Atmospheric Pressure Plasma Activation of Hydroxyapatite to Improve Fluoride Incorporation and Modulate Bacterial Biofilm.

Maria Elena Zarif,Veronica Sătulu,Ecaterina Andronescu,Sorin Vizireanu,Alexandru Mihai Grumezescu,Sașa Alexandra Yehia,Alina Maria Holban,Florica Marinescu,Alexandru Titus Farcașiu,Bogdan Biță,Gheorghe Dinescu,Alexandra Cătălina Bîrcă

doi:10.3390/ijms222313103

Abstract

Despite the technological progress of the last decade, dental caries is still the most frequent oral health threat in children and adults alike. Such a condition has multiple triggers and is caused mainly by enamel degradation under the acidic attack of microbial cells, which compose the biofilm of the dental plaque. The biofilm of the dental plaque is a multispecific microbial consortium that periodically develops on mammalian teeth. It can be partially removed through mechanical forces by individual brushing or in specialized oral care facilities. Inhibition of microbial attachment and biofilm formation, as well as methods to strengthen dental enamel to microbial attack, represent the key factors in caries prevention. The purpose of this study was to elaborate a cold plasma-based method in order to modulate microbial attachment and biofilm formation and to improve the retention of fluoride (F−) in an enamel-like hydroxyapatite (HAP) model sample. Our results showed improved F retention in the HAP model, which correlated with an increased antimicrobial and antibiofilm effect. The obtained cold plasma with a dual effect exhibited through biofilm modulation and enamel strengthening through fluoridation is intended for dental application, such as preventing and treating dental caries and enamel deterioration.

Highlights

Dental caries is chronic, multifactorial, and one of the most common oral diseases
Without a previous plasma activation (HAP_g) or with a previous plasma activation step (HAP_DBDp_g), the presence of carbon is explained by the chemical composition of the fluoride-containing compound, while for the untreated HAP sample (HAP_i), the small amount of C represents residual carbon from the environment, resulting during sample manipulation
The viability of the analyzed Gram-positive (Staphylococcus aureus-S. aureus and Enterococcus faecalis-E. faecalis) and Gram-negative (Escherichia coli-E. coli and Pseudomonas aeruginosa-P. aeruginosa) bacteria revealed that these microorganisms can survive less than 24h on the plasma-activated HAP surfaces

Summary

Introduction

Multifactorial, and one of the most common oral diseases. It is mainly caused by tooth demineralization under the acidic attack of bacteria composing the dental plaque biofilm [1]. Carious lesions can be divided into non-cavitated and cavitated caries. To prevent the restorative care of the latter, non-cavitated caries must be early detected and treated using non-restorative approaches [4,5]. Fluoride administration has been the foundation of measures taken to reduce the prevalence and severity of tooth decay [6]. Fluoride can be delivered systemically and topically. The preventive effect of fluoride supplements is mainly posteruptive; systemic fluoride administration increases the risks of fluorosis. Topical fluoride application is preferred to the detriment of systemic fluoridation [7]. Topical fluorides are represented by home-use self-applied products (i.e., fluoride toothpaste) and professionally applied fluoride products (gel, varnish, foam), which are more concentrated and are applied less frequently [8]

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