Bactericidal efficacy of cold plasma in processed bone. A new approach for adjuvant therapy of medication-related osteonecrosis of the jaw?

Abstract

BackgroundMedication-related osteonecrosis of the jaw is a difficult to treat side effect of antiresorptive therapy. Despite intensive efforts in the treatment of this disease, therapy continues to be prolonged, burdensome and sometimes insufficient. Since bacterial contamination of the necrotic bone is a major factor in these problems, we have examined the antibacterial effect of physical cold atmospheric pressure plasma on contaminated bone. MethodsA total of 72 cortico-cancellous porcine bone cylinders were processed and incubated in Streptococcus mitis broth and afterwards treated with cold atmospheric plasma, chlorhexidine or sodium chloride solution (control). After grinding up the specimens, the bacteria were transferred to aqueous solution and a colony-forming unit count was performed. ResultsPhysical cold atmospheric pressure plasma showed the best results in terms of reduction in colony-forming unit count in porcine bone: overall median in colony-forming unit/ml was significantly below that for chlorhexidine (p=0.004) and control (p=0.008). ConclusionThese results suggest that cold atmospheric pressure plasma has profound effectiveness on the bacterially contaminated bone in vitro. The use on cancellous bone is possibly a promising technique and could be a useful tool in the therapeutic range for the treatment of medication-related osteonecrosis of the jaw.