R.E.J. Sladek, R. Walraven, E. Stoffels, P.J.A. Tielbeek, R.A. Koolhoven

Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The

Netherlands

E-mail: R.E.J.Sladek@tue.nl

Plasma treatment of caries: a novel method in dentistry

Dental cariesIn dentistry dental cavities (Figure 1) as a result of caries are a major problem. Cavities in teeth can be cleaned and/or sterilised by mechanically drilling or laser techniques. In both methods heating or vibrations can take place and this can be painful for the patient (heating and vibrations can irritate the nerve).

Dental cariesIn dentistry dental cavities (Figure 1) as a result of caries are a major problem. Cavities in teeth can be cleaned and/or sterilised by mechanically drilling or laser techniques. In both methods heating or vibrations can take place and this can be painful for the patient (heating and vibrations can irritate the nerve).

Conclusions• plasma treatment is a very promising tissue saving technique.• plasma treatment of teeth is painless!

Conclusions• plasma treatment is a very promising tissue saving technique.• plasma treatment of teeth is painless!

PlansBacterial viability experimentsIn the near future we will investigate the efficiency of plasma-aided destruction of Escherichia coli and bacteria present in dental plaque.

PlansBacterial viability experimentsIn the near future we will investigate the efficiency of plasma-aided destruction of Escherichia coli and bacteria present in dental plaque.

GoalOur goal is to find a less destructive (no fractures) and less painful approach to clean dental cavities. This may be done by use of a non-thermal atmospheric plasma.

GoalOur goal is to find a less destructive (no fractures) and less painful approach to clean dental cavities. This may be done by use of a non-thermal atmospheric plasma.

Why plasma?Plasma is an efficient source of various radicals, capable of bacterial decontamination, while it operates at room temperature and does not cause bulk destruction of the tissue.The advantage of this novel tissue-saving treatment is that it is superficial and that the plasma can easily penetrate the cavity, which is not possible with lasers. Also the use of plasmas is relatively cheap compared to the use of lasers.

Why plasma?Plasma is an efficient source of various radicals, capable of bacterial decontamination, while it operates at room temperature and does not cause bulk destruction of the tissue.The advantage of this novel tissue-saving treatment is that it is superficial and that the plasma can easily penetrate the cavity, which is not possible with lasers. Also the use of plasmas is relatively cheap compared to the use of lasers.

ResultsUsing thermocouples, it has been verified that there is only little temperature increase (1 – 5 °C) in the gas and even less in dental tissue. The modeling results are shown in Figure 7. The two-dimensional temperature profile within the tooth has been calculated in a cylinder geometry. Thermal flux from the plasma has been measured using a thermal probe described elsewhere. Teeth can be safely exposed to the plasma (see Figure 9), no pain is experienced.

ResultsUsing thermocouples, it has been verified that there is only little temperature increase (1 – 5 °C) in the gas and even less in dental tissue. The modeling results are shown in Figure 7. The two-dimensional temperature profile within the tooth has been calculated in a cylinder geometry. Thermal flux from the plasma has been measured using a thermal probe described elsewhere. Teeth can be safely exposed to the plasma (see Figure 9), no pain is experienced.

ExperimentsTemperature measurementsTemperature measurements will be made during plasma treatment. A thermo

sensor (pt-100) isinserted into the pulp chamber (Figure 4) and the temperature is recorded. Also a temperature distribution model in Matlab® is made. The model is

compared to the experiment.According to Zach and Cohen, an increase in intra-pulpal temperature below

2.2 C fall within the saferange of thermal stress.Dental plaque experimentPlasma treatment on dental plaque will be investigated ex-vivo by confocal

microscopy (CLSM) and vitalfluorescence techniques. Plaque is collected on enamel slabs (Figure 5). The

slabs are inserted intoacrylic splints worn by participants.

ExperimentsTemperature measurementsTemperature measurements will be made during plasma treatment. A thermo

sensor (pt-100) isinserted into the pulp chamber (Figure 4) and the temperature is recorded. Also a temperature distribution model in Matlab® is made. The model is

compared to the experiment.According to Zach and Cohen, an increase in intra-pulpal temperature below

2.2 C fall within the saferange of thermal stress.Dental plaque experimentPlasma treatment on dental plaque will be investigated ex-vivo by confocal

microscopy (CLSM) and vitalfluorescence techniques. Plaque is collected on enamel slabs (Figure 5). The

slabs are inserted intoacrylic splints worn by participants.Figure 1: Dental cavity (left), tooth structure (right).

Figure 2: A scheme of the experimental set-up.

Experimental set-upRF- driven ‘plasma needle’ Tungsten wire inside a ceramic tube (Figure 2 and 3). Because of the ceramic tube, the plasma stays at the tip of the needle. The diameter of the tunsten wire inside the perspex tube is 0.3 mm. The inner diameter of the perspex tube is 4.0 mm. Helium flows via the gas inlet through the perspex tube to the tip of the needle. The plasma is formed at the tip of the tungsten wire.

Experimental parameters Gas He (2 l/min) RF frequency 13.56 MHz

Power dissipated in plasma 50 –100 mW

Voltage 200 - 400 V

Experimental set-upRF- driven ‘plasma needle’ Tungsten wire inside a ceramic tube (Figure 2 and 3). Because of the ceramic tube, the plasma stays at the tip of the needle. The diameter of the tunsten wire inside the perspex tube is 0.3 mm. The inner diameter of the perspex tube is 4.0 mm. Helium flows via the gas inlet through the perspex tube to the tip of the needle. The plasma is formed at the tip of the tungsten wire.

Experimental parameters Gas He (2 l/min) RF frequency 13.56 MHz

Power dissipated in plasma 50 –100 mW

Voltage 200 - 400 V

Figure 3: Portable plasma needle.

Figure 4: (left) Radiograph of electrical thermistor implanted within the pulp chamber (Miserendino et al. 1989). (right) Temperature measurement.

Figure 5: CLSM vital-stained 2-day-old plaqueon enamel. Thickness up to 32 m. Magnification x500. (Netuschil et al. 1998)

gas inlet

RF-signal

gas inlet

RF-signal

RF amplifier

function generator

dual coupler

power meter

gas inlet

tungsten wire

plasma

perspexceramic tube

matching network

RF amplifier

waveformgenerator

dual coupler

power meter

gas inlet

tungsten wire

plasma

perspexceramic tube

matching network

RF amplifier

function generator

dual coupler

power meter

gas inlet

tungsten wire

plasma

perspexceramic tube

matching network

RF amplifier

waveformgenerator

dual coupler

power meter

gas inlet

tungsten wire

plasma

perspexceramic tube

matching network

Applied voltage

22

24

26

28

30

0 100 200

Time (sec)

T (

0 C)

120 mV140 mV160 mV180 mV200 mV220 mV240 mV260 mV280 mV300 mV

Figure 7: Temperature distribution in cylinder of dentine (rplasma=1 mm, Qin=2000 J/m2 . s).

Figure 8: Temperature in pulp chamber Treatment time of 60 seconds.

Figure 9: First in vivo experiment