项研究的目的是使用四种不同的染色方法比较驴的BALF细胞学结果:改良的May-GrunwaldGiemsa(mMGG),Diff-Quick(DQ),甲苯胺蓝(TB)和Perls普鲁士蓝(PPB)。9只健康的Amiata母驴被招募。如前所述进行BAL程序,并用每种方法对细胞离心的BALF载玻片进行染色。巨噬细胞的mMGG和DQ之间没有差异,中性粒细胞,和嗜酸性粒细胞,而DQ与DQ之间的肥大细胞计数存在差异TB,但不是在mMGG与DQ或mMGG与TB。最后,与mMGG相比,血铁皮噬菌体的分类计数没有差异,DQ和PPB。mMGG似乎是鉴定所有可能的细胞类型的极好的染色剂。包括驴BALF中的肥大细胞.DQ,如果单独使用,可能导致肥大细胞识别不当。这些结果与关于马中BALF染色方法的文献一致。
    Bronchoalveolar lavage fluid (BALF) cytology is used for the diagnosis of non-infectious lower airway inflammation in equids. Discrepancies have been reported in the differential cell count when different staining methods were used both in humans and horses. The objective of this study was to compare the results of BALF cytology in donkeys using four different staining methods: modified May-Grunwald Giemsa (mMGG), Diff-Quick (DQ), Toluidine blue (TB) and Perls Prussian blue (PPB). Nine healthy Amiata female donkeys were enrolled. The BAL procedure was performed as previously described and pairs of cytocentrifuged BALF slides were stained with each method. No differences between mMGG and DQ were found for macrophages, neutrophils, and eosinophils, while differences were found in mast cell count between DQ vs.TB, but not between mMGG vs. DQ or mMGG vs. TB. Finally, no differences were obtained in the differential count for hemosiderophages comparing mMGG, DQ and PPB. The mMGG appears to be an excellent stain for the identification of all possible cell types, including mast cells in the BALF of donkeys. DQ, if used alone, may lead to inappropriate identification of mast cells. These results are consistent with the literature on BALF staining methods in horses.
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  • 文章类型: Journal Article
    背景:这项研究的目的是研究使用能量密度为6至30J/cm2的635nm二极管激光照射和甲苯胺蓝O(TBO)作为光敏剂的抗菌光动力疗法(PDT)对附着在钛植入物表面的Aggregatitacter放线菌生存力的影响。
    方法:用单独的TBO或与不同的暴露参数(在635nm下6-30J/cm2的光剂量)和0.2%的氯己定(CHX)组合处理被放线菌感染的钛植入物。治疗后,确定菌落形成单位(CFU)/ml以评估PDT功效。通过场发射扫描电子显微镜(FESEM)分析了放线菌生物膜的结构。
    结果:在最佳条件下,菌落数量减少了90%。用CHX治疗更有效(集落形成减少了95%),但这种药物有副作用,可以避免与PDT。
    结论:这项研究证实了PDT对放线菌群的疗效,取决于光剂量。用TBO+635nm二极管激光器处理的效果可能与CHX相当,但也许副作用较少。
    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.
    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.
    CONCLUSIONS: 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.
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