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Evaluation of efficacy of non-thermal atmospheric pressure plasma in treatment of periodontitis: a randomized controlled clinical trial

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Abstract

Objectives

In this clinical study, we aim to evaluate the effectiveness of non-thermal atmospheric pressure plasma (NAPP), which is a novel procedure used in periodontal pocket decontamination adjunctive to non-surgical periodontal treatment (NSPT).

Methods

The study included 25 systemically healthy periodontitis patients. In the split-mouth design, NAPP application into the pockets, in addition to NSPT, was performed. Clinical periodontal data, gingival crevicular fluid, and subgingival plaque samples of patients were taken before and during the first and third months of treatment. Biochemical assays were conducted using enzyme-linked immunosorbent assay. Analysis of bacteria was performed with polymerase chain reaction method.

Results

There was more clinical attachment level (CAL) gain in the 3rd month in the test group (deep pockets: 3.90 mm, pockets ≥ 5 mm: 2.72 mm) compared to the control group (deep pockets: 3.40 mm, pockets ≥ 5 mm: 2.58 mm) (p < 0.05), but no significant difference between groups in CAL. Clinical periodontal parameters improved in both study groups (p < 0.05). However, the gingival index (GI) and the bleeding on probing (BOP) rate decreased more in the test group (GI: 0.55, BOP: 9.48%, and GI: 0.38, BOP: 8.46% in the 1st and 3rd months, respectively) compared to the control group (GI: 0.68, BOP: 13.43%, and GI: 0.52, BOP: 14.58%) (p < 0.05). In addition, there was no significant difference in probing depth and biochemical markers between groups (p > 0.05). It was observed that NAPP reduced the number of bacteria more than the control group in the 1st and 3rd months.

Conclusions

It was seen that the single-time NAPP application concurrent with NSPT provided additional CAL gain, elimination of putative periodontopathogens and reduced their recolonization. Longitudinal studies with larger population and longer time are required.

Clinical relevance

NSPT is an effective method for the treatment of periodontitis but bacteria recolonization that causes recurrence of the periodontal disease occurs within a short period. NAPP can reduce the recurrence of periodontal disease by providing better bacterial elimination and should, therefore, be used in maintenance of periodontitis.

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Funding

This study was funded by The Scientific and Technological Research Council of Turkey (TÜBİTAK) with the project number 315S274.

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Authors and Affiliations

  1. Faculty of Dentistry, Department of Periodontology, Katip Celebi University, Izmir, Turkey

    Diğdem Küçük, Levent Savran, Mehmet Sağlam & Serhat Köseoğlu

  2. Private Practice, Izmir, Turkey

    Diğdem Küçük

  3. Faculty of Engineering and Architecture, Department of Biomedical Engineering, Katip Celebi University, Izmir, Turkey

    Utku Kürşat Ercan & Ozan Karaman

  4. Department of Biomedical Engineering, Tissue Engineering and Regenerative Medicine Laboratory, Katip Celebi University, Izmir, Turkey

    Ziyşan Buse Yarali

  5. The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, USA

    Alpdoğan Kantarci

  6. Hamidiye Faculty of Dentistry, Department of Periodontology, Health Sciences University, 34668, Istanbul, Turkey

    Serhat Köseoğlu

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  1. Diğdem Küçük
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  2. Levent Savran
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  3. Utku Kürşat Ercan
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  7. Mehmet Sağlam
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  8. Serhat Köseoğlu
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Corresponding author

Correspondence to Serhat Köseoğlu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This prospective, split-mouth, double-masked, placebo controlled randomized clinical trial (RCT) was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2008, and the study protocol was approved by the Research Ethics Committee of İzmir Katip Çelebi University of Medical Sciences (Date:16.09.2015, version number:1). This study was registered at Turkish Medicines And Medical Devices Agency (number: 71146310 [2015-AC-CE-00129]).

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Informed consent was obtained from all patients in the study.

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Küçük, D., Savran, L., Ercan, U.K. et al. Evaluation of efficacy of non-thermal atmospheric pressure plasma in treatment of periodontitis: a randomized controlled clinical trial. Clin Oral Invest 24, 3133–3145 (2020). https://doi.org/10.1007/s00784-019-03187-2

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  • DOI: https://doi.org/10.1007/s00784-019-03187-2

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