The Effectiveness of Cold Atmospheric Plasma (CAP) on Bacterial Reduction in Dental Implants: A Systematic Review

BACKGROUND

The emergence of dental implants has revolutionized the management of tooth loss. However, the placement of clinical implants exposes them to complex oral environment and numerous microscopic entities, such as bacteria. Cold atmospheric plasma (CAP) is often used to treat the surfaces of dental implants, which alters morphological features and effectively reduces bacterial load.

PURPOSE

This systematic review aims to assess the existing literature on the bactericidal properties of CAP when used on various kinds of dental implant surfaces.

REVIEW METHOD

An in-depth examination of MEDLINE/PubMed and EMBASE was performed to identify relevant studies, with the most recent search conducted in May 2023. Studies were selected based on their exploration of CAP's effects on dental implants compared to control groups, focusing on CAP's bactericidal efficacy. However, studies that lacked a control group or that failed to measure bactericidal effects were excluded.

RESULTS

After applying the selection criteria, 15 studies were ultimately included in the systematic review. The collected data suggest that CAP can effectively reduce bacterial loads on dental implant surfaces, including pathogens like Streptococcus mitis and Staphylococcus aureus. Furthermore, CAP appears to combat biofilms and plaques that are key contributors to periimplantitis.

CONCLUSION

CAP emerges as a promising treatment option, exhibiting significant bactericidal activity on dental implant surfaces. CAP can decrease the rates of bacterial biofilm and plaque formation, leading to improved outcomes for dental implant patients.

The effect of calcium hydroxide on the bond strength of resilon/epiphany self-etch and assessment of calcium hydroxide removal techniques: an ex-vivo study

OBJECTIVE

Calcium hydroxide is the most widely used intracanal medicament in endodontics, which should be removed prior to permanent root canal filling to minimize its intervention with the bonding of endodontic sealers. This ex-vivo study aimed to evaluate the effect of pretreatment with calcium hydroxide on the bond strength of Resilon/Epiphany self etch (SE) to the radicular dentin after removing the calcium hydroxide by hand file or ultrasonic methods.

MATERIALS AND METHODS

Thirty-six single-rooted human extracted teeth were used in this study. After root canal preparation, the teeth were divided into three groups. In group 1, as the control, no pretreatment was performed; while in groups 2 and 3, this was carried out using calcium hydroxide paste. After one week, the paste was removed with hand stainless steel K-files in group 2 and ultrasonic instrumentation in group 3. All samples were obturated with Resilon/Epiphany SE. One-millimeter slices of mid-root dentin were prepared for the push-out test (14 slices per group). After the bond strength was assessed, the failure modes were examined. The data were analyzed using one-way ANOVA and Dunnett Post Hoc tests.

RESULTS

Group 2 significantly showed the lowest bond strength (0.947 ± 0.47) (P = 0.01). No significant differences were found between the control group (2.32 ± 1.43) and group 3 (1.78 ± 1.04) (P = 0.01).

CONCLUSIONS

Under the conditions of this ex vivo study, calcium hydroxide as the intracanal medicament and its removal using hand instrumentation adversely affected the bond strength of Resilon/Epiphany SE.