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Muniz AB, Vegian MRDC, Pereira Leite LD, da Silva DM, Moreira Milhan NV, Kostov KG, Koga-Ito CY. Non-Thermal Atmospheric Pressure Plasma Application in Endodontics. Biomedicines 2023; 11:biomedicines11051401. [PMID: 37239072 DOI: 10.3390/biomedicines11051401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/15/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
The failure of endodontic treatment is frequently associated with the presence of remaining microorganisms, mainly due to the difficulty of eliminating the biofilm and the limitation of conventional irrigation solutions. Non-thermal atmospheric pressure plasma (NTPP) has been suggested for many applications in the medical field and can be applied directly to biological surfaces or indirectly through activated liquids. This literature review aims to evaluate the potential of NTPP application in Endodontics. A search in the databases Lilacs, Pubmed, and Ebsco was performed. Seventeen manuscripts published between 2007 and 2022 that followed our established inclusion criteria were found. The selected manuscripts evaluated the use of NTPP regarding its antimicrobial activity, in the direct exposure and indirect method, i.e., plasma-activated liquid. Of these, 15 used direct exposure. Different parameters, such as working gas and distance from the apparatus to the substrate, were evaluated in vitro and ex vivo. NTPP showed a disinfection property against important endodontic microorganisms, mainly Enterococcus faecalis and Candida albicans. The antimicrobial potential was dependent on plasma exposure time, with the highest antimicrobial effects over eight minutes of exposure. Interestingly, the association of NTPP and conventional antimicrobial solutions, in general, was shown to be more effective than both treatments separately. This association showed antimicrobial results with a short plasma exposure time, what could be interesting in clinical practice. However, considering the lack of standardization of the direct exposure parameters and few studies about plasma-activated liquids, more studies in the area for endodontic purposes are still required.
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Affiliation(s)
- Ana Bessa Muniz
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
| | - Mariana Raquel da Cruz Vegian
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
| | - Lady Daiane Pereira Leite
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
| | - Diego Morais da Silva
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
| | - Noala Vicensoto Moreira Milhan
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
| | - Konstantin Georgiev Kostov
- Department of Physics, Faculty of Engineering in Guaratinguetá, São Paulo State University (UNESP), Guaratinguetá 12516-410, SP, Brazil
| | - Cristiane Yumi Koga-Ito
- Department of Environment Engineering and Sciences Applied to Oral Health Graduate Program, São José dos Campos Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos 12247-016, SP, Brazil
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Zhang M, Ao X, Zheng Z, Chen W. Promoting the adhesion of human gingival epithelial cells on titanium surface by non-thermal atmospheric plasma irradiation. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2022; 40:285-292. [PMID: 38597008 PMCID: PMC9207796 DOI: 10.7518/hxkq.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/09/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This work aimed to study the biological behavior of human gingival epithelial cells (HGECs) irradiated by non-thermal atmospheric plasma (NTAP) on a titanium surface. METHODS Cultured HGECs (3⁃5 generations) with the best activity were digested and treated for varying times (0, 10, 20, 30, and 60 s) by NTAP and then seeded on the surface of a titanium disc. The HGECs were cultured in oral keratinocyte medium and 1% penicillin/streptomycin solution. The cells were kept in an atmosphere of 5% CO2 at 37 ℃ and incubated for different times (4, 12, 24, and 48 h; n=5). Cell counting kit-8 (CCK-8) was used to detect cell adhesion capacity. Scanning electron microscopy (SEM) was conducted to observe the morphology of cells on titanium plates. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot were used to evaluate the gene expression of adhesion-related molecules, such as Laminin α3, Integrin β4, and Plectin. RESULTS The number of adhered cells increased at 0‑20 s, whereas that gradually decreased at 20⁃60 s. Therefore, cell culture at the two time points showed that HGECs adhesion reached the maximum when NATP was irradiated for 20 s. Compared with the control group, more cells in the treatment group adhered to the titanium surface at each time point (P<0.05). Cells in the treatment group showed more irregular polygons, more protrusions and pseudopods, and a larger cell diffusion area on the titanium surface than those in the control group. qRT-PCR showed that the expression levels of Laminin α3, Integrin β4, and Plectin adhesion-related genes on the titanium surface in the treatment group were higher than those in the control group at each culture time point (P<0.05). Western blot showed that the expression levels of Laminin α3, Integrin β4, and Plectin adhesion-related proteins on the titanium surface were higher in the treatment group than in the control group at 4 and 12 h. CONCLUSIONS After NTAP treatment, the results showed that 20 s of treatment time could maximize the number of adhered cells on the titanium surface; change the cell adhesion morphology; and significantly upregulate the expression of adhesion-related genes and proteins of Laminin α3, Integrin β4, and Plectin. Furthermore, it could promote the biological sealing effect of HGECs on the titanium surface.
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Affiliation(s)
- Min Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiaogang Ao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Choi EH, Kaushik NK, Hong YJ, Lim JS, Choi JS, Han I. Plasma bioscience for medicine, agriculture and hygiene applications. THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY 2022; 80:817-851. [PMID: 35261432 PMCID: PMC8895076 DOI: 10.1007/s40042-022-00442-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/19/2021] [Indexed: 06/14/2023]
Abstract
Nonthermal biocompatible plasma (NBP) sources operating in atmospheric pressure environments and their characteristics can be used for plasma bioscience, medicine, and hygiene applications, especially for COVID-19 and citizen. This review surveyed the various NBP sources, including a plasma jet, micro-DBD (dielectric barrier discharge) and nanosecond discharged plasma. The electron temperatures and the plasma densities, which are produced using dielectric barrier discharged electrode systems, can be characterized as 0.7 ~ 1.8 eV and (3-5) × 1014-15 cm-3, respectively. Herein, we introduce a general schematic view of the plasma ultraviolet photolysis of water molecules for reactive oxygen and nitrogen species (RONS) generation inside biological cells or living tissues, which would be synergistically important with RONS diffusive propagation into cells or tissues. Of the RONS, the hydroxyl radical [OH] and hydrogen peroxide H2O2 species would mainly result in apoptotic cell death with other RONS in plasma bioscience and medicines. The diseased biological protein, cancer, and mutated cells could be treated by using a NBP or plasma activated water (PAW) resulting in their apoptosis for a new paradigm of plasma medicine.
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Affiliation(s)
- Eun Ha Choi
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
| | - Nagendra Kumar Kaushik
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
| | - Young June Hong
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
| | - Jun Sup Lim
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
| | - Jin Sung Choi
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
| | - Ihn Han
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center and Applied Plasma Medicine Center, Kwangwoon University, Seoul, 01897 Korea
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Nima G, Harth-Chu E, Hiers RD, Pecorari VGA, Dyer DW, Khajotia SS, Giannini M, Florez FLE. Antibacterial efficacy of non-thermal atmospheric plasma against Streptococcus mutans biofilm grown on the surfaces of restorative resin composites. Sci Rep 2021; 11:23800. [PMID: 34893687 PMCID: PMC8664839 DOI: 10.1038/s41598-021-03192-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/28/2021] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to evaluate the antimicrobial efficacy of non-thermal atmospheric plasma (NTAP) against Streptococcus mutans biofilms. Resin discs were fabricated, wet-polished, UV sterilized, and immersed in water for monomer extraction (37 °C, 24 h). Biofilms of bioluminescent S. mutans strain JM10 was grown on resin discs in anaerobic conditions for (37 °C, 24 h). Discs were divided into seven groups: control (CON), 2% chlorhexidine (CHX), only argon gas 150 s (ARG) and four NTAP treatments (30 s, 90 s, 120 s, 150 s). NTAP was applied using a plasma jet device. After treatment, biofilms were analyzed through the counting of viable colonies (CFU), bioluminescence assay (BL), scanning electron microscopy (SEM), and polymerase chain reaction (PCR). All NTAP-treated biofilm yielded a significant CFU reduction when compared to ARG and CON. BL values showed that NTAP treatment for 90 s, 120 s or 150 s resulted in statistically significantly lower metabolic activity when compared to the other groups. CHX displayed the lowest means of CFU and BL. SEM showed significant morphological changes in NTAP-treated biofilm. PCR indicated damage to the DNA structure after NTAP treatment. NTAP treatment was effective in lowering the viability and metabolism of S. mutans in a time-dependent manner, suggesting its use as an intraoral surface-decontamination strategy.
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Affiliation(s)
- Gabriel Nima
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.
| | - Erika Harth-Chu
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Rochelle Denise Hiers
- Department of Restorative Sciences, Division of Dental Biomaterials, College of Dentistry, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - David W Dyer
- Department of Microbiology and Immunology, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sharukh Soli Khajotia
- Department of Restorative Sciences, Division of Dental Biomaterials, College of Dentistry, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Marcelo Giannini
- Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Fernando Luis Esteban Florez
- Department of Restorative Sciences, Division of Dental Biomaterials, College of Dentistry, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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In vitro and in vivo research of atmosphere pressure nonequilibrium plasmas on root canal disinfection: implication for alternative strategy for irrigation. Clin Oral Investig 2021; 25:5833-5842. [PMID: 33763712 DOI: 10.1007/s00784-021-03888-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/12/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate an intracanal disinfection methodology of APNPs (atmosphere pressure nonequilibrium plasmas) or modified APNPs in root canal treatment and evaluate the antimicrobial efficiency against in vitro infected dentinal tubules and in vivo experimental apical periodontitis. MATERIALS AND METHODS Dentine specimens were centrifugated with Enterococcus faecalis to generate 1-day-old and 3-week-old biofilms, and were treated with 2% chlorhexidine (Chx), APNP or modified APNP for 3 and 10 min (n=4). LIVE/DEAD staining was employed to analyze the ratio of deactivated bacteria. Experimental apical periodontitis in beagles was induced. Root canal therapy with APNPs or modified APNPs was performed and the antimicrobial effect was evaluated by histological and radiographical analyses. RESULTS APNP deactivated 1-day-old and 3-week-old E. feacalis in dentinal tubules as much as 2% Chx irrigating. Modified APNP significantly deactivated more E. faecalis biofilms in dentinal tubules for 3-min and 10-min treatments, without thermal damage or dentinal destruction being observed. In beagles' apical periodontitis, significantly increased BV/TV and decreased lesion volume of apical bone were found in modified APNP group than 2% Chx irrigation group according to μCT. Fewer inflammatory cells and bacterial residual in dentine were observed in modified APNP-treated apical tissue by histology staining compared with those in the 2% Chx irrigation group. CONCLUSION The antimicrobial effect of APNP jet irradiation was comparable to that of 2% Chx irrigation. No structural damage in dentine or tissue necrosis at the periapical region was induced upon treatment. The modified APNP demonstrated an increased antimicrobial efficacy compared with 2% Chx irrigation both in vitro and in vivo. CLINICAL RELEVANCE The modified APNPs can be used as an alternative intracanal disinfection strategy.
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Jungbauer G, Moser D, Müller S, Pfister W, Sculean A, Eick S. The Antimicrobial Effect of Cold Atmospheric Plasma against Dental Pathogens-A Systematic Review of In-Vitro Studies. Antibiotics (Basel) 2021; 10:211. [PMID: 33672690 PMCID: PMC7924351 DOI: 10.3390/antibiotics10020211] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022] Open
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.
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Affiliation(s)
- Gert Jungbauer
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (D.M.); (A.S.); (S.E.)
| | - Dominick Moser
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (D.M.); (A.S.); (S.E.)
| | - Steffen Müller
- Department of Cranio-Maxillofacial Surgery, Hospital of the University of Regensburg, 93053 Regensburg, Germany;
| | - Wolfgang Pfister
- Department of Hospital Hygiene, Sophien- und Hufeland-Klinikum Weimar, 99425 Weimar, Germany;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (D.M.); (A.S.); (S.E.)
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (D.M.); (A.S.); (S.E.)
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Comprehensive biomedical applications of low temperature plasmas. Arch Biochem Biophys 2020; 693:108560. [PMID: 32857998 PMCID: PMC7448743 DOI: 10.1016/j.abb.2020.108560] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
The main component of plasma medicine is the use of low-temperature plasma (LTP) as a powerful tool for biomedical applications. LTP generates high reactivity at low temperatures and can be activated with noble gases with molecular mixtures or compressed air. LTP reactive species are quickly produced, and are a remarkably good source of reactive oxygen and nitrogen species including singlet oxygen (O2), ozone (O3), hydroxyl radicals (OH), nitrous oxide (NO), and nitrogen dioxide (NO2). Its low gas temperature and highly reactive non-equilibrium chemistry make it appropriate for the alteration of inorganic surfaces and delicate biological systems. Treatment of oral biofilm-related infections, treatment of wounds and skin diseases, assistance in cancer treatment, treatment of viruses' infections (e.g. herpes simplex), and optimization of implants surfaces are included among the extensive plasma medicine applications. Each of these applications will be discussed in this review article.
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Schramm S, Hiller KA, Cantzler S, Weilemann H, Cantzler M, Zimmermann JL, Cieplik F, Maisch T. The Latest Time Point of Retreatment (LTPR) as a Novel Method to Determine Antibacterial Effects for Binary Use of Cold Atmospheric Plasma and Conventional Agents. Front Microbiol 2020; 11:576500. [PMID: 33193191 PMCID: PMC7658100 DOI: 10.3389/fmicb.2020.576500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandra Schramm
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | | | | | | | | | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
- *Correspondence: Tim Maisch,
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Changes in enamel after bleaching pre-treatment with non-thermal atmospheric plasma. CLINICAL PLASMA MEDICINE 2020. [DOI: 10.1016/j.cpme.2020.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dijksteel GS, Ulrich MMW, Vlig M, Sobota A, Middelkoop E, Boekema BKHL. Safety and bactericidal efficacy of cold atmospheric plasma generated by a flexible surface Dielectric Barrier Discharge device against Pseudomonas aeruginosa in vitro and in vivo. Ann Clin Microbiol Antimicrob 2020; 19:37. [PMID: 32814573 PMCID: PMC7439657 DOI: 10.1186/s12941-020-00381-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Cold atmospheric plasma (CAP), which is ionized gas produced at atmospheric pressure, could be a novel and potent antimicrobial therapy for the treatment of infected wounds. Previously we have shown that CAP generated with a flexible surface Dielectric Barrier Discharge (sDBD) is highly effective against bacteria in vitro and in ex vivo burn wound models. In the current paper, we determined the in vitro and in vivo safety and efficacy of CAP generated by this sDBD device. Methods The effect of CAP on DNA mutations of V79 fibroblasts was measured using a hypoxanthine–guanine-phosphoribosyltransferase (HPRT) assay. Furthermore, effects on cell proliferation, apoptosis and DNA damage in ex vivo burn wound models (BWMs) were assessed using immunohistochemistry. Next, 105 colony forming units (CFU) P. aeruginosa strain PAO1 were exposed to CAP in a 3D collagen-elastin matrix environment to determine the number of surviving bacteria in vitro. Finally, rat excision wounds were inoculated with 107 CFU PAO1 for 24 h. The wounds received a single CAP treatment, repeated treatments on 4 consecutive days with CAP, 100 µL of 1% (wt/wt) silver sulfadiazine or no treatment. Wound swabs and punch biopsies were taken to determine the number of surviving bacteria. Results Exposure of V79 fibroblasts to CAP did not increase the numbers of mutated colonies. Additionally, the number of proliferative, apoptotic and DNA damaged cells in the BWMs was comparable to that of the unexposed control. Exposure of PAO1 to CAP for 2 min resulted in the complete elimination of bacteria in vitro. Contrarily, CAP treatment for 6 min of rat wounds colonized with PAO1 did not effectively reduce the in vivo bacterial count. Conclusions CAP treatment was safe but showed limited efficacy against PAO1 in our rat wound infection model.
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Affiliation(s)
- Gabrielle S Dijksteel
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands. .,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Magda M W Ulrich
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Dept. of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
| | - Ana Sobota
- Dept. of Applied Physics, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Bouke K H L Boekema
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
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Antibacterial efficacy of cold atmospheric plasma against Enterococcus faecalis planktonic cultures and biofilms in vitro. PLoS One 2019; 14:e0223925. [PMID: 31770390 PMCID: PMC6879142 DOI: 10.1371/journal.pone.0223925] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022] Open
Abstract
Nosocomial infections have become a serious threat in our times and are getting more difficult to handle due to increasing development of resistances in bacteria. In this light, cold atmospheric plasma (CAP), which is known to effectively inactivate microorganisms, may be a promising alternative for application in the fields of dentistry and dermatology. CAPs are partly ionised gases, which operate at low temperature and are composed of electrons, ions, excited atoms and molecules, reactive oxygen and nitrogen species. In this study, the effect of CAP generated from ambient air was investigated against Enterococcus faecalis, grown on agar plates or as biofilms cultured for up to 72 h. CAP reduced the colony forming units (CFU) on agar plates by > 7 log10 steps. Treatment of 24 h old biofilms of E. faecalis resulted in CFU-reductions by ≥ 3 log10 steps after CAP treatment for 5 min and by ≥ 5 log10 steps after CAP treatment for 10 min. In biofilm experiments, chlorhexidine (CHX) and UVC radiation served as positive controls and were only slightly more effective than CAP. There was no damage of cytoplasmic membranes upon CAP treatment as shown by spectrometric measurements for release of nucleic acids. Thus, membrane damage seems not to be the primary mechanism of action for CAP towards E. faecalis. Overall, CAP showed pronounced antimicrobial efficacy against E. faecalis on agar plates as well as in biofilms similar to positive controls CHX or UVC.
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Izadjoo M, Zack S, Kim H, Skiba J. Medical applications of cold atmospheric plasma: state of the science. J Wound Care 2019; 27:S4-S10. [PMID: 30207843 DOI: 10.12968/jowc.2018.27.sup9.s4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cold atmospheric plasmas (CAP) have been used in multiple medical fields and have become a promising medical technology. CAP-generating devices are safe and easy to operate and can now be manufactured at a low cost due to advancements in electronics and microchips. A primary application of CAP is as a broad-spectrum antimicrobial technology. With the high incidence of infections caused by drug-resistant microorganisms, a non-antibiotic based treatment modality such as CAP holds great therapeutic promise, particularly in the wound care field. In addition to its antimicrobial properties, CAP treatment enhances wound healing by increasing cutaneous microcirculation, monocyte stimulation, and keratinocyte proliferation. CAP has been used by dentists for disinfection of teeth, enhancing gingival fibroblast activity, and even teeth whitening. CAP can combat tumour growth by increasing the efficacy of antitumour therapeutic agents, reactivating apoptotic pathways, or down-regulating growth-related gene sites. Most of the health-care related research on CAP has occurred in the past 15 years; the field is relatively young and needs additional research, as well as confirmation of the existing supporting literature. The purpose of this report is to provide the reader with an overview of the therapeutic application of the cold plasma technology.
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Affiliation(s)
- Mina Izadjoo
- President and Chief Science Officer, Trideum Biosciences, Integrated Pharma Services, Integrated MicroSciences, Frederick, Maryland, US
| | | | - Hosan Kim
- Senior Scientist, Trideum Biosciences, Integrated Pharma Services
| | - Jeffry Skiba
- Chief Technology Officer, Integrated Pharma Services, Integrated MicroSciences, Frederick, Maryland, US
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Imiolczyk SM, Hertel M, Hase I, Paris S, Blunck U, Hartwig S, Preissner S. The Influence of Cold Atmospheric Plasma Irradiation on the Adhesive Bond Strength in Non-Demineralized and Demineralized Human Dentin: An In Vitro Study. Open Dent J 2018. [DOI: 10.2174/1874210601812010960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
While aiming at the use of Cold Atmospheric Plasmas (CAPs) in restorative dentistry, the present study intended to assess if plasma irradiation increases the Tensile Bond Strength (TBS) in non-demineralized and demineralized dentin.
Materials and Methods:
Forty-eight human dentin samples were assigned to three different treatment modalities: I: Plasma jet irradiation (CAP I); II: Dielectric barrier discharge plasma treatment (CAP II); and III: No plasma (control). In each group, half of the specimens had previously been demineralized. A fourth generation of adhesive and dental composite was applied to all of the samples. The testing of the TBS was performed after artificial aging.
Results:
In the non-demineralized dentin, the mean TBS values were significantly higher after using CAP II (16.95 MPa) than in the control samples (4.2 MPa; p = 0.001). Significantly higher TBS values were also obtained after irradiating the demineralized dentin with CAP I and CAP II (11.68 and 4.6 MPa) when compared to the control samples (0 MPa; p = 0.003 and 0.038). The differences between both of the plasma sources were only slightly significant (p = 0.05).
Conclusion:
CAPs can potentially enhance the adhesive/dentin interfacial bonding strength, whereby the underlying effects seem to depend on the type of plasma source and the degree of dentinal (de-) mineralization. In the non-demineralized dentin, after a complete caries excavation, dielectric barrier discharge devices might be favorable over the plasma jets, in order to improve the adhesive/dentin interfacial bonding. In contrast, the plasma jets could be more effective in the demineralized dentin after an incomplete caries excavation.
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Pasqual-Melo G, Gandhirajan RK, Stoffels I, Bekeschus S. Targeting malignant melanoma with physical plasmas. CLINICAL PLASMA MEDICINE 2018. [DOI: 10.1016/j.cpme.2018.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Vasilieva T, Hein AM, Vargin A, Kudasova E, Kochurova E, Nekludova M. The effect of polymeric denture modified in low-temperature glow discharge on human oral mucosa: Clinical case. CLINICAL PLASMA MEDICINE 2018. [DOI: 10.1016/j.cpme.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ballout H, Hertel M, Doehring J, Kostka E, Hartwig S, Paris S, Preissner S. Effects of plasma jet, dielectric barrier discharge, photodynamic therapy and sodium hypochlorite on infected curved root canals. JOURNAL OF BIOPHOTONICS 2018; 11:e201700186. [PMID: 29024574 DOI: 10.1002/jbio.201700186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
The aim of this investigation was to evaluate the effects of 2 different cold atmospheric plasma (CAP) sources, photodynamic therapy and sodium hypochlorite (NaOCl), on infected root canals. Therefore, 50 standardized curved human root canals were infected with Enterococcus faecalis and assigned to 5 groups-negative control (NC), plasma jet (CAP I), dielectric barrier discharge (CAP II), photodynamic therapy (PDT) and NaOCl + passive ultrasonic irrigation-for 30 s. Colony forming units (CFUs) were determined. NaOCl was significantly more effective at reducing CFUs than all test groups (P < .0001 [Mann-Whitney U test]) in both parts of the root canal. CFUs in PDT were significantly lower than those in CAP II (P = .015), and those in CAP I were lower than those in CAP II (P = .05). Among all other groups and in the apical parts, no significant differences were found (P > .05).
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Affiliation(s)
- Husam Ballout
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Moritz Hertel
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jonas Doehring
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eckehard Kostka
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Hartwig
- Department for Oral and Maxillofacial and Facial Plastic Surgery, Johannes Wesling Hospital Minden, University Hospital of the Ruhr University Bochum, Bochum, Germany
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Sterilization of Biofilm on a Titanium Surface Using a Combination of Nonthermal Plasma and Chlorhexidine Digluconate. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6085741. [PMID: 29057263 PMCID: PMC5625801 DOI: 10.1155/2017/6085741] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/09/2017] [Indexed: 11/18/2022]
Abstract
Nosocomial infections caused by opportunistic bacteria pose major healthcare problem worldwide. Out of the many microorganisms responsible for such infections, Pseudomonas aeruginosa is a ubiquitous bacterium that accounts for 10-20% of hospital-acquired infections. These infections have mortality rates ranging from 18 to 60% and the cost of treatment ranges from $20,000 to $80,000 per infection. The formation of biofilms on medical devices and implants is responsible for the majority of those infections. Only limited progress has been made to prevent this issue in a safe and cost-effective manner. To address this, we propose employing jet plasma to break down and inactivate biofilms in vitro. Moreover, to improve the antimicrobial effect on the biofilm, a treatment method using a combination of jet plasma and a biocide known as chlorhexidine (CHX) digluconate was investigated. We found that complete sterilization of P. aeruginosa biofilms can be achieved after combinatorial treatment using plasma and CHX. A decrease in biofilm viability was also observed using confocal laser scanning electron microscopy (CLSM). This treatment method sterilized biofilm-contaminated surfaces in a short treatment time, indicating it to be a potential tool for the removal of biofilms present on medical devices and implants.
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Lunov O, Zablotskii V, Churpita O, Lunova M, Jirsa M, Dejneka A, Kubinová Š. Chemically different non-thermal plasmas target distinct cell death pathways. Sci Rep 2017; 7:600. [PMID: 28377599 PMCID: PMC5428849 DOI: 10.1038/s41598-017-00689-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/08/2017] [Indexed: 02/07/2023] Open
Abstract
A rigorous biochemical analysis of interactions between non-thermal plasmas (NTPs) and living cells has become an important research topic, due to recent developments in biomedical applications of non-thermal plasmas. Here, we decouple distinct cell death pathways targeted by chemically different NTPs. We show that helium NTP cells treatment, results in necrosome formation and necroptosis execution, whereas air NTP leads to mTOR activation and autophagy inhibition, that induces mTOR-related necrosis. On the contrary, ozone (abundant component of air NTP) treatment alone, exhibited the highest levels of reactive oxygen species production leading to CypD-related necrosis via the mitochondrial permeability transition. Our findings offer a novel insight into plasma-induced cellular responses, and reveal distinct cell death pathways triggered by NTPs.
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Affiliation(s)
- Oleg Lunov
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, 18221, Czech Republic.
| | - Vitalii Zablotskii
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, 18221, Czech Republic
| | - Olexander Churpita
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, 18221, Czech Republic
| | - Mariia Lunova
- Institute for Clinical & Experimental Medicine (IKEM), Prague, 14021, Czech Republic
| | - Milan Jirsa
- Institute for Clinical & Experimental Medicine (IKEM), Prague, 14021, Czech Republic
| | - Alexandr Dejneka
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, 18221, Czech Republic
| | - Šárka Kubinová
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, 18221, Czech Republic.,Institute of Experimental Medicine AS CR, Prague, 14220, Czech Republic
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