The Emerging Role of Cold Atmospheric Plasma in Implantology: A Review of the Literature

Abstract

In recent years, cold atmospheric plasma (CAP) technologies have received increasing attention in the field of biomedical applications. The aim of this article is to review the currently available literature to provide an overview of the scientific principles of CAP application, its features, functions, and its applications in systemic and oral diseases, with a specific focus on its potential in implantology. In this narrative review, PubMed, Medline, and Scopus databases were searched using key words like “cold atmospheric plasma”, “argon plasma”, “helium plasma”, “air plasma”, “dental implants”, “implantology”, “peri-implantitis”, “decontamination”. In vitro studies demonstrated CAP’s potential to enhance surface colonization and osteoblast activity and to accelerate mineralization, as well as to determine a clean surface with cell growth comparable to the sterile control on both titanium and zirconia surfaces. The effect of CAP on biofilm removal was revealed in comparative studies to the currently available decontamination modalities (laser, air abrasion, and chlorhexidine). The combination of mechanical treatments and CAP resulted in synergistic antimicrobial effects and surface improvement, indicating that it may play a central role in surface “rejuvenation” and offer a novel approach for the treatment of peri-implantitis. It is noteworthy that the CAP conditioning of implant surfaces leads to an improvement in osseointegration in in vivo animal studies. To the best of our knowledge, this is the first review of the literature providing a summary of the current state of the art of this emerging field in implantology and it could represent a point of reference for basic researchers and clinicians interested in approaching and testing new technologies.

Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study

“…Very few studies have been published in the literature on the effects of a combined treatment of CAP with other devices. In a recent review [18], only 17 in vitro studies and 5 in vivo on animal models investigating the effects of CAP on biocompatibility, surface improvement, and cleaning efficacy were found in the literature. Among these studies, only Matthes et al [31] assessed the effects of a combined biofilm removal with an optimized AA with erythritol powder and an argon CAP on osteoblast-like cells spreading.…”

“…Cold atmospheric plasma (CAP) is an innovative, yet earlystage, treatment modality in the oral implantology field. In a recent review [18] based on 23 studies investigating the effects of CAP on biocompatibility, surface improvement, and cleaning efficacy of implant surfaces, it was suggested that CAP is a promising option for the treatment of periimplantitis [19,20], although further evidence is necessary to draw final conclusions. The hypothesized benefits in incorporating CAP for peri-implantitis treatment is that it can act via a liquid medium.…”

Influence of cold atmospheric plasma on dental implant materials — an in vitro analysis

“…Various innovative strategies using laser, photodynamic therapy, and ozone (O 3 ) as well as cold atmospheric plasma (CAP) treatment have emerged to provide a stable debridement procedure that seeks to meet all necessary criteria for periodontal healing [17][18][19][20]. Cold atmospheric plasma is a highly reactive gas that has been described to generate a variety of reactive species (ozone, reactive oxygen, and nitrogen species) with antimicrobial effects [21]. Although the precise mode of action is still under investigation, similar efficacy to the effect of 0.2% chlorhexidine digluconat could be observed in bacterial biofilms [22].…”

Applications of Cold Atmospheric Pressure Plasma in Dentistry- A Review

“…By altering the surface roughness and wettability, plasma therapy can improve cell adhesion. Plasma therapy lowers the contact angle and supports the spread of osteoblastic cells in chairside operations using NTAPP prior to implant placement [12,13].…”