Preventing Candida albicans Contamination on Packaged Ti-6Al-4V Alloy Surfaces by Cold Atmospheric Plasma Treatment

Recent investigations have demonstrated that opportunistic fungi, such as Candida albicans, are associated with the contamination of implantable devices, biofilm formation, and consequent resistance to antimicrobial treatment. Preventing biofilm formation on implantable device surfaces represents a significant challenge in medicine and dentistry. This study aimed to evaluate the effects of cold atmospheric plasma (CAP) treatment on Ti-6Al-4V alloy surfaces, sterilized in an autoclave at 120 °C for 20 min in surgical-grade paper packaging, focusing on their potential to optimize surface physicochemical properties and reduce C. albicans colonization. X-ray photoelectron spectroscopy (XPS) revealed the formation of Ti-O-H peaks and the oxidation of titanium (Ti³⁺ to Ti⁴⁺) on CAP-treated surfaces. Sessile drop tests demonstrated a significant improvement in wettability, with a reduction in contact angle (68.94° vs 36.1°, p < 0.05). Microbiological assays showed a reduction in C. albicans colony-forming units (CFUs) (42,500 ± 8,838 vs 24,000 ± 7,920; p < 0.05) and a decrease in pseudohyphae formation (32.7 ± 9.7 vs 11.6 ± 1.8; p < 0.05). Scanning electron microscopy (SEM) further confirmed a reduction in yeast aggregates on treated surfaces incubated with fungal strains for 90 min. Data normality was assessed using the Shapiro-Wilk test, and statistical comparisons were performed with t tests at a significance level of p < 0.05. These findings suggest that CAP is a promising tool for enhancing surface wettability and reducing fungal contamination on Ti-6Al-4V implants sealed in surgical-grade paper, offering potential benefits for medical and dental applications.