Cold Plasma Effects on Dental Implant Stability

Clinical Evaluation of Cold Plasma Surface Activation Using Different Plasma Systems on Early Implant Stability: A Randomized Controlled Within-Patient Trial

Cold plasma-mediated implant surface activation may reverse the biological aging of titanium by enhancing hydrophilicity and cellular response. The aim of this study was to clinically compare the effects of three different cold plasma systems on the stability of dental implants. In this prospective randomized controlled within-patient trial, a total of 44 implants were placed in 11 patients. In each patient, four implants were randomly allocated to one of the following groups: control, vacuum plasma, argon jet plasma, and cold atmospheric plasma. All implants were placed using a single-stage protocol with a minimum insertion torque of 45 Ncm. Implant stability was assessed using resonance frequency analysis (ISQ values) immediately after placement and at 2, 4, and 8 weeks.

Study Overview

• Status: Completed
• Conditions: Dental Implants; Cold Atmospheric Plasma
• Intervention / Treatment: Procedure: Dental implant placement; Procedure: Dental implant placement and vacuum plasma application; Procedure: Dental implant placement and argon jet plasma application; Procedure: Dental implant placement and cold atmospheric plasma application

• Study Type: Interventional
• Enrollment (Actual): 11
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kahramanmaraş, Turkey (Türkiye)
    • Kahramanmaras Sutcu Imam University, Faculty of Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 18 years.
• Presence of edentulous areas requiring ≥4 implants for fixed prosthetic rehabilitation.
• Good or moderate oral hygiene.
• Adequate patient compliance to attend all follow-up appointments.
• Willingness to voluntarily participate in the study.

Exclusion Criteria:

• Refusal to participate.
• Need for alveolar ridge augmentation.
• Systemic conditions that may impair healing (e.g., uncontrolled diabetes, immunodeficiency, ongoing chemotherapy or radiotherapy, history of head-and-neck radiotherapy, substance or alcohol abuse).
• Untreated periodontal disease.
• Heavy smoking (>10 cigarettes/day).
• Age < 18 years.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Arm; The implant was inserted without the application of any supplementary surface modification.	Procedure: Dental implant placement; The dental implant was placed without any plasma application.
Experimental: Vacuum Plasma Application; The implant was placed into a sterile low-pressure plasma chamber (5-10 Torr) and exposed to non-thermal low-pressure cold plasma for 60 seconds prior to placement.	Procedure: Dental implant placement and vacuum plasma application; The dental implant was placed with non-thermal low-pressure cold plasma application
Experimental: Argon Jet Plasma Application; A portable atmospheric argon plasma jet was applied circumferentially to the implant surface for 60 seconds while the implant was rotated in a sterile holder.	Procedure: Dental implant placement and argon jet plasma application; The dental implant was placed with argon jet plasma application
Experimental: Cold Atmospheric Plasma (CAP) Application; Cold plasma generated at atmospheric pressure using ambient air was applied circumferentially to the implant surface for 60 seconds while the implant was rotated in a sterile holder.	Procedure: Dental implant placement and cold atmospheric plasma application; The dental implant was placed with cold atmospheric plasma application

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Implant Stability	The primary outcome measure was implant stability, quantified using Implant Stability Quotient (ISQ) values obtained by resonance frequency analysis (RFA). Changes in mean ISQ values were assessed at four predefined time points across four different implant surface treatment groups. The secondary outcome measure was the early stability pattern, evaluated based on serial ISQ measurements recorded during the first 8 weeks following implant placement.	Measurements were performed at four different time points: • Immediately after placement (baseline), • 2 weeks, • 4 weeks, • 8 weeks.

Collaborators and Investigators

• Sponsor: Kahramanmaras Sutcu Imam University

Study record dates

Study Major Dates

• Study Start (Actual): February 24, 2025
• Primary Completion (Actual): July 8, 2025
• Study Completion (Actual): September 9, 2025

Study Registration Dates

• First Submitted: December 11, 2025
• First Submitted That Met QC Criteria: January 9, 2026
• First Posted (Actual): January 16, 2026

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 6, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Osseointegration; Cold atmospheric plasma; Surface modification
• Other Study ID Numbers: HRÜ/25.03.28

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No