In-vitro assessment of the efficiency of cold atmospheric plasma on decontamination of titanium dental implants

Christian Flörke; Josephine Janning; Cedric Hinrichs; Eleonore Behrens; Kim Rouven Liedtke; Sinan Sen; David Christofzik; Jörg Wiltfang; Aydin Gülses

doi:10.1186/s40729-022-00411-9

In-vitro assessment of the efficiency of cold atmospheric plasma on decontamination of titanium dental implants

Int J Implant Dent. 2022 Mar 11;8(1):12. doi: 10.1186/s40729-022-00411-9.

Authors

Christian Flörke¹, Josephine Janning¹, Cedric Hinrichs¹, Eleonore Behrens¹, Kim Rouven Liedtke², Sinan Sen³, David Christofzik⁴, Jörg Wiltfang¹, Aydin Gülses⁵

Affiliations

¹ Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus B, 24105, Kiel, Germany.
² Christian Albrechts University, Department of Orthopedics, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
³ Christian Albrechts University, Department of Orthodontics, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
⁴ Christian Albrechts University, Department of Conservative Dentistry, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
⁵ Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus B, 24105, Kiel, Germany. aguelses@mkg.uni-kiel.de.

Abstract

Background: The aim of the current study was to comparatively assess the efficiency of three different adjunctive therapy options (cold atmospheric plasma, [CAP], photodynamic therapy [PDT] and chemical decontamination via 35% phosphoric acid gel [PAG]) on decontamination of titanium implant surfaces in-vitro.

Materials and methods: Implants were inserted in concavities of four mm in depth mimicking a bone defect at the implant recipient site. In each model, two implants were inserted in the fourth and one implant in the third quadrants. After contamination with E. faecalis, the first group has been treated with CAP for 3 min, the second group with 35% PAG (and the third group with PDT. After treatment, quantification of bacterial colonization was assessed by quantification via colony forming units and qualitatively by fluorescence microscopy and scanning electron microscopy.

Results: With a mean value of 1.24 × 10⁵ CFU/ml, the CAP treated implants have showed the least microorganisms. The highest number of CFU was found after PDT with mean value of 8.28 × 10⁶ CFU/ml. For the implants that were processed with phosphoric acid, a mean value of 3.14 × 10⁶ CFU/ml could be detected. When the groups were compared, only the CAP and PDT groups differed significantly from each other (p = 0.005).

Conclusion: A complete cleaning of the micro-textured implant surface or the killing of the bacteria could not be achieved by any of the investigated treatment options, thus bacteria in the microstructure of the titanium surface cannot be completely reached by mechanical and physico-chemical processes.

Clinical relevance: The main goal of the adjunctive peri-implantitis treatment is the decontamination of the implant surface. However, there is still an ongoing need to define the most appropriate adjunctive therapy method. Due to its antimicrobial effects, CAP combined with mechanical debridement could be a feasible treatment modality in the management of peri-implantitis.

Keywords: Bacteria; Biofilm; Cold atmospheric plasma; Peri-implantitis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Decontamination
Dental Implants* / microbiology
Humans
Peri-Implantitis* / prevention & control
Plasma Gases* / pharmacology
Titanium / pharmacology

Substances

Dental Implants
Plasma Gases
Titanium