The In-Vitro Activity of a Cold Atmospheric Plasma Device Utilizing Ambient Air against Bacteria and Biofilms Associated with Periodontal or Peri-Implant Diseases

Abstract

Due to its antimicrobial and healing-promoting effects, the application of cold atmospheric plasma (CAP) appears to be a promising modality in various fields of general medicine and dentistry. The aim of the present study was to evaluate the antibacterial and anti-biofilm activity of a handheld device utilizing ambient air for plasma generation. Suspensions of 11 oral bacteria (among them Fusobacterium nucleatum, Porphyromonas gingivalis, Parvimonas micra, Streptococcus gordonii, and Tannerella forsythia) were exposed to CAP for 10, 30, 60, and 120 s. Before and after treatment, colony forming unit (CFU) counts were determined. Then, 12-species biofilms were cultured on dentin and titanium specimens, and CAP was applied for 30, 60, and 120 s before quantifying CFU counts, biofilm mass, and metabolic activity. A reduction of ≥3 log10 CFU, was found for ten out of the eleven tested species at 30 s (except for T. forsythia) and for all species at 60 s. For biofilm grown on dentin and titanium specimens, the log10 reductions were 2.43 log10 CFU/specimen and by about 4 log10 CFU/specimen after 120 s of CAP. The CAP application did not reduce the biomass significantly, the metabolic activity of the biofilms on dentin and titanium decreased by 98% and 95% after 120 s of CAP. An application of 120 s of CAP had no cytotoxic effect on gingival fibroblasts and significantly increased the adhesion of gingival fibroblasts to the titanium surface. These results are promising and underline the potential of CAP for implementation in periodontal and peri-implantitis therapy.

Comparison of early osseointegration of non-thermal atmospheric plasma-functionalized/ SLActive titanium implant surfaces in beagle dogs

“…NTAP treatment can produce a high level of reactive oxygen/nitrogen species (ROS/RNS), high-density level of -OH and -NH 2 groups, and less carbon contamination on the titanium implant surface ( Jemat et al, 2015 ; Lee et al, 2017 ; Guo et al, 2020 ). Additionally, NTAP can functionalize titanium implants effectively and reduce bacterial adhesion, thereby reducing the incidence of peri-implantitis ( Jungbauer et al, 2022 ).…”

The applications of cold atmospheric plasma in dentistry

“…The disorder affects millions of people worldwide leading to tooth loss, discomfort, and a poor quality of life. [66,67] Recent studies have investigated the use of CAP as a unique treatment method for periodontal disease. An investigation of the antibacterial effects of plasma therapy on P. gingivalis biofilms was conducted by Hong et al They utilized NTAP treatment with pure argon gas and its mixture with 1 vol.% oxygen to evaluate the effectiveness of biofilm removal.…”

Opinions from five oral specialists on 3D printing in the challenge of customized oral healthcare. What can plasma technology bring?

“…[15,21] The antimicrobial and surface modification potential of plasma demonstrated in in vitro and in vivo models would suggest CAP as a promising option in the treatment of contaminated titanium implants (e.g., peri-implantitis). [22,23] Furthermore, the use of plasma on the titanium surface has shown beneficial effects with an increase in bone formation around titanium biomaterials. This is explained by the modifications of the surface state and in particular the wettability and the reduction of reactive oxygen species.…”

“…The antimicrobial and surface modification potential of plasma demonstrated in in vitro and in vivo models would suggest CAP as a promising option in the treatment of contaminated titanium implants (e.g., peri‐implantitis). [ 22,23 ]…”