Lukasz Jablonowski

Atmospheric pressure plasma: a high-performance tool for the efficient removal of biofilms.

Introduction The medical use of non-thermal physical plasmas is intensively investigated for sterilization and surface modification of biomedical materials. A further promising application is the removal or etching of organic substances, e.g., biofilms, from surfaces, because remnants of biofilms after conventional cleaning procedures are capable to entertain inflammatory processes in the adjacent tissues. In general, contamination of surfaces by micro-organisms is a major source of problems in health care. Especially biofilms are the most common type of microbial growth in the human body and therefore, the complete removal of pathogens is mandatory for the prevention of inflammatory infiltrate. Physical plasmas offer a huge potential to inactivate micro-organisms and to remove organic materials through plasma-generated highly reactive agents. Method In this study a Candida albicans biofilm, formed on polystyrene (PS) wafers, as a prototypic biofilm was used to verify the etching capability of the atmospheric pressure plasma jet operating with two different process gases (argon and argon/oxygen mixture). The capability of plasma-assisted biofilm removal was assessed by microscopic imaging. Results The Candida albicans biofilm, with a thickness of 10 to 20 µm, was removed within 300 s plasma treatment when oxygen was added to the argon gas discharge, whereas argon plasma alone was practically not sufficient in biofilm removal. The impact of plasma etching on biofilms is localized due to the limited presence of reactive plasma species validated by optical emission spectroscopy.

Synergistic Effects of Nonthermal Plasma and Disinfecting Agents against Dental Biofilms In Vitro

Aim. Dental biofilms play a major role in the pathogenesis of many dental diseases. In this study, we evaluated the synergistic effect of atmospheric pressure plasma and different agents in dentistry on the reduction of biofilms. Methods and Results. We used monospecies (S. mutans) and multispecies dental biofilm models grown on titanium discs in vitro. After treatment with one of the agents, the biofilms were treated with plasma. Efficacy of treatment was determined by the number of colony forming units (CFU) and by live-dead staining. For S. mutans biofilms no colonies could be detected after treatment with NaOCl or H2O2. For multispecies biofilms the combination with plasma achieved a higher CFU reduction than each agent alone. We found an additive antimicrobial effect between argon plasma and agents irrespective of the treatment order with cultivation technique. For EDTA and octenidine, antimicrobial efficacy assessed by live-dead staining differed significantly between the two treatment orders (P < 0.05). Conclusions. The effective treatment of dental biofilms on titanium discs with atmospheric pressure plasma could be increased by adding agents in vitro.

Medical Plasma in Dentistry: A Future Therapy for Peri-implantitis

Biofilm formation plays a major role in the pathogenesis of many oral diseases especially in peri-implantits. To evaluate the anti-biofilm effect of different plasma devices and processes we used different dental biofilm models: Candida albicans, Streptococcus mutans, Streptococcus sanguinis, aerobe multispecies human saliva and anaerobe plaque biofilms. After 10 min treatment we reduced the biofilms by 5 log10 steps using dielectric barrier discharge (DBD) plasma. Chlorhexidine is the gold standard antiseptic which achieved in the same time only a 1.5 log10 reduction. All plasma devices (DBD or plasma jets) damaged the membrane of the microorganisms but only etching plasma sources can remove the biofilm as shown in CLSM micrographs. It is possible to improve the plasma process using antiseptics like octenidine. This combination significantly reduced CFU values after 1 min plasma treatment compared to the plasma control. Beside the anti-biofilm effect an additional effect of plasma is the contact angle reduction of different titanium implant surfaces from 90° to super-hydrophilic (<5°). This can improve the implant healing process. Thus in the future, plasma could be an interesting treatment option in dentistry, especially in treatment of peri-implantits.

Plasmaanwendungen in der Zahn-, Mund- und Kieferheilkunde

Plasma kann zum Abtrag von dentalen Plaquebiofilmen und der Desinfektion von Oberflachen bei physiologischen Temperaturen genutzt werden. Zudem kann uber die reaktiven Prozesse an der Implantatoberflache die Oberflachenenergie zugunsten einer gesteigerten Hydrophilie verandert werden. Dieser Prozess unterstutzt die Adhasion von Bindegewebs- und Knochenzellen am Implantat und damit auch moglicherweise auch die Wundheilungsprozesse. Die beschriebenen Effekte zum Abtrag organischen Materials und zur Desinfektion konnen zur hauslichen Aufbereitung dentaler Prothesen genutzt werden, um das Risiko einer prothesenassoziierten Stomatitis zu verringern. Plasma besitzt auch eine gute Spaltgangigkeit und kann damit auch an schwer erreichbaren Stellen seine antimikrobielle Wirkung entfalten. Diese Eigenschaft eroffnet fur kaltes Plasma eine weitere Therapieanwendung im Bereich der Wurzelkanalbehandlung.