The Antimicrobial Effect of Cold Atmospheric Plasma against Dental Pathogens—A Systematic Review of In-Vitro Studies

Abstract

Interest in the application of cold atmospheric plasma (CAP) in the medical field has been increasing. Indications in dentistry are surface modifications and antimicrobial interventions. The antimicrobial effect of CAP is mainly attributed to the generation of reactive oxygen and reactive nitrogen species. The aim of this article is to systematically review the available evidence from in-vitro studies on the antimicrobial effect of CAP on dental pathogens. A database search was performed (PubMed, Embase, Scopus). Data concerning the device parameters, experimental set-ups and microbial cultivation were extracted. The quality of the studies was evaluated using a newly designed assessment tool. 55 studies were included (quality score 31–92%). The reduction factors varied strongly among the publications although clusters could be identified between groups of set pathogen, working gases, and treatment time intervals. A time-dependent increase of the antimicrobial effect was observed throughout the studies. CAP may be a promising alternative for antimicrobial treatment in a clinically feasible application time. The introduced standardized protocol is able to compare the outcome and quality of in-vitro studies. Further studies, including multi-species biofilm models, are needed to specify the application parameters of CAP before CAP should be tested in randomized clinical trials.

Non-Thermal O2 Plasma Efficacy on C. albicans and Its Effect on Denture Base Resin Color

“…RONS cause photodesorption or etching of the cell wall, peroxidation of lipids and ergosterol, the latter being a critical sterol of the cell membrane [57]. This leads to an increase in membrane permeability favoring leakage of cytoplasm and intracellular components, and ultimately to lethal cellular damage [40,53,58,59]. Our SEM images highlighted the rupture of the cell membrane and the leakage of intracellular components after a 120-min O 2 NTP, which is in accordance with the previous hypotheses.…”

“…Indeed, destroying those clusters was more difficult due to their thickness and the presence of an extracellular matrix. Hence, the deeper yeast layers were better protected from NTP [37,40,61]. According to many authors [38,40,53], increasing the treatment time or producing intracellular ROS in biofilm [62] would favor the destructuration of those clusters.…”

“…Hence, the deeper yeast layers were better protected from NTP [37,40,61]. According to many authors [38,40,53], increasing the treatment time or producing intracellular ROS in biofilm [62] would favor the destructuration of those clusters. Despite the clusters on resin surface, our NTP plasma led to a significant 6-log viability reduction after a 120-min treatment in low working pressure.…”

“…Cold plasma, or non-thermal process, has been developed as a new disinfection method in the medical field for the last decade. Plasma is an ionized gas consisting of ions, electrons, UVs, photons, neutral species and reactive oxygen and nitrogen species (RONS) that have shown their efficacy to inactivate various micro-organisms such as bacteria, spores, yeasts or viruses [36][37][38][39][40]. Many techniques using non-thermal plasma [41][42][43][44] differ from one another in terms of operating pressure (low or atmospheric pressure), and operating conditions (electrical current, gas nature and flow rate).…”

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

“…Furthermore, periodontal disease treatment was primarily aimed at controlling accumulation of the microbial dental plaque, which has an important role in the onset and progression of periodontal disease. NTAP is being currently investigated as an antiseptic, and several studies have revealed the antibacterial effect both in vivo and in vitro [54]. In addition, the most obvious advantage that is accepted in this regard is that plasma achieves this effect without damaging human cells [55].…”