In-vitro biofilm removal from TiUnite® implant surface with an air polishing and two different plasma devices.


Journal

BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684

Informations de publication

Date de publication:
13 May 2024
Historique:
received: 16 03 2023
accepted: 04 04 2024
medline: 14 5 2024
pubmed: 14 5 2024
entrez: 13 5 2024
Statut: epublish

Résumé

We investigated the efficacy of two different cold atmospheric pressure jet plasma devices (CAP09 and CAPmed) and an air polishing device with glycine powder (AP) either applied as monotherapies or combined therapies (AP + CAP09; AP + CAPmed), in microbial biofilm removal from discs with anodised titanium surface. Discs covered with 7-day-old microbial biofilm were treated either with CAP09, CAPmed, AP, AP + CAP09 or AP + CAPmed and compared with negative and positive controls. Biofilm removal was assessed with flourescence and electron microscopy immediately after treatment and after 5 days of reincubation of the treated discs. Treatment with CAP09 or CAPmed did not lead to an effective biofilm removal, whereas treatment with AP detached the complete biofilm, which however regrew to baseline magnitude after 5 days of reincubation. Both combination therapies (AP + CAP09 and AP + CAPmed) achieved a complete biofilm removal immediately after cleaning. However, biofilm regrew after 5 days on 50% of the discs treated with the combination therapy. AP treatment alone can remove gross biofilm immediately from anodised titanium surfaces. However, it did not impede regrowth after 5 days, because microorganisms were probably hidden in holes and troughs, from which they could regrow, and which were inaccessible to AP. The combination of AP and plasma treatment probably removed or inactivated microorganisms also from these hard to access spots. These results were independent of the choice of plasma device.

Sections du résumé

BACKGROUND BACKGROUND
We investigated the efficacy of two different cold atmospheric pressure jet plasma devices (CAP09 and CAPmed) and an air polishing device with glycine powder (AP) either applied as monotherapies or combined therapies (AP + CAP09; AP + CAPmed), in microbial biofilm removal from discs with anodised titanium surface.
METHODS METHODS
Discs covered with 7-day-old microbial biofilm were treated either with CAP09, CAPmed, AP, AP + CAP09 or AP + CAPmed and compared with negative and positive controls. Biofilm removal was assessed with flourescence and electron microscopy immediately after treatment and after 5 days of reincubation of the treated discs.
RESULTS RESULTS
Treatment with CAP09 or CAPmed did not lead to an effective biofilm removal, whereas treatment with AP detached the complete biofilm, which however regrew to baseline magnitude after 5 days of reincubation. Both combination therapies (AP + CAP09 and AP + CAPmed) achieved a complete biofilm removal immediately after cleaning. However, biofilm regrew after 5 days on 50% of the discs treated with the combination therapy.
CONCLUSION CONCLUSIONS
AP treatment alone can remove gross biofilm immediately from anodised titanium surfaces. However, it did not impede regrowth after 5 days, because microorganisms were probably hidden in holes and troughs, from which they could regrow, and which were inaccessible to AP. The combination of AP and plasma treatment probably removed or inactivated microorganisms also from these hard to access spots. These results were independent of the choice of plasma device.

Identifiants

pubmed: 38741081
doi: 10.1186/s12903-024-04230-9
pii: 10.1186/s12903-024-04230-9
doi:

Substances chimiques

Titanium D1JT611TNE
Plasma Gases 0
Dental Implants 0
Glycine TE7660XO1C
titanium nickelide 12035-60-8
Nickel 7OV03QG267

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

558

Informations de copyright

© 2024. The Author(s).

Références

Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(Suppl):S21–41.
pubmed: 22834392
Claffey N, Clarke E, Polyzois I, Renvert S. Surgical treatment of peri-implantitis. J Clin Periodontol. 2008;35:316–32. https://doi.org/10.1111/j.1600-051X.2008.01277.x .
doi: 10.1111/j.1600-051X.2008.01277.x pubmed: 18724859
Tonetti MS, Claffey N. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European workshop in Periodontology. J Clin Periodontol. 2005;32(Suppl 6):210–3. https://doi.org/10.1111/j.1600-051X.2005.00822.x .
doi: 10.1111/j.1600-051X.2005.00822.x pubmed: 16128839
Hentenaar DFM, de Waal YCM, Stewart RE, van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol air polishing in the surgical treatment of peri-implantitis: a randomized controlled trial. Clin Oral Implants Res. 2021. https://doi.org/10.1111/clr.13881 .
doi: 10.1111/clr.13881 pubmed: 34808006 pmcid: 9299917
Gonçalves F, Zanetti AL, Zanetti RV, Martelli FS, Avila-Campos MJ, Tomazinho LF, Granjeiro JM. Effectiveness of 980-mm diode and 1064-nm extra-long-pulse neodymium-doped yttrium aluminum garnet lasers in implant disinfection. Photomed Laser Surg. 2010;28:273–80. https://doi.org/10.1089/pho.2009.2496 .
doi: 10.1089/pho.2009.2496 pubmed: 19811080
Hentenaar DFM, de Waal YCM, van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Non-surgical peri-implantitis treatment using a pocket irrigator device; clinical, microbiological, radiographical and patient-centred outcomes-A pilot study. Int J Dental Hygiene. 2020;18:403–12. https://doi.org/10.1111/idh.12462 .
doi: 10.1111/idh.12462
Berglundh T, Wennström JL, Lindhe J. Long-term outcome of surgical treatment of peri-implantitis. A 2-11-year retrospective study. Clin Oral Implants Res. 2018;29:404–10. https://doi.org/10.1111/clr.13138 .
doi: 10.1111/clr.13138 pubmed: 29575025
Tastepe CS, Liu Y, Visscher CM, Wismeijer D. Cleaning and modification of intraorally contaminated titanium discs with calcium phosphate powder abrasive treatment. Clin Oral Implants Res. 2013;24:1238–46. https://doi.org/10.1111/j.1600-0501.2012.02536.x .
doi: 10.1111/j.1600-0501.2012.02536.x pubmed: 22882522
Sahrmann P, Ronay V, Hofer D, Attin T, Jung RE, Schmidlin PR. In vitro cleaning potential of three different implant debridement methods. Clin Oral Impl Res. 2015;26:314–9. https://doi.org/10.1111/clr.12322 .
doi: 10.1111/clr.12322
Keim D, Nickles K, Dannewitz B, Ratka C, Eickholz P, Petsos H. In-vitro efficacy of three different implant-surface decontamination methods in three different defect configurations. Clin Oral Impl Res. 2019;30:550–8. https://doi.org/10.1111/clr.13441 .
doi: 10.1111/clr.13441
Lang NP, Lindhe J. Clinical periodontology and Implant Dentistry. 2nd ed. Somerset: Wiley; 2015.
Carcuac O, Derks J, Abrahamsson I, Wennstrom JL, Petzold M, Berglundh T. Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial. J Clin Periodontol. 2017;44:1294–303. https://doi.org/10.1111/jcpe.12813 .
doi: 10.1111/jcpe.12813 pubmed: 28902426
Hentenaar DFM, de Waal YCM, Vissink A, van Winkelhoff AJ, Meijer HJA, Liefers SC, et al. Biomarker levels in peri-implant crevicular fluid of healthy implants, untreated and non-surgically treated implants with peri-implantitis. J Clin Periodontol. 2021;48:590–601. https://doi.org/10.1111/jcpe.13423 .
doi: 10.1111/jcpe.13423 pubmed: 33454996
Albouy J-P, Abrahamsson I, Persson LG, Berglundh T. Implant surface characteristics influence the outcome of treatment of peri-implantitis: an experimental study in dogs. J Clin Periodontol. 2011;38:58–64. https://doi.org/10.1111/j.1600-051X.2010.01631.x .
doi: 10.1111/j.1600-051X.2010.01631.x pubmed: 21092053
Ivanoff C-J, Widmark G, Johansson C, Wennerberg A. Histologic evaluation of bone response to oxidized and turned titanium micro-implants in human jawbone. Int J Oral Maxillofacial Implants. 2003;18:341–8.
von Woedtke T, Schmidt A, Bekeschus S, Wende K, Weltmann K-D. Plasma medicine: a field of Applied Redox Biology. Vivo. 2019;33:1011–26. https://doi.org/10.21873/invivo.11570 .
doi: 10.21873/invivo.11570
Daeschlein G, Napp M, von Podewils S, Lutze S, Emmert S, Lange A, et al. In Vitro susceptibility of Multidrug resistant skin and Wound pathogens against Low Temperature Atmospheric pressure plasma jet (APPJ) and Dielectric Barrier Discharge plasma (DBD). Plasma Process Polym. 2014;11:175–83. https://doi.org/10.1002/ppap.201300070 .
doi: 10.1002/ppap.201300070
Duske K, Koban I, Kindel E, Schröder K, Nebe B, Holtfreter B, et al. Atmospheric plasma enhances wettability and cell spreading on dental implant metals. J Clin Periodontol. 2012;39:400–7. https://doi.org/10.1111/j.1600-051X.2012.01853.x .
doi: 10.1111/j.1600-051X.2012.01853.x pubmed: 22324415
Duske K, Jablonowski L, Koban I, Matthes R, Holtfreter B, Sckell A, et al. Cold atmospheric plasma in combination with mechanical treatment improves osteoblast growth on biofilm covered titanium discs. Biomaterials. 2015;52:327–34. https://doi.org/10.1016/j.biomaterials.2015.02.035 .
doi: 10.1016/j.biomaterials.2015.02.035 pubmed: 25818439
Matthes R, Duske K, Kebede TG, Pink C, Schlüter R, von Woedtke T, et al. Osteoblast growth, after cleaning of biofilm-covered titanium discs with air‐polishing and cold plasma. J Clin Periodontol. 2017;44:672–80. https://doi.org/10.1111/jcpe.12720 .
doi: 10.1111/jcpe.12720 pubmed: 28303583
Kamionka J, Matthes R, Holtfreter B, Pink C, Schlüter R, von Woedtke T, et al. Efficiency of cold atmospheric plasma, cleaning powders and their combination for biofilm removal on two different titanium implant surfaces. Clin Oral Investig. 2022;26:3179–87. https://doi.org/10.1007/s00784-021-04300-0 .
doi: 10.1007/s00784-021-04300-0 pubmed: 34988694 pmcid: 8898218
von Woedtke T, Schmidt A, Bekeschus S, Wende K. Introduction to plasma medicine. In: Metelmann H-R, von Woedtke T, Weltmann K-D, editors. Comprehensive clinical plasma medicine: Cold Physical plasma for medical application. Cham: Springer International Publishing; 2018. pp. 3–21. https://doi.org/10.1007/978-3-319-67627-2_1 .
doi: 10.1007/978-3-319-67627-2_1
Assadian O, Ousey KJ, Daeschlein G, Kramer A, Parker C, Tanner J, Leaper DJ. Effects and safety of atmospheric low-temperature plasma on bacterial reduction in chronic wounds and wound size reduction: a systematic review and meta‐analysis. Int Wound J. 2019;16:103–11. https://doi.org/10.1111/iwj.12999 .
doi: 10.1111/iwj.12999 pubmed: 30311743
Reuter S, von Woedtke T, Weltmann K-D. The kINPen—a review on physics and chemistry of the atmospheric pressure plasma jet and its applications. J Phys D: Appl Phys. 2018;51:233001. https://doi.org/10.1088/1361-6463/aab3ad .
doi: 10.1088/1361-6463/aab3ad
Mann MS, Tiede R, Gavenis K, Daeschlein G, Bussiahn R, Weltmann K-D, et al. Introduction to DIN-specification 91315 based on the characterization of the plasma jet kINPen® MED. Clin Plasma Med. 2016;4:35–45. https://doi.org/10.1016/j.cpme.2016.06.001 .
doi: 10.1016/j.cpme.2016.06.001
Miebach L, Freund E, Clemen R, Weltmann K-D, von Hans-Robert-Metelmann, Woedtke T, et al. Conductivity augments ROS and RNS delivery and tumor toxicity of an argon plasma jet. Free Radic Biol Med. 2022;180:210–9. https://doi.org/10.1016/j.freeradbiomed.2022.01.014 .
doi: 10.1016/j.freeradbiomed.2022.01.014 pubmed: 35065239
Benjamini Y, Hochberg Y. Controlling the false Discovery rate: a practical and powerful Approach to multiple testing. J Roy Stat Soc: Ser B (Methodol). 1995;57:289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x .
doi: 10.1111/j.2517-6161.1995.tb02031.x
StataCorp. Stata Statistical Software: release 14. College Station. TX: StataCorp LP; 2015.
R Core Team. R: a Language and Environment for Statistical Computing. Vienna, Austria: R Foundation; 2022.
Gerling T, Brandenburg R, Wilke C, Weltmann K-D. Power measurement for an atmospheric pressure plasma jet at different frequencies: distribution in the core plasma and the effluent. Eur Phys J Appl Phys. 2017;78:10801. https://doi.org/10.1051/epjap/2017160489 .
doi: 10.1051/epjap/2017160489
Duske K, Wegner K, Donnert M, Kunert U, Podbielski A, Kreikemeyer B, et al. Comparative in Vitro Study of different Atmospheric pressure plasma jets concerning their antimicrobial potential and Cellular reaction. Plasma Process Polym. 2015;12:1050–60. https://doi.org/10.1002/ppap.201400176 .
doi: 10.1002/ppap.201400176
Sauer K, Stoodley P, Goeres DM, Hall-Stoodley L, Burmølle M, Stewart PS, Bjarnsholt T. The biofilm life cycle: expanding the conceptual model of biofilm formation. Nat Rev Microbiol. 2022;20:1–13. https://doi.org/10.1038/s41579-022-00767-0 .
doi: 10.1038/s41579-022-00767-0
Hao C-P, Cao N-J, Zhu Y-H, Wang W. The osseointegration and stability of dental implants with different surface treatments in animal models: a network meta-analysis. Sci Rep. 2021;11:13849. https://doi.org/10.1038/s41598-021-93307-4 .
doi: 10.1038/s41598-021-93307-4 pubmed: 34226607 pmcid: 8257659
Kumari R, Blawert C, Majumdar JD. Microstructures and properties of plasma Electrolytic Oxidized Ti Alloy (Ti-6Al-4V) for bio-implant application. Metall Mater Trans A. 2016;47:788–800. https://doi.org/10.1007/s11661-015-3256-y .
doi: 10.1007/s11661-015-3256-y
Renvert S, Polyzois I, Claffey N. How do implant surface characteristics influence peri-implant disease? // how do implant surface characteristics influence peri-implant disease? J Clin Periodontol. 2011;38(Suppl 11):214–22. https://doi.org/10.1111/j.1600-051X.2010.01661.x .
doi: 10.1111/j.1600-051X.2010.01661.x pubmed: 21323717
Albouy J-P, Abrahamsson I, Berglundh T. Spontaneous progression of experimental peri-implantitis at implants with different surface characteristics: an experimental study in dogs. J Clin Periodontol. 2012;39:182–7. https://doi.org/10.1111/j.1600-051X.2011.01820.x .
doi: 10.1111/j.1600-051X.2011.01820.x pubmed: 22136592
Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of Implant Therapy analyzed in a Swedish Population: early and late Implant loss. J Dent Res. 2015;94:44–51. https://doi.org/10.1177/0022034514563077 .
doi: 10.1177/0022034514563077
Carcuac O, Abrahamsson I, Charalampakis G, Berglundh T. The effect of the local use of chlorhexidine in surgical treatment of experimental peri-implantitis in dogs. J Clin Periodontol. 2015;42:196–203. https://doi.org/10.1111/jcpe.12332 .
doi: 10.1111/jcpe.12332 pubmed: 25385434
Carcuac O, Derks J, Abrahamsson I, Wennström JL, Berglundh T. Risk for recurrence of disease following surgical therapy of peri-implantitis-a prospective longitudinal study. Clin Oral Implants Res. 2020;31:1072–7. https://doi.org/10.1111/clr.13653 .
doi: 10.1111/clr.13653 pubmed: 32870513
Htet M, Madi M, Zakaria O, Miyahara T, Xin W, Lin Z, et al. Decontamination of Anodized Implant Surface with different modalities for Peri-implantitis Treatment: lasers and mechanical debridement with citric acid. J Periodontol. 2016;87:953–61. https://doi.org/10.1902/jop.2016.150615 .
doi: 10.1902/jop.2016.150615 pubmed: 26966876
Schwarz F, Becker K, Bastendorf K-D, Cardaropoli D, Chatfield C, Dunn I, et al. Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis. Quintessence Int. 2016;47:293–6. https://doi.org/10.3290/j.qi.a35132 .
doi: 10.3290/j.qi.a35132 pubmed: 26574612
Moharrami M, Perrotti V, Iaculli F, Love RM, Quaranta A. Effects of air abrasive decontamination on titanium surfaces: a systematic review of in vitro studies. Clin Implant Dent Relat Res. 2019;21:398–421. https://doi.org/10.1111/cid.12747 .
doi: 10.1111/cid.12747 pubmed: 30838790
Toma S, Lasserre JF, Taïeb J, Brecx MC. Evaluation of an air-abrasive device with amino acid glycine-powder during surgical treatment of peri-implantitis. Quintessence Int. 2014;45:209–19. https://doi.org/10.3290/j.qi.a31205 .
doi: 10.3290/j.qi.a31205 pubmed: 24570988
Toma S, Brecx MC, Lasserre JF. Clinical evaluation of three Surgical modalities in the treatment of Peri-implantitis: a Randomized Controlled Clinical Trial. J Clin Med. 2019;8(966):1–12. https://doi.org/10.3390/jcm8070966 .
doi: 10.3390/jcm8070966
Carcuac O, Derks J, Charalampakis G, Abrahamsson I, Wennstrom J, Berglundh T, Wennström J. Adjunctive systemic and local antimicrobial therapy in the Surgical treatment of peri-implantitis // adjunctive systemic and Local Antimicrobial Therapy in the Surgical treatment of peri-implantitis: a Randomized Controlled Clinical Trial: a Randomized Controlled Clinical Trial. J Dent Res. 2016;95:50–7. https://doi.org/10.1177/0022034515601961 .
doi: 10.1177/0022034515601961 pubmed: 26285807
Hui WL, Perrotti V, Iaculli F, Piattelli A, Quaranta A. The emerging role of Cold Atmospheric plasma in Implantology: a review of the literature. Nanomaterials (Basel Switzerland). 2020. https://doi.org/10.3390/nano10081505 .
doi: 10.3390/nano10081505 pubmed: 32962288 pmcid: 7520466
Rupf S, Idlibi AN, Marrawi FA, Hannig M, Schubert A, von Mueller L, et al. Removing biofilms from Microstructured Titanium Ex vivo: a Novel Approach using Atmospheric plasma technology // removing biofilms from microstructured titanium ex vivo: a novel approach using atmospheric plasma technology. PLoS ONE. 2011;6:e25893. https://doi.org/10.1371/journal.pone.0025893 .
doi: 10.1371/journal.pone.0025893 pubmed: 22016784 pmcid: 3189945
Hui WL, Ipe D, Perrotti V, Piattelli A, Fang Z, Ostrikov K, Quaranta A. Novel technique using cold atmospheric plasma coupled with air-polishing for the treatment of titanium discs grown with biofilm: an in-vitro study. Dent Mater. 2021;37:359–69. https://doi.org/10.1016/j.dental.2020.11.027 .
doi: 10.1016/j.dental.2020.11.027 pubmed: 33358017
Koch M, Burkovski A, Zulla M, Rosiwal S, Geißdörfer W, Dittmar R, Grobecker-Karl T. Pilot study on the Use of a laser-structured double Diamond Electrode (DDE) for Biofilm removal from Dental Implant surfaces. J Clin Med. 2020;9:3036. https://doi.org/10.3390/jcm9093036 .
doi: 10.3390/jcm9093036 pubmed: 32967183 pmcid: 7565428
Koch M, Göltz M, Xiangjun M, Karl M, Rosiwal S, Burkovski A. Electrochemical Disinfection of Dental Implants Experimentally Contaminated with microorganisms as a model for Periimplantitis. J Clin Med. 2020;9:475. https://doi.org/10.3390/jcm9020475 .
doi: 10.3390/jcm9020475 pubmed: 32050444 pmcid: 7074531
Schlee M, Naili L, Rathe F, Brodbeck U, Zipprich H. Is complete re-osseointegration of an infected Dental Implant possible? Histologic results of a dog study: a short communication. J Clin Med. 2020;9:235. https://doi.org/10.3390/jcm9010235 .
doi: 10.3390/jcm9010235 pubmed: 31963136 pmcid: 7020040
Ratka C, Weigl P, Henrich D, Koch F, Schlee M, Zipprich H. The Effect of in Vitro Electrolytic Cleaning on Biofilm-contaminated Implant surfaces. J Clin Med. 2019;8:1397. https://doi.org/10.3390/jcm8091397 .
doi: 10.3390/jcm8091397 pubmed: 31500093 pmcid: 6780638
Matthes R, Jablonowski L, Pitchika V, Holtfreter B, Eberhard C, Seifert L, et al. Efficiency of biofilm removal by combination of water jet and cold plasma: an in-vitro study. BMC Oral Health. 2022;22:157. https://doi.org/10.1186/s12903-022-02195-1 .
doi: 10.1186/s12903-022-02195-1 pubmed: 35524324 pmcid: 9074283
Idlibi AN, Al-Marrawi F, Hannig M, Lehmann A, Rueppell A, Schindler A, et al. Destruction of oral biofilms formed in situ on machined titanium (Ti) surfaces by cold atmospheric plasma. Biofouling. 2013;29:369–79. https://doi.org/10.1080/08927014.2013.775255 .
doi: 10.1080/08927014.2013.775255 pubmed: 23574038
Hui WL, Perrotti V, Piattelli A, Ostrikov KK, Fang Z, Quaranta A. Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study. Clin Oral Investig. 2021;1–10. https://doi.org/10.1007/s00784-021-03949-x .
Leung K, Bi J, Giannelis G, Owen G, Larjava H. Decontamination of multispecies oral biofilm from rough implant surface by airflow with glycine. Clin Exp Dent Res. 2022;8:322–8. https://doi.org/10.1002/cre2.507 .
doi: 10.1002/cre2.507 pubmed: 34704380
Pham CM, Chen C-Y, Kim DM. The effects of using erbium, chromium-doped:yttrium-scandium-gallium-garnet laser on the surface modification, bacterial decontamination, and cell adhesion on zirconia discs: an in vitro study. Lasers Med Sci. 2021;36:1701–8. https://doi.org/10.1007/s10103-021-03313-1 .
doi: 10.1007/s10103-021-03313-1 pubmed: 33929623
Amate-Fernández P, Figueiredo R, Blanc V, Àlvarez G, León R, Valmaseda-Castellón E. Erythritol-enriched powder and oral biofilm regrowth on dental implants: an in vitro study. Med Oral Patol Oral Cir Bucal. 2021;26:e602–10. https://doi.org/10.4317/medoral.24622 .
doi: 10.4317/medoral.24622 pubmed: 33772566 pmcid: 8412445

Auteurs

Sandra Haude (S)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany.

Rutger Matthes (R)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany.

Vinay Pitchika (V)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany.

Birte Holtfreter (B)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany.

Rabea Schlüter (R)

Imaging Center of the Department of Biology, University of Greifswald, Greifswald, Germany.

Torsten Gerling (T)

ZIK Plasmatis, Leibniz-Institute for Plasma Science and Technology e.V. (INP), a member of the Leibniz Research Alliance Leibniz Health Technology, Greifswald, Germany.

Thomas Kocher (T)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany.

Lukasz Jablonowski (L)

Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Paediatric Dentistry, Dental School, University Medicine Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D - 17475, Germany. lukasz.jablonowski@uni-greifswald.de.

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