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In vitro and in vivo research of atmosphere pressure nonequilibrium plasmas on root canal disinfection: implication for alternative strategy for irrigation

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Abstract

Objective

To investigate an intracanal disinfection methodology of APNPs (atmosphere pressure nonequilibrium plasmas) or modified APNPs in root canal treatment and evaluate the antimicrobial efficiency against in vitro infected dentinal tubules and in vivo experimental apical periodontitis.

Materials and methods

Dentine specimens were centrifugated with Enterococcus faecalis to generate 1-day-old and 3-week-old biofilms, and were treated with 2% chlorhexidine (Chx), APNP or modified APNP for 3 and 10 min (n=4). LIVE/DEAD staining was employed to analyze the ratio of deactivated bacteria. Experimental apical periodontitis in beagles was induced. Root canal therapy with APNPs or modified APNPs was performed and the antimicrobial effect was evaluated by histological and radiographical analyses.

Results

APNP deactivated 1-day-old and 3-week-old E. feacalis in dentinal tubules as much as 2% Chx irrigating. Modified APNP significantly deactivated more E. faecalis biofilms in dentinal tubules for 3-min and 10-min treatments, without thermal damage or dentinal destruction being observed. In beagles’ apical periodontitis, significantly increased BV/TV and decreased lesion volume of apical bone were found in modified APNP group than 2% Chx irrigation group according to μCT. Fewer inflammatory cells and bacterial residual in dentine were observed in modified APNP-treated apical tissue by histology staining compared with those in the 2% Chx irrigation group.

Conclusion

The antimicrobial effect of APNP jet irradiation was comparable to that of 2% Chx irrigation. No structural damage in dentine or tissue necrosis at the periapical region was induced upon treatment. The modified APNP demonstrated an increased antimicrobial efficacy compared with 2% Chx irrigation both in vitro and in vivo.

Clinical relevance

The modified APNPs can be used as an alternative intracanal disinfection strategy.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (Nos. 81271189) and Department of Science and Technology, Hubei Provincial People’s Government (Nos. 2015BCE058).

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Authors and Affiliations

  1. Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, China

    Yichen Yao, Ke Song, Hui Chen, Xiaoxiao Ding, Qi Shi & Yingguang Cao

  2. State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan, China

    Xinpei Lu

Authors
  1. Yichen Yao
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  2. Ke Song
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  3. Hui Chen
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  4. Xiaoxiao Ding
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  7. Yingguang Cao
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Contributions

Yichen Yao contributed to design, data acquisition, analysis, and interpretation, and drafted the manuscript; Ke Song contributed to data acquisition and analysis and critically revised the manuscript; Hui Chen contributed to data acquisition and analysis; Xiaoxiao Ding contributed to data acquisition and analysis; Qi Shi contributed to conception and design; Xinpei Lu and Yingguang Cao contributed to conception, design, and data interpretation, and critically revised the manuscript. All the authors gave final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Yingguang Cao.

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Ethical approval

All procedures were performed were conducted strictly in full accordance with the ethical principles and standards of the institutional and national research committee and with the 1964 World Medical Association Declaration of Helsinki and its later amendments (version 2008). All experimental protocols were reviewed and approved by the Science and Ethics Commission of Tongji Medical College, Huazhong University of Science and Technology (IACUC No. 2134).

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The authors declare no competing interests.

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Yao, Y., Song, K., Chen, H. et al. In vitro and in vivo research of atmosphere pressure nonequilibrium plasmas on root canal disinfection: implication for alternative strategy for irrigation. Clin Oral Invest 25, 5833–5842 (2021). https://doi.org/10.1007/s00784-021-03888-7

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  • DOI: https://doi.org/10.1007/s00784-021-03888-7

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