Efficacy of cold atmospheric pressure plasma jet against Enterococcus faecalis in apical canal of human single-rooted teeth: a preliminary study

Abstract

Many factors that may affect the success of root canal treatment are complexity of root canal system, especially in the apical part, and the virulence of bacteria such as biofilm formation. A cold atmospheric pressure plasma jet is a novel method for sterilization and applied for root canal disinfection. The purpose of this study was to investigate the effect of the cold atmospheric pressure plasma jet on Enterococcus faecalis (E. faecalis) biofilms infected in the apical root canals. Methods: Fifty-four single rooted-teeth were infected with E. faecalis for seven days and allocated into five groups. Group I performed as positive control. Group II-V were served as experimental groups: NaOCl, plasma, NaOCl + plasma and gas only, respectively. The disinfection was evaluated by colony count (per milligram) at the depths of 0.05 and 0.10 mm of root dentin. The remaining bacteria was also counted from the grounded root dentin. Data was analysed by one-way ANOVA and post hoc test, with a level of significance set at P<.05. Results: The NaOCl, plasma and NaOCl + plasma groups significantly reduced the E. faecalis, but no significant difference was found among these groups (P>0.5). The NaOCl + plasma group significantly reduced E. faecalis in the deeper dentin level compared to the other groups. Conclusion: The cold atmospheric pressure plasma jet had antimicrobial activity against E. faecalis biofilm as well as the use of NaOCl. The combined treatment yielded the most promising result and may be beneficial in root canal disinfection.

The applications of cold atmospheric plasma in dentistry

“…[85,86] Furthermore, CAP has been found to have no negative effects on dental pulp stem cells, making it suitable for use in endodontic procedures. [82,83,[87][88][89][90] One study compared the effectiveness of traditional disinfectants with CAP using argon combined with 1% oxygen as a working gas on Candida albicans in human root canals. The study demonstrated that Plasma/O 2 treatment dramatically decreased the number of live C. albicans cells in extracted human teeth.…”

“…CAP jet and NaOCl were successful in removing E. faecalis biofilm, with the combination approach producing the most hopeful outcome. [90] Furthermore, a study that investigated the effects of NTAP treatment on human root dentin surfaces, on the recruitment, attachment, and growth of human dental pulp stem cells (hDPSCs), found that these surfaces supported improved hDPSCs attachment, spreading, subcellular activity, and proliferation, which may promote pulp-dentin regeneration in clinical settings. [87] When combined with traditional disinfectants, the use of CAP in endodontic treatment can have an additive effect on the removal of bacterial biofilms and the number of bacteria in infected root canals.…”

“…[ 85,86 ] Furthermore, CAP has been found to have no negative effects on dental pulp stem cells, making it suitable for use in endodontic procedures. [ 82,83,87–90 ]…”

“…The study demonstrated that Plasma/O 2 treatment dramatically decreased the number of live C. albicans cells in extracted human teeth. [ 90 ] Another study examined the efficacy of CAP jets in removing the E. faecalis biofilm from the apical root canal at varying dentin depths. CAP jet and NaOCl were successful in removing E. faecalis biofilm, with the combination approach producing the most hopeful outcome.…”

Non-Thermal Atmospheric Pressure Plasma Application in Endodontics

“…Its pathogenicity can be attributed to its high survival ability inside dentinal tubules [4,21,23]. Its environmental resistance is due to characteristics such as the species' capacity to form biofilms and ability to support high pH, such as the one used in intracanal medication with Ca (OH) 2 [24]. This pathogen tends to stand out when in a stable multi-species microbiota, becoming the dominant species [21].…”