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Published on: November 3, 2016
Effects of Cold Atmospheric Plasma on Cellular Behavior in Oral and Dental Tissues: A Systematic Review
Mahdi Kadkhodazadeh1,2, Negar Dehghani3, Sara Nashibi4
1Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Purpose:
Cold Atmospheric Plasma (CAP) is known for its ability to interact with living tissues without causing thermal damage. In dentistry, CAP has been explored for its potential for direct therapeutic applications, such as tissue regeneration, wound healing, and sterilization. CAP is currently transitioning from strong preclinical evidence to limited but growing clinical use, mainly within specialized research settings. This study aimed to systematically review the current literature on the effects of CAP on oral and dental tissue cell behavior, focusing on outcomes like proliferation, differentiation, apoptosis, wound healing, and anti-inflammatory responses.
Methods:
A comprehensive search was conducted in PubMed, Web of Science, and Scopus databases up to February 2025, addressing the following PICO question: "What is the effect of CAP (I) on the behavior of oral and dental tissue cells (P) compared to standard treatments or no treatment (C) in the context of dental therapies concerning outcomes such as proliferation, differentiation, apoptosis, wound healing, or anti-inflammatory effects (O)?". Studies that investigated the direct application of CAP on relevant cell types in dental contexts were included. Risk of bias was assessed using the risk of bias tool for animal intervention studies (SYRCLE's RoB tool) and JBI Critical Appraisal Tool for Assessment of Risk of Bias for Randomized Controlled Trials.
Results:
The search yielded 964 studies. A total of 29 studies were included in the review: 22 in vitro, 8 in vivo, and 1 clinical study. CAP promoted oral tissue healing by enhancing cell proliferation, migration, and wound closure, with low cytotoxicity. It also reduced inflammation and modulated immune responses, supporting regenerative processes in oral tissues.
Conclusion:
CAP facilitates tissue repair by promoting cell activity, reducing inflammation, and inducing osteogenic differentiation. However, extended exposure may cause harmful effects such as apoptosis and inflammation, emphasizing the need for precise control of exposure for effective therapeutic outcomes.
