Dental silicate ceramics surface modification by nonthermal plasma : a systematic review

Birk, Luka (author), Rener-Sitar, Ksenija (author), Benčina, Metka (author), Junkar, Ita (author)

Objectives: Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed to systematically review the available scientific evidence on the effectiveness of using NTP for the surface treatment of etchable, silica-based dental ceramics before cementation, and elucidate its potential to replace the hazardous and technically demanding protocol of hydrofluoric acid (HF) etching. Methods: A valid search query was developed with the help of PubMed's Medical Subject Headings (MeSH) vocabulary thesaurus and translated to three electronic databases: PubMed, Web of Science, and Scopus. The methodological quality of the studies was assessed according to an adapted version of the Methodological Index for Non-Randomized Studies (MINORS). Results: Thirteen in vitro study reports published between 2008 and 2023 were selected for the qualitative and quantitative data synthesis. The implemented methodologies were diverse, comprising 19 different plasma treatment protocols with various device settings. Argon, helium, oxygen, or atmospheric air plasma may significantly increase the wettability and roughness of silicate ceramics by plasma cleaning, etching, and activation, but the treatment generally results in inferior bond strength values after cementation compared to those achieved with HF etching. The technically demanding protocol of plasma-enhanced chemical vapor deposition was employed more commonly, in which the surface deposition of hexamethyl disiloxane with subsequent oxygen plasma activation proved the most promising, yielding bond strengths comparable to those of the positive control. Lack of power analysis, missing adequate control, absence of examiner blinding, and non-performance of specimen aging were common methodological frailties that contributed most to the increase in bias risk (mean MINORS score 15.3 ± 1.1). Significance: NTP can potentially improve the adhesive surface characteristics of dental silicate ceramics in laboratory conditions, but the conventional protocol of HF etching still performs better in terms of the resin-ceramic bond strength and longevity. More preclinical research is needed to determine the optimal NTP treatment settings and assess the aging of plasma-treated ceramic surfaces in atmospheric conditions.

• Language: English
• Keywords: nonthermal plasma, plasma surface modification, dental silicate ceramics, surface properties, adhesive cementation
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: Str. 531–545
• Numbering: Vol. 40, iss. 3
• PID: 20.500.12556/RUL-156207
• UDC: 616.31
• ISSN on article: 1879-0097
• DOI: 10.1016/j.dental.2024.01.001
• COBISS.SI-ID: 183140099
• Publication date in RUL: 14.05.2024

Record is a part of a journal

• Title: Dental materials
• Publisher: Elsevier, Academy of Dental Materials
• ISSN: 1879-0097
• COBISS.SI-ID: 23223813

Licences

• License: CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
• Link: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Description: The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.

Secondary language

• Language: Slovenian
• Keywords: netermična plazma, modifikacija plazemske površine, zobna silikatna keramika, površinske lastnosti, adhezivno cementiranje

Projects

• Funder: ARRS - Slovenian Research Agency
• Project number: J3-4502
• Name: Inovativna obdelava površin zobnih nadomestkov s plinsko plazmo

• Funder: Other - Other funder or multiple funders
• Funding programme: COST
• Project number: CA20114
• Name: Therapeutical Applications of Cold Plasmas
• Acronym: PlasTHER