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REVIEW article

Front. Oral. Health
Sec. Oral Infections and Microbes
Volume 5 - 2024 | doi: 10.3389/froh.2024.1483078
This article is part of the Research Topic Odontogenic Infection as a Complication of Dental Caries: Microbiological and Molecular Aspects - Volume II View all articles

Disinfection of dental root canals by cold atmospheric plasma: a systematic review and meta-analysis of dental biofilm

Provisionally accepted
Lorenzo Sanesi Lorenzo Sanesi 1VALENTINA PUCA VALENTINA PUCA 2VITO CARLO ALBERTO CAPONIO VITO CARLO ALBERTO CAPONIO 1Morena Pinti Morena Pinti 2Giuseppe Balice Giuseppe Balice 3Beatrice Femminella Beatrice Femminella 3Michele Paolantonio Michele Paolantonio 3Ilaria Cela Ilaria Cela 3Nagendra Kumar Kaushik Nagendra Kumar Kaushik 4Eun Ha Choi Eun Ha Choi 4Rossella Grande Rossella Grande 2ELOISA SARDELLA ELOISA SARDELLA 5Vittoria Perrotti Vittoria Perrotti 3*
  • 1 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Apulia, Italy
  • 2 Department of Pharmacy, University 'G. d'Annunzio' of Chieti-Pescara, Chieti, Italy
  • 3 Department of Innovative Technologies in Medicine and Dentistry, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
  • 4 Plasma Bioscience Research Center, Kwangwoon University, Seoul, Republic of Korea
  • 5 CNR- Istituto di Nanotecnologia (CNR-NANOTEC) UoS Bari, Bari, Italy

The final, formatted version of the article will be published soon.

    The intricate structure of the tooth root canals has a role in the colonization and biofilm formation in hidden areas that are hardly reached by standard endodontic treatments. This review aims at summarizing data from in vitro and ex vivo studies for a better understanding of the application of cold atmospheric plasma (CAP) for the disinfection of dental root canals.Methods: PubMed, Scopus, and Web of Science databases were screened. Characteristics of the included studies were extracted, and a meta-analysis on ex vivo studies was carried out to evaluate the effect of CAP on colony forming unit assay of Enterococcus faecalis (E. faecalis). The study was performed following the PRISMA 2020 guidelines.Results: A total of 31 studies fulfilled the selection criteria. Only 2 investigations reported an indirect plasma treatment, 28 trials used direct CAP administration, while 1 study applied both methods. Most of the studies were conducted on E. faecalis using as carrier gas Helium or Argon alone or in combination with Oxygen as well air. A considerable heterogeneity among studies was found regarding treatments which varied for source type, settings, and protocols of application. Despite this, CAP showed effectiveness in reducing E. faecalis colony forming unit with a standardized mean difference of 4.51, 95% C.I.=2. 55-6.48, p-value<0.001.The data demonstrated the antimicrobial effect of direct CAP application against microorganisms. In-vitro studies showed an effect that depended on the time and distance of treatment, while the meta-analysis performed on ex vivo studies showed that the effect of CAP was independent of time and distance.

    Keywords: Biofilm, cold atmospheric plasma, Oral microorganisms, plasma medicine, Disinfection, dental root canals

    Received: 19 Aug 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Sanesi, PUCA, CAPONIO, Pinti, Balice, Femminella, Paolantonio, Cela, Kaushik, Choi, Grande, SARDELLA and Perrotti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Vittoria Perrotti, Department of Innovative Technologies in Medicine and Dentistry, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, 66013, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.