# Low Temperature Plasma as an Approach for the Treatment of Peri-Implantitis

> **NIH NIH R21** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $154,880

## Abstract

Biofilm formed around dental implants trigger inflammation, which plays a leading role into promoting osteoclast
mediated bone resorption and inhibiting bone formation, resulting in net bone loss around implants referred to
as peri-implantitis. Once established, peri-implantitis progresses and leads to implant loss. The use of low
temperature plasma (LTP) as a co-adjuvant to treat peri-implantitis is promising, as unlike current peri-implantitis
treatment strategies and demonstrated by our preliminary data, has the unique potential to simultaneously (i)
decontaminate infected surfaces while (ii) allowing for the creation of a suitable environment for bone regrowth
around the implant (iii) without damaging peri-implant related tissues. Advantages of LTP over traditional
antimicrobial applications are that LTP can be used for site-specific treatment, provides an almost instantaneous
bactericidal response, antimicrobial resistance is less likely to occur, and there are minimal side effects. Our
hypothesis is that LTP, coupled with surgical debridement, is a unique efficacious approach for treatment of
peri-implantitis. To address our hypothesis, the following specific aims are proposed: Aim 1) To determine the
LTP protocol most disruptive to in vitro multispecies peri-implantitis related biofilms, while maintaining low
cytotoxicity. Biofilms in several levels of maturation comprising of Streptococcus oralis, Actinomyces naeslundii,
Veillonela dispar, and Porphyromonas gingivalis will be treated with LTP in different conditions and compared to
controls, which includes gas flow, 0.12% Chlorhexidine, 14 µg/mL of amoxycillin and 140 µg/mL metronidazole,
individually or in combination. Efficacy, in the absence of toxicity, will be confirmed using in vitro reconstituted
oral (ROE) and gingival epithelium (RGE) infected or not with P. gingivalis; Aim 2) To evaluate the effect of LTP
treatment on peri-implantitis using a Gottingen minipig model. Ligature induced peri-implantitis will be developed
in the jaws of miniature swine. These will be surgically treated coupled with two LTP regimens or with appropriate
controls, allowed to heal, and the level of both soft and hard tissue reattachment evaluated by histology assays
and three-dimensional image reconstruction. Anabolic and catabolic events will also be assessed. The proposed
project will expand on our preliminary experiments and refine a unique approach for the treatment of emerging
problem of peri-implantitis, using LTP’s synergistic effects to decontaminate and/or detoxify the infected peri-
implantitis site, and create a suitable environment for bone regrowth around the implant, all of this in a single
and short time application (minutes) and low-toxicity to the mucosa. Furthermore, our proposed experiments will
test LTP in a large preclinical animal model that is remarkably similar to humans allowing direct translation of
findings toward clinical practice.

## Key facts

- **NIH application ID:** 9985091
- **Project number:** 5R21DE028929-02
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Paulo G Coelho
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,880
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985091

## Citation

> US National Institutes of Health, RePORTER application 9985091, Low Temperature Plasma as an Approach for the Treatment of Peri-Implantitis (5R21DE028929-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9985091. Licensed CC0.

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