Evaluation of the protective effects of non-thermal atmospheric plasma on alveolar bone loss in experimental periodontitis

Abstract

Objectives The inhibition of bone destruction is one of the main goals of periodontitis treatment. The aim of this study was to investigate the protective effects of non-thermal atmospheric plasma (NTAP) on alveolar bone loss radiographically, histomorphometrically, and histologically in experimental periodontitis in rats. Materials and methods A total of twenty-eight rats were randomly divided into three groups: control group (CG) (n = 8), periodontitis group (PG) (n = 10), and NTAP group (NTAPG) (n = 10). In PG and NTAPG, experimental periodontitis was created with ligating. The kINPen 11 plasma jet was applied around the ligatured teeth in NTAPG. The samples from each group were radiographically assessed with microcomputed tomography (micro-CT); then, histological (presence of osteoclasts and inflammatory cells) and immunohistochemical (immunoreactive of OCN and ALP) findings were compared. ResultsThe results revealed a significant increase in alveolar bone loss in the PG compared with CG and NTAPG (p < 0.05). Inflammation, alveolar resorption, and cement damage were reduced significantly in the group treated with NTAP compared to the PG (p < 0.05). Significantly higher levels of osteoclasts were detected in the PG in comparison with both CG and NTAPG (p < 0.05). The lowest osteocalcin and ALP values were determined in PG, and the differences between PG and both groups were also significant (p < 0.05). Conclusion Within the limitations of the present study, we can say that NTAP may enhance the bone remodeling process by inhibiting inflammation and preventing alveolar bone destruction.Clinical relevance NTAP has clinical potential for accelerating and treating periodontitis with the inflammatory response modulation, osteoblast differentiation, and alveolar bone loss reduction.

The therapeutic perspective of cold atmospheric plasma in periodontal disease

“…Thus, in an experiment using a periodontitis rat model, the levels of TNF‐α and IL‐1β were reported to be significantly decreased at 7 and 30 days after 2‐min CAP irradiation, while the expression of the anti‐inflammatory cytokine IL‐10, a tissue‐protecting molecule in the periodontal inflammation, was upregulated (Zhang et al, 2018). Similar results were obtained from other periodontitis rat models, whose histological results revealed less infiltration of inflammatory cells in rats treated by argon CAP jet (Kusakcı‐Seker et al, 2021). In a clinical trial, Küçük et al (2020) found that the combined application of SRP and CAP remarkably influenced several clinical markers in patients with periodontitis, wherein CAL was increased but the gingival index and bleeding on probing rate decreased significantly in the CAP‐SRP group compared with the SRP group.…”

“…In general, rat models are more frequently used due to better operability. In a rat periodontitis model, compared with the control, consecutive CAP irradiation led to less osteoclast infiltration, a lower level of alveolar resorption and cementum damage of infected teeth, and lower expression of OCN and ALP (Kusakcı‐Seker et al, 2021). Nowadays, the therapeutic efficacy of SRP in PD is unsatisfactory due to the complex anatomic structures of the periodontium.…”

“…Moderate periodontal inflammatory response contributed significantly to resisting periodontal pathogens, but the excessive inflammation eventually broke down the periodontium in controls. Herein, CAP was also reported to ameliorate excessive inflammation in PD (Kusakcı‐Seker et al, 2021), and promoted tissue repair to some extent (Choi et al, 2021; Kleineidam et al, 2019; Kusakcı‐Seker et al, 2021; Lima et al, 2021; Zhang et al, 2018). To the best of our knowledge, reviews about the application of CAP in PD have not been reported previously.…”