title: Cold plasma: a novel approach to treat infected dentin-a combined ex vivo and in vitro study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the antimicrobial effect of cold plasma (CP) on infected dentin surfaces in vitro and ex vivo.
  
  
  METHODS
  To examine the effect of cold plasma on root surfaces, 24 root surfaces were infected with Streptococcus mitis. Specimens were randomly divided into three groups: Within the control group (C), root surfaces were rinsed with NaCl; root surfaces in the second group were additionally scaled and root planed (SRP), and in the third group, root surfaces were rinsed, scaled, root planed, and in addition, CP was applied (SRP + CP). To examine the effect of CP on root caries lesions (RCLs), 16 freshly extracted teeth with symmetrical carious lesions were equally divided into two groups. In the control group, carious lesions were treated with chlorhexidine (CHX), whereas CHX was applied in conjunction with CP in the test group (CHX + CP). For microbiological analysis, dentin samples were serially diluted and CFU counts were estimated after 24 h of incubation.
  
  
  RESULTS
  Compared to C, mean CFU values for SRP and SRP + CP were significantly lower (p < 0.05). In addition, mean CFUs for SRP + CP were reduced to 0 and, therefore, significantly lower than SRP (2.98 log CFU/mL) alone (p = 0.000, Mann-Whitney U). Regarding RCLs, significantly lower mean CFU values were observed for CHX + CP when compared to CHX (4.45 vs. 2.67 log CFU/mL, p = 0.002, Mann-Whitney U test).
  
  
  CONCLUSIONS
  For disinfection of exposed root surfaces, the adjunctive application of CP is promising. In addition, the combined application of CHX + CP has the potential to disinfect root dentin surfaces.
  
  
  CONCLUSIONS
  It was shown that the combination of cold plasma with CHX is the best available option for the disinfection of root surfaces.
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Pierdzioch
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hartwig
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Sascha R
authors.initials: SR
authors.lastname: Herbst
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Jan Dirk
authors.initials: JD
authors.lastname: Raguse
authors.affiliation: Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Dommisch
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Shady
authors.initials: S
authors.lastname: Abu-Sirhan
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Henrik C
authors.initials: HC
authors.lastname: Wirtz
authors.affiliation: Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Hertel
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Paris
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Assmanshauser Str. 4-6, 14197, Berlin, Germany. saskia.preissner@charite.de.
authors.forename: Saskia
authors.initials: S
authors.lastname: Preissner
mesh_terms: D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D002710:Chlorhexidine / Q000494:pharmacology; D012534:Dental Scaling; D003804:Dentin / Q000187:drug effects* / Q000382:microbiology*; D004203:Disinfection / Q000379:methods*; D006801:Humans; D058626:Plasma Gases; D016745:Root Planing; D012965:Sodium Chloride; D034361:Streptococcus mitis; D007507:Therapeutic Irrigation; D014092:Tooth Root / Q000187:drug effects* / Q000382:microbiology*
chemical_list: D000891:Anti-Infective Agents, Local; D058626:Plasma Gases; D012965:Sodium Chloride; D002710:Chlorhexidine
keywords: Aging society; Cold plasma; Periodontitis; Root caries; Tissue tolerable plasma