Tooth bleaching with nonthermal atmospheric pressure plasma.

We demonstrated that room temperature plasma could be used for tooth bleaching. A nonthermal, atmospheric pressure, helium plasma jet device was developed to enhance the tooth bleaching effect of hydrogen peroxide (H(2)O(2)). All teeth were sectioned sagittally into halves, which were assigned randomly to either the experimental group or the control group. The experimental group was treated with H(2)O(2) (28%, 20 microL every 30 seconds) plus plasma (5 W) for 10 minutes; the control group was treated with H(2)O(2) alone for the same duration. Removal of the tooth surface protein was demonstrated by scanning electron microscopy images and Ponceau staining. Production of hydroxyl radicals (.OH) was measured by using electron spin resonance spin-trapping. Combining plasma and H(2)O(2) improved the bleaching efficacy by a factor of 3 compared with using H(2)O(2) alone. Tooth surface proteins were noticeably removed by plasma treatment. When a piece of tooth was added to a solution of H(2)O(2) as a catalyst, production of *OH after plasma treatment was 1.9 times greater than when using H(2)O(2) alone. We suggest that the improvement in tooth bleaching induced by plasma is due to the removal of tooth surface proteins and to increased *OH production.