The sterilization of medical devices is paramount to achieve an acceptable level of sterility assurance and to prevent hospital-acquired infections. However, some medical devices cannot be sterilized by usual processes such as autoclave (AC) and gamma-ray irradiation (GI). A new non-thermal plasma (NTP) process using sealed bag that preserves the sterile state of the devices could be used as an alternative sterilization method. The aim of the study was to assess the cytocompatibility of titanium and poly(etheretherketone) (PEEK) surfaces after O₂-NTP sterilization compared to GI and AC. MG-63 osteoblast-like cells were seeded on titanium (TA6V) and PEEK disks sterilized by AC, GI and O₂-NTP. The cells’ viability and proliferation, determined by WST-1 and DNA quantification respectively, were enhanced whatever the material types from 3 to 10 days. When seeded on titanium, MG-63 cells showed a higher viability and proliferation after GI and O₂-NTP treatment compared to AC treatment. When cultured on PEEK, MG-63 cells showed a higher viability after O₂-NTP treatment. No difference of proliferation was observed whatever the sterilization processes. The cell colonization of the materials’ surface was confirmed by scanning electron microscopy. Lactate dehydrogenase (LDH) assay revealed no cytotoxicity. Thus, O₂-NTP led to similar cell responses to AC and GI and could be a cost-effective alternative process to the usual sterilization methods for fragile medical devices.

As the worldwide population has been experiencing since 2020, viruses represent a serious threat to global well-being. To avoid viral transmission through surgery or medical examination, sterilization of medical material is needed. From emerging sterilization processes, the use of non-thermal plasma (NTP) arises as a promising technique to efficiently reduce microbial burden on medical devices, including new complex polymers as thermosensitive ones. Thus, we evaluated the antiviral efficacy of a low-pressure NTP process taking place in a sealed bag. For this purpose, two different plasmas, O₂ 100% plasma and Ar 80%–O₂ 20% plasma, were tested against two viruses: the bovine viral diarrhea virus and the porcine parvovirus, surrogates of human hepatitis C virus and human parvovirus B19, respectively. The efficacy of both NTP treatments on viral load can be detected after only five minutes. Moreover, the longer the NTP treatments last, the more the load decreases. The most effective load reduction was obtained with a 120-min O₂ plasma treatment inducing a minimum of four-log viral load reduction. So, this process demonstrated strong virucidal capacity inside a sealed bag and represents a very interesting opportunity in the field of fragile medical devices sterilization or disinfection.

Denture stomatitis is a disease involving C. albicans, which can affect elderly and immuno-compromised people. To avoid any recurrence of this pathology, it is necessary to treat patients regularly and disinfect dentures. However, the denture cleansers’ efficacy is not optimal and often leads to adverse color effects on the denture base resins. The aim of this study was to investigate the efficacy of a low-pressure non-thermal O₂ plasma (NTP) treatment on C. albicans seeded on ProBase^®Hot resin (Ivoclar Vivadent). The viability reduction of C. albicans was assessed by colony forming units (CFU) analysis and by scanning electron microscopy (SEM). The effect of repeated treatments on the resin color was evaluated by spectrophotometry. The resin samples were placed in a sealed bag in which O₂ plasma was generated in low-pressure conditions. The results showed that a 120-min O₂ NTP treatment led to a 6-log reduction of C. albicans viability (p < 0.05) and to yeasts’ major alterations observed by SEM. Furthermore, significant slight color changes of the resin (∆E₀₀ = 1.33) were noted only after six plasma treatments (p < 0.05). However, the denture aesthetic was preserved, as the color changes were not perceptible and remained below the acceptability threshold (∆E₀₀ < 4).