Table 1.

The advantages and shortcomings of different physical methods for eradicating biofilms

Physical methods	Advantages	Shortcomings	Refs.
Non‐thermal (cold) plasma	*Antimicrobials generated locally *High level of oxidation/reactive species renders resistance unlikely	*Accessibility of plasma *Biofilm EPS may protect cells deeper down *Response to plasma is species‐dependent *Highly localized	[265]
Microbubbles	*Physical action reduces probability of resistance *Readily combined with irrigants and shear	*Accessibility *Biofilm can resist removal due to the viscoelasticity *Residual cells may remain	[266]
Photodynamic and/or photothermal therapy	*Antimicrobial activity can be controlled locally *Can be readily combined with surface modifications	*Delivery to infected site and transport into biofilm *Accessibility of light *Biofilm EPS may protect cells * Cytotoxic effects due to the generated heat	[265]
Ultrasound	*Readily projected through skin and soft tissue *Local delivery *Physical action reduces probability of resistance	*Limited targeting *Influence of pressure waves on viscoelastic biofilms not well understood *Local delivery limited to small and accessible areas	[267]
Magnetic manipulation systems	*Avoiding the limited tissue penetration *Physical targeting *Efficiently penetrate biofilm *Biofilm mechanical destruction	*Difficult to target in vivo	[247, 268]
Catalytic therapy	*Use via the generation of reactive oxygen species (ROS), deactivating bacteria by destructing the proteins, DNA, and polysaccharides *Damage the EPS of biofilms and weaken the resistance of bacteria in biofilms to environmental stress	*Low therapeutic efficacy without the addition of H2O2 *Lack of targeting ability to bacterial biofilms	[257, 269]
Electrical stimulation	*Projected through induction or connected wires *On‐demand antimicrobial generation *Also promote wound healing	*Electrochemistry of body fluids not well understood * Heat generation *Delivery of electrical currents to deep tissue *Cytotoxicity	[270]