High-efficiency tooth bleaching using non-thermal atmospheric pressure plasma with low concentration of hydrogen peroxide

Abstract

Light-activated tooth bleaching with a high hydrogen peroxide (HP; H2O2) concentration has risks and the actual role of the light source is doubtful. The use of conventional light might result in an increase in the temperature and cause thermal damage to the health of the tooth tissue.Objective:This study investigated the efficacy of tooth bleaching using non-thermal atmospheric pressure plasma (NAPP) with 15% carbamide peroxide (CP; CH6N2O3) including 5.4% HP, as compared with conventional light sources. Material and Methods:Forty human teeth were randomly divided into four groups: Group I (CP+NAPP), Group II (CP+plasma arc lamp; PAC), Group III (CP+diode laser), and Group IV (CP alone). Color changes (ΔE ) of the tooth and tooth surface temperatures were measured. Data were evaluated by one-way analysis of variance (ANOVA) and post-hoc Tukey's tests. Results:Group I showed the highest bleaching efficacy, with a ΔE value of 1.92-, 2.61 and 2.97-fold greater than those of Groups II, III and IV, respectively (P<0.05). The tooth surface temperature was maintained around 37ºC in Group I, but it reached 43ºC in Groups II and III. Conclusions:The NAPP has a greater capability for effective tooth bleaching than conventional light sources with a low concentration of HP without causing thermal damage. Tooth bleaching using NAPP can become a major technique for in-office bleaching in the near future.

Uses of cold plasma in conservative dentistry and endodontics

“…The penetration and subsequent polymerization of the adhesive monomers increases the bond strength. Incomplete penetration will lead to leakage and disruption of the hybrid layer 21 . Resin adhesive penetration into the demineralised dentin under the influence of plasma treatment was studied by Y Zhang et al Extracted, noncarious, unerupted human third molars were used.…”

Atmospheric Pressure Plasma Jet as an Accelerator of Tooth Bleaching

“…Similar whitening effects were also reported in the study by Choi et al (26) where they used APP with different gases. In the study by Nam et al (27), three different sources (APP, plasma arc lamp and diode laser) for activation of carbamide peroxide were used, and APP obtained the best bleaching results.…”

“…Slični rezultati objavljeni su u studiji Choe i suradnika (26) -oni su se koristili APM-om s različitim reaktivnim plinovima. U studiji Nama i suradnika (27) korištena su tri različita izvora (APM, plazmatski luk i diodni laser) za aktivaciju karbamid-peroksidnog gela i APM je pokazao najbolje rezultate.…”

“…Vrijeme aplikacije za APM iznosi devet minuta, što je oko šest puta kraće u odnosu na vrijeme koje je predložio proizvođač gela za izbjeljivanje. Pri korištenju APM-a temperatura uzoraka ispod je tjelesne temperature, što znači da pacijent neće osjetiti bol u slučaju topline niti će susjedno tkivo biti oštećeno zbog temperaturnog šoka (27). Zato smatramo da je APM primjenjiv u terapijama koje zahtijevaju kemijsku aktivaciju bez povećanja temperature, kao što je izbjeljivanje zuba.…”

“…Clinical outcome of this heat generation is expansion of the liquids inside the dentinal tubules and the pulp which in combination with dehydration of the bleached hard dental tissues result in hyperemia and post-operative sensitivity (43). As the temperature of the sample surface with APP jet treatment is under the body temperature, which means that a patient could not feel a sense of pain from cold or heat and the tooth pulp or tooth surrounding tissue will not be thermally damaged (27). For this reason, APP jet is applicable to therapies that require chemical activation without temperature increase such as tooth bleaching.…”