Cold plasma is well-tolerated and does not disturb skin barrier or reduce skin moisture.

BACKGROUND: Cold plasma, a new treatment principle in dermatology based on ionic discharge delivering reactive molecular species and UV-light, exhibits strong antimicrobial efficacy in vitro and in vivo. Before implementing plasma as new medical treatment tool, its safety must be proven, as well as assessing skin tolerance and patient acceptance. PATIENTS AND METHODS: We investigated the plasma effects of three different plasma sources (pulsed, non-pulsed atmospheric pressure plasma jet (APPJ) and a dielectric barrier discharge (DBD)) on the transepidermal water loss (TEWL) and skin moisture after treating the fingertips of four healthy male volunteers. RESULTS: TEWL values were reduced by pulsed APPJ and DBD by about 20% but increased after non-pulsed APPJ by 5-20%. TEWL values normalized 30 min after all forms of plasma treatment. Skin moisture was increased immediately and 30 min after treatment with pulsed APPJ but was not affected by non-pulsed APPJ and DBD. CONCLUSIONS: All plasma treatments were well-tolerated and did not damage the skin barrier nor cause skin dryness. Cold plasma fulfils basic recommendations for safe use on human skin and as future option may serve as the first physical skin antiseptic.

Atmospheric plasma enhances wettability and cell spreading on dental implant metals.

OBJECTIVES: Treatment regimens, which predictably support re-osseointegration of implants with peri-implantitis, are needed. Increased wettability may be an important factor for re-osseointegration. In this study, a cold atmospheric pressure gas-discharge plasma was applied to reduce water contact angles on titanium discs with different surface topography and to improve the spreading of osteoblastic cells. MATERIAL AND METHODS: An argon plasma jet with different oxygen admixtures was used to treat titanium discs with different topologies, i.e. machined, SLA(®) , SLActive(®) , diamond bur-treated or Airflow(®) -treated. Water contact angles were measured before and after plasma treatment. The spreading behaviour of human osteoblastic cells was investigated. RESULTS: Contact angle of titanium discs (baseline values: 68°-117°) were significantly reduced close to 0° irrespective of surface topography after the application of argon plasma with 1.0% oxygen admixture for 60 s or 120 s. The cell size of osteoblastic cells grown on argon-oxygen-plasma-treated titanium discs was significantly larger than on non-treated surfaces (p < 0.001) irrespective of surface topography. CONCLUSIONS: Plasma treatment reduced contact angle and supported spreading of osteoblastic cells. The application of cold plasma may be supportive in the treatment of peri-implant lesions and may improve the process of re-osseointegration.

Antimicrobial efficacy of non-thermal plasma in comparison to chlorhexidine against dental biofilms on titanium discs in vitro - proof of principle experiment.

AIM: Dental biofilms play a major role in the pathogenesis of peri-implant mucositis. Biofilm reduction is a pre-requisite for a successful therapy of peri-implant mucosal lesions. In this study, we evaluated the effect of three different plasma devices on the reduction of Streptococcus mutans (S. mutans) and multispecies human saliva biofilms. MATERIAL AND METHODS: We assessed the efficacy of three different non-thermal atmospheric pressure plasma devices against biofilms of S. mutans and saliva multispecies grown on titanium discs in vitro in comparison with a chlorhexidine digluconate (CHX) rinse. Efficacy of plasma treatment was determined by the number of colony forming units (CFU) and by scanning electron microscopy. The results were reported as reduction of CFU (CFU(untreated) -CFU(treated) ). RESULTS: The application of plasma was much more effective than CHX against biofilms. The maximum reduction of CHX was 3.36 for S. mutans biofilm and 1.50 for saliva biofilm, whereas the colony forming units (CFU) reduction of the volume dielectric barrier discharge argon plasma was 5.38 for S. mutans biofilm and 5.67 for saliva biofilm. CONCLUSIONS: Treatment of single- and multispecies dental biofilms on titanium discs with non-thermal atmospheric pressure plasma was more efficient than CHX application in vitro. Thus, the development of plasma devices for the treatment of peri-implant mucositis may be fruitful.

The modified HET-CAM as a model for the assessment of the inflammatory response to tissue tolerable plasma.

Plasma medicine is a novel, highly interdisciplinary field of research. Although the knowledge is rare concerning plasma based biomedical mechanisms, correct dosages and treatment times, animal experiments have been carried out. To follow the 3Rs (reduction, refinement, replacement), it is necessary to define methods for the screening of plasma parameters. In order to determine a reliable test and validate the use of tissue tolerable plasma (TTP) for the treatment of chronic wounds, we have selected the modified hen's egg test on the chorioallantoic membrane (mod. HET-CAM) as a model to benchmark the inflammation potential of plasma. Inflammations of different intensities provoked by using an HF-plasma jet corresponded to the time of plasma-tissue interaction. Additionally, the plasma mode and the gas composition were changed to assess their influence on the efficacy of treatment. Pulsed plasma led to the mildest inflammation, while the addition of 0.1% oxygen to the argon carrier gas led to the most distinct reaction. It was found that the influence of the exposure time was greater than that of the mode and the gas composition. All inflammations were alleviated, when hydrocortisone (HC) was added immediately after plasma treatment. The results of the study demonstrate that the modified HET-CAM test is suitable for screening plasma sources and for the determination of the optimum parameters for treatment of chronic wounds. To transfer the chronic wound into an acute healing wound without harmful inflammation, the maximum time for plasma-tissue interaction should not exceed 5s with the tested plasma source. Furthermore, it is possible to induce defined plasma-inflammations on the chorioallantoic membrane and to determine the anti-inflammatory potential of test substances.