Biofilm formation by human bacterial pathogens on implanted medical devices causes major morbidity and mortality among patients, and leads to billions of dollars in healthcare cost. Biofilm is a complex bacterial community that is highly resistant to antibiotics and human immunity. As a result, novel therapeutic solutions other than the conventional antibiotic therapies are in urgent need. In this review, we will discuss the recent research in discovery of alternative approaches to prevent or treat biofilms. Current anti-biofilm technologies could be divided into two groups. The first group focuses on targeting the biofilm forming process of bacteria based on our understanding of the molecular mechanism of biofilm formation. Small molecules and enzymes have been developed to inhibit or disrupt biofilm formation. Another group of anti-biofilm technologies focuses on modifying the biomaterials used in medical devices to make them resistant to biofilm formation. While these novel anti-biofilm approaches are still in nascent phases of development, efforts devoted to these technologies could eventually lead to anti-biofilm therapies that are superior to the current antibiotic treatment.

The objective of this study is to investigate the treatment effects of non-thermal atmospheric gas plasmas on dentin surfaces for composite restoration. Extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. The dentin surfaces were treated by using a non-thermal atmospheric argon plasma brush for various durations. The molecular changes of the dentin surfaces were analyzed using FTIR/ATR and an increase in carbonyl groups on dentin surfaces was detected with plasma treated dentin. Adper Single Bond Plus adhesive and Filtek Z250 dental composite were applied as directed. To evaluate the dentin/composite interfacial bonding, the teeth thus prepared were sectioned into micro-bars as the specimens for tensile test. Student Newman Keuls tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment. However, the bonding strength to plasma treated inner dentin did not show any improvement. It was found that plasma treatment of peripheral dentin surface up to 100 s gave an increase in interfacial bonding strength, while a prolong plasma treatment of dentin surfaces, e.g., 5 min treatments, showed a decrease in interfacial bonding strength.

Objective The purpose of this study was to reveal the effectiveness of non-thermal atmospheric plasma brush in surface wettability and modification of four dental substrates. Methods Specimens of dental substrates including dentin, enamel, and two composites Filtek Z250, Filtek LS Silorane were prepared (~2 mm thick, ~10 mm diameter). The prepared surfaces were treated for 5–45 s with a non-thermal atmospheric plasma brush working at temperatures from 36 to 38 °C. The plasma-treatment effects on these surfaces were studied with contact-angle measurement, X-ray photoemission spectroscopy (XPS) and scanning electron microscopy (SEM). Results The non-thermal atmospheric argon plasma brush was very efficient in improving the surface hydrophilicity of four substrates studied. The results indicated that water contact angle values decreased considerably after only 5 s plasma treatment of all these substrates. After 30 s treatment, the values were further reduced to <5°, which was close to a value for super hydrophilic surfaces. XPS analysis indicated that the percent of elements associated with mineral in dentin/enamel or fillers in the composites increased. In addition, the percent of carbon (%C) decreased while %O increased for all four substrates. As a result, the O/C ratio increased dramatically, suggesting that new oxygen-containing polar moieties were formed on the surfaces after plasma treatment. SEM surface images indicated that no significant morphology change was induced on these dental substrates after exposure to plasmas. Significance Without affecting the bulk properties, a super-hydrophilic surface could be easily achieved by the plasma brush treatment regardless of original hydrophilicity/hydrophobicity of dental substrates tested.