Volume 9, Issue 1 (3-2024)                   J Res Dent Maxillofac Sci 2024, 9(1): 61-70 | Back to browse issues page

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Ghodrati H, Monem Moharrer S, Azizi A. Cold Atmospheric Pressure Plasma: A New Approach for Management of Periodontitis and Peri-implantitis. J Res Dent Maxillofac Sci 2024; 9 (1) :61-70
URL: http://jrdms.dentaliau.ac.ir/article-1-527-en.html
1- Department of Prosthodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Faculty of Dentistry, Tehran Medical Science Islamic Azad University, Tehran, Iran. , saramonem1378@gmail.com
3- Oral Medicine Department, Faculty of Dentistry, Tehran University of Medical Sciences, Islamic Azad University, Tehran, Iran.
Abstract:   (661 Views)
Background and Aim: Plasma is commonly known as the fourth state of matter. Cold atmospheric pressure plasma (CAPP) is a new, simple, and non-invasive approach that has become popular in various fields. Due to its potential antibacterial properties, it has become a widely used disinfectant in clinical science. It has even been employed for therapeutic purposes, such as cancer treatment and wound healing. This review aims to introduce CAPP as a new approach for management of periodontitis and peri-implantitis.
Materials and Methods: A search was conducted in Scopus, PubMed and Web of Science databases for articles published between 2000 and 2023 using the keywords: “plasma gases”, “non-thermal atmospheric pressure plasma”, “cold atmospheric pressure plasma”, “cold plasma”, “periodontal”, “periodontitis” and “peri-implantitis”. 
Results: The results showed that CAPP is effective for reducing the bacterial load and inflammation, modification of implant surfaces, promoting tissue regeneration, and improvement of clinical parameters. The use of CAPP in periodontal therapy and management of peri-implantitis is still in its early stages but studies have shown promising results.
Conclusion: CAPP appears to be a promising adjuvant therapy for periodontitis and management of peri-implantitis. However, further clinical studies are needed to fully explore its potential and determine its effectiveness for this purpose.
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Type of Study: Review article | Subject: Periodontology

1. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005 Nov 19;366(9499):1809-20. [DOI:10.1016/S0140-6736(05)67728-8] [PMID]
2. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S173-S182.
3. Mehrotra N, Singh S. Periodontitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
4. Lasserre JF, Brecx MC, Toma S. Oral Microbes, Biofilms and Their Role in Periodontal and Peri-Implant Diseases. Materials (Basel). 2018 Sep 22;11(10):1802. [DOI:10.3390/ma11101802] [PMID] []
5. Rawlinson A, Walsh TF. Rationale and techniques of non-surgical pocket management in periodontal therapy. Br Dent J. 1993 Mar 6;174(5):161-6. [DOI:10.1038/sj.bdj.4808111] [PMID]
6. Mombelli A, Schmid B, Rutar A, Lang NP. Persistence patterns of Porphyromonas gingivalis, Prevotella intermedia/nigrescens, and Actinobacillus actinomyetemcomitans after mechanical therapy of periodontal disease. J Periodontol. 2000 Jan;71(1):14-21. [DOI:10.1902/jop.2000.71.1.14] [PMID]
7. Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical treatment of periodontitis. J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):76-86.. [DOI:10.1016/S1532-3382(12)70019-2] [PMID]
8. Meimandi M, Talebi Ardakani MR, Esmaeil Nejad A, Yousefnejad P, Saebi K, Tayeed MH. The Effect of Photodynamic Therapy in the Treatment of Chronic Periodontitis: A Review of Literature. J Lasers Med Sci. 2017 Summer;8(Suppl 1):S7-S11. [DOI:10.15171/jlms.2017.s2] [PMID] []
9. Prathapachandran J, Suresh N. Management of peri-implantitis. Dent Res J (Isfahan). 2012 Sep;9(5):516-21. [DOI:10.4103/1735-3327.104867] [PMID] []
10. Hashim D, Cionca NA. Comprehensive Review of Peri-implantitis Risk Factors. Curr Oral Health Rep. 7: 262-73. [DOI:10.1007/s40496-020-00274-2]
11. Crookes W. On Radiant Matter: A Lecture Delivered to the British Association for the Advancement of Science, at Sheffield, Friday, August 22, 1879. EJ Davey; 1879. [DOI:10.5962/bhl.title.32913]
12. Lata S, Chakravorty S, Mitra T, Pradhan PK, Mohanty S, Patel P, et al. Aurora Borealis in dentistry: The applications of cold plasma in biomedicine. Materials Today Bio. 2022 Jan;13:100200. [DOI:10.1016/j.mtbio.2021.100200] [PMID] []
13. Schulz M. Introduction to Plasma Theory. Eos, Transactions American Geophysical :union:. 1986;67(7):79. [DOI:10.1029/EO067i007p00079-02]
14. Kaushik NK, Ghimire B, Li Y, Adhikari M, Veerana M, Kaushik N, Jha N, Adhikari B, Lee SJ, Masur K, von Woedtke T, Weltmann KD, Choi EH. Biological and medical applications of plasma-activated media, water and solutions. Biol Chem. 2018 Dec 19;400(1):39-62. [DOI:10.1515/hsz-2018-0226] [PMID]
15. Bradu C, Kutasi K, Magureanu M, Puač N, Živković S. Reactive nitrogen species in plasma-activated water: generation, chemistry and application in agriculture. Journal of Physics D: Applied Physics. 2020 Apr 7;53(22):223001. [DOI:10.1088/1361-6463/ab795a]
16. Borges AC, Kostov KG, Pessoa RS, de Abreu GMA, Lima GdMG, Figueira LW, et al. Applications of Cold Atmospheric Pressure Plasma in Dentistry. Appl. Sce. 2021;11(5):1975. [DOI:10.3390/app11051975]
17. Hoffmann C, Berganza C, Zhang J. Cold Atmospheric Plasma: methods of production and application in dentistry and oncology. Med Gas Res. 2013 Oct 1;3(1):21. [DOI:10.1186/2045-9912-3-21] [PMID] []
18. Bora B, Jain J, Inestrosa-Izurieta MJ, Avaria G, Moreno J, Pavez C et al. Development of plasma needle to be used for biomedical applications. Journal of Physics: Conference Series. 2016;720(1):012038. [DOI:10.1088/1742-6596/720/1/012038]
19. Cha S, Park YS. Plasma in dentistry. Clin Plasma Med. 2014 Jul;2(1):4-10. [DOI:10.1016/j.cpme.2014.04.002] [PMID] []
20. Haghighi L, Azizi A, Vatanpour M, Ramezani G. Antibacterial Efficacy of Cold Atmospheric Plasma, Photodynamic Therapy with Two Photosensitizers, and Diode Laser on Primary Mandibular Second Molar Root Canals Infected with Enterococcus faecalis: An In Vitro Study. Int J Dent. 2023 Apr 21;2023:5514829. [DOI:10.1155/2023/5514829] [PMID] []
21. Hong Q, Sun H, Chen M, Zhang S, Yu Q. Plasma treatment effects on destruction and recovery of Porphyromonas gingivalis biofilms. PLoS One. 2022 Sep 14;17(9):e0274523. [DOI:10.1371/journal.pone.0274523] [PMID] []
22. de Morais Gouvêa Lima G, Carta CFL, Borges AC, Nishime TMC, da Silva CAV, Caliari MV, et al. Cold Atmospheric Pressure Plasma Is Effective against P. gingivalis (HW24D-1) Mature Biofilms and Non-Genotoxic to Oral Cells. Applied Sciences. 2022 Jul 19;12(14):7247. [DOI:10.3390/app12147247]
23. Liu D, Xiong Z, Du T, Zhou X, Cao Y, Lu X. Bacterial-killing effect of atmospheric pressure non-equilibrium plasma jet and oral mucosa response. J Huazhong Univ Sci Technolog Med Sci. 2011 Dec;31(6):852-6. [DOI:10.1007/s11596-011-0690-y] [PMID]
24. Mahasneh A, Darby M, Tolle S, Hynes W, Laroussi M, Karakas E. Inactivation of Porphyromonas gingivalis by Low-Temperature Atmospheric Pressure Plasma. Plasma Med. 2011;1(3-4):191-204. [DOI:10.1615/PlasmaMed.2012002854]
25. Jungbauer G, Favaro L, Müller S, Sculean A, Eick S. The In-Vitro Activity of a Cold Atmospheric Plasma Device Utilizing Ambient Air against Bacteria and Biofilms Associated with Periodontal or Peri-Implant Diseases. Antibiotics (Basel). 2022 May 31;11(6):752. [DOI:10.3390/antibiotics11060752] [PMID] []
26. Fan C, Ji Q, Zhang C, Xu S, Sun H, Li Z. TGF β induces periodontal ligament stem cell senescence through increase of ROS production. Mol Med Rep. 2019 Oct;20(4):3123-3130. [DOI:10.3892/mmr.2019.10580]
27. Kleineidam B, Nokhbehsaim M, Deschner J, Wahl G. Effect of cold plasma on periodontal wound healing-an in vitro study. Clin Oral Investig. 2019 Apr;23(4):1941-50. [DOI:10.1007/s00784-018-2643-3] [PMID]
28. Arndt S, Landthaler M, Zimmermann JL, Unger P, Wacker E, Shimizu T, Li YF, Morfill GE, Bosserhoff AK, Karrer S. Effects of cold atmospheric plasma (CAP) on ß-defensins, inflammatory cytokines, and apoptosis-related molecules in keratinocytes in vitro and in vivo. PLoS One. 2015 Mar 13;10(3):e0120041. [DOI:10.1371/journal.pone.0120041] [PMID] []
29. Arndt S, Unger P, Wacker E, Shimizu T, Heinlin J, Li YF, Thomas HM, Morfill GE, Zimmermann JL, Bosserhoff AK, Karrer S. Cold atmospheric plasma (CAP) changes gene expression of key molecules of the wound healing machinery and improves wound healing in vitro and in vivo. PLoS One. 2013 Nov 12;8(11):e79325. [DOI:10.1371/journal.pone.0079325] [PMID] []
30. Kwon JS, Kim YH, Choi EH, Kim CK, Kim KN, Kim KM. Non-thermal atmospheric pressure plasma increased mRNA expression of growth factors in human gingival fibroblasts. Clin Oral Investig. 2016 Sep;20(7):1801-8. [DOI:10.1007/s00784-015-1668-0] [PMID]
31. Zhang Y, Xiong Y, Xie P, Ao X, Zheng Z, Dong X, et al. Non-thermal plasma reduces periodontitis-induced alveolar bone loss in rats. Biochem Biophys Res Commun. 2018 Sep 10;503(3):2040-6. [DOI:10.1016/j.bbrc.2018.07.154] [PMID]
32. Seo SH, Han I, Lee HS, Choi JJ, Choi EH, Kim KN, Park G, Kim KM. Antibacterial activity and effect on gingival cells of microwave-pulsed non-thermal atmospheric pressure plasma in artificial saliva. Sci Rep. 2017 Aug 21;7(1):8395. [DOI:10.1038/s41598-017-08725-0] [PMID] []
33. Jeong WS, Kwon JS, Choi EH, Kim KM. The Effects of Non-Thermal Atmospheric Pressure Plasma treated Titanium Surface on Behaviors of Oral Soft Tissue Cells. Sci Rep. 2018 Oct 29;8(1):15963. [DOI:10.1038/s41598-018-34402-x] [PMID] []
34. Zhou X, Wu D, Liang D, Zhang W, Shi Q, Cao Y. Evaluation of modified cold-atmospheric pressure plasma (MCAP) for the treatment of peri-implantitis in beagles. Oral Dis. 2022 Mar;28(2):495-502. [DOI:10.1111/odi.13757] [PMID]
35. Koban I, Duske K, Jablonowski L, Schröder K, Nebe B, Sietmann R, et al. Atmospheric plasma enhances wettability and osteoblast spreading on dentin in vitro: Proof-of-principle. Plasma Process Polym. 2011;8(10):975-82. [DOI:10.1002/ppap.201100030]
36. Matthes R, Duske K, Kebede TG, Pink C, Schlüter R, von Woedtke T, Weltmann KD, Kocher T, Jablonowski L. Osteoblast growth, after cleaning of biofilm-covered titanium discs with air-polishing and cold plasma. J Clin Periodontol. 2017 Jun;44(6):672-680. [DOI:10.1111/jcpe.12720] [PMID]
37. Küçük D, Savran L, Ercan UK, Yarali ZB, Karaman O, Kantarci A, Sağlam M, Köseoğlu S. Evaluation of efficacy of non-thermal atmospheric pressure plasma in treatment of periodontitis: a randomized controlled clinical trial. Clin Oral Investig. 2020 Sep;24(9):3133-45. [DOI:10.1007/s00784-019-03187-2] [PMID]
38. Koban I, Holtfreter B, Hübner NO, Matthes R, Sietmann R, Kindel E, Weltmann KD, Welk A, Kramer A, Kocher T. Antimicrobial efficacy of non-thermal plasma in comparison to chlorhexidine against dental biofilms on titanium discs in vitro proof of principle experiment. J Clin Periodontol. 2011 Oct;38(10):956-65. [DOI:10.1111/j.1600-051X.2011.01740.x] [PMID]
39. Preissner S, Wirtz HC, Tietz AK, Abu-Sirhan S, Herbst SR, Hartwig S, Pierdzioch P, Schmidt-Westhausen AM, Dommisch H, Hertel M. Bactericidal efficacy of tissue tolerable plasma on microrough titanium dental implants: An in-vitro-study. J Biophotonics. 2016 Jun;9(6):637-44. [DOI:10.1002/jbio.201500189] [PMID]
40. Shi Q, Song K, Zhou X, Xiong Z, Du T, Lu X, Cao Y. Effects of non-equilibrium plasma in the treatment of ligature-induced peri-implantitis. J Clin Periodontol. 2015 May;42(5):478-87. [DOI:10.1111/jcpe.12403] [PMID]
41. Carreiro AFP, Delben JA, Guedes S, Silveira EJD, Janal MN, Vergani CE, Pushalkar S, Duarte S. Low-temperature plasma on peri-implant-related biofilm and gingival tissue. J Periodontol. 2019 May;90(5):507-15. [DOI:10.1002/JPER.18-0366] [PMID]
42. Lee JY, Kim KH, Park SY, Yoon SY, Kim GH, Lee YM, Rhyu IC, Seol YJ. The bactericidal effect of an atmospheric-pressure plasma jet on Porphyromonas gingivalis biofilms on sandblasted and acid-etched titanium discs. J Periodontal Implant Sci. 2019 Oct 4;49(5):319-29. [DOI:10.5051/jpis.2019.49.5.319] [PMID] []
43. Yang Y, Zheng M, Yang Y, Li J, Su YF, Li HP, Tan JG. Inhibition of bacterial growth on zirconia abutment with a helium cold atmospheric plasma jet treatment. Clin Oral Investig. 2020 Apr;24(4):1465-77. [DOI:10.1007/s00784-019-03179-2] [PMID]
44. Canullo L, Rakic M, Corvino E, Burton M, Krumbeck JA, Chittoor Prem A, Ravidà A, Ignjatović N, Sculean A, Menini M, Pesce P. Effect of argon plasma pre-treatment of healing abutments on peri-implant microbiome and soft tissue integration: a proof-of-concept randomized study. BMC Oral Health. 2023 Jan 17;23(1):27. [DOI:10.1186/s12903-023-02729-1] [PMID] []

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