The application of ozone in dentistry: a systematic review of literature.

THE ORAL CAVITY APPEARS AS AN OPEN ECOSYSTEM, WITH A DYNAMIC BALANCE BETWEEN THE ENTRANCE OF MICROORGANISMS, COLONIZATION MODALITIES, AND HOST DEFENSES AIMED TO THEIR REMOVAL: To avoid elimination, bacteria need to adhere to either hard dental surfaces or epithelial surfaces. The oral biofilm formation and development, and the inside selection of specific microorganisms have been correlated with the most common oral pathologies, such as dental caries, periodontal disease, and peri-implantitis. The mechanical removal of the biofilm and adjunctive use of antibiotic disinfectants or various antibiotics have been the conventional methods for periodontal therapy. Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms, and its application in medicine and dentistry has been indicated for the treatment of 260 different pathologies. The ozone therapy has been more beneficial than present conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment. The exposition of molecular mechanisms of ozone further benefits practical function in dentistry.

Ozone therapy in dentistry: A strategic review.

Collagen scaffolds functionalised with copper-eluting bioactive glass reduce infection and enhance osteogenesis and angiogenesis both in vitro and in vivo.

Gingival and Periodontal diseases represent a major concern both in dentistry and medicine. The majority of the contributing factors and causes in the etiology of these diseases are reduced or treated with ozone in all its application forms (gas, water, oil). The beneficial biological effects of ozone, its anti-microbial activity, oxidation of bio-molecules precursors and microbial toxins implicated in periodontal diseases and its healing and tissue regeneration properties, make the use of ozone well indicated in all stages of gingival and periodontal diseases. The primary objective of this article is to provide a general review about the clinical applications of ozone in periodontics. The secondary objective is to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. This objective would be of importance to future researchers in terms of what has been tried and what the potentials are for the clinical application of ozone in Periodontics.

Ozone therapy in periodontics

Medical gases are pharmaceutical gaseous molecules which offer solutions to medical needs and include traditional gases, such as oxygen and nitrous oxide, as well as gases with recently discovered roles as biological messenger molecules, such as carbon monoxide, nitric oxide and hydrogen sulphide. Medical gas therapy is a relatively unexplored field of medicine; however, a recent increasing in the number of publications on medical gas therapies clearly indicate that there are significant opportunities for use of gases as therapeutic tools for a variety of disease conditions. In this article, we review the recent advances in research on medical gases with antioxidant properties and discuss their clinical applications and therapeutic properties.

Therapeutic antioxidant medical gas.

Aim The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry. Background Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks. Conclusion The future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies. Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.

/pdf/ozone-therapy-in-medicine-and-dentistry-1qqlbty0is.pdf

Ozone therapy in medicine and dentistry.

OBJECTIVE: New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy. MATERIAL AND METHODS: Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofoxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn's tests at a signifcance level of 5%. Cell viability was assessed for the different concentrations and times. RESULTS: All drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mgjL produced viable fibroblasts at all experimental times in all groups. CONCLUSIONS: Cell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofoxacin hydrochloride.

/pdf/time-and-concentration-dependent-cytotoxicity-of-antibiotics-120lyzxfh7.pdf

Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy.

The root canal treatment has been dramatically changed since the emergence of ozone therapy.Due toits potent antimicrobial activity and biocompatibility, ozone can be applied as an agent to improve decontamination procedures and possibly increase success rates. The aim of this study was to compare the antimicrobial activity of 3different concentrations of aqueous ozone on Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis.This study used a standardized suspension of 3 bacteria. These suspensions were cultivated and spectrophotometrically adjusted to a final concentration of 4.46X108 CFU/mL.Then they were submitted to groups: Group I – aqueous ozone 2 µg/mL; Group II – aqueous ozone 5 µg/mL; Group III – aqueous ozone 8 µg/mL, and Group Control – bidistilled cold sterile water with no ozone. Bidistilled cold sterile water was ozonated for 5 minutes. Then 10 mL of each suspension were added to 90 mL of each group in a glass flask. After 1 minute of contact, 1 mL of each flask was added to 9 mL of 0.1% sodium tiossulfate to neutralize the ozone, and then serial dilution was performed. After 24 hours of incubation, the CFU counting was performed. In parallel, 1 mL of each glass flask was added to 9 mL of TSB broth and incubated for 7 days for visual analyses of turbidity broth. The results showed Group I presented Enterococcus faecalis growth. Group II and III presented no CFU counting, but aqueous ozone at 5 µg/mL presented 2 bleary tubes of Enterococcus faecalis, indicating bacterium growth. Group III (aqueous ozone 8 µg/mL) showed no CFU counting or blurry broth. According to the applied methodology, it was possible to conclude that the aqueous ozone in concentration of 8 µg/mL was the most efficient to eliminate the three evaluated bacteria.

/pdf/comparison-of-the-antimicrobial-activity-of-three-different-4ueqdgy2p2.pdf

Comparison of the antimicrobial activity of three different concentrations of aqueous ozone on Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis – in vitro study

Objectives This study evaluated the antimicrobial efficacy of ozone therapy in teeth contaminated with Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus using a mono-species biofilm model. Parallel to this, the study aimed to evaluate the cytotoxicity of ozone for human gingival fibroblasts. Material and Methods: One hundred and eighty single-root teeth were contaminated with a mono-species biofilm of Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus. Groups were formed: Group I – control; Group II – standard protocol; Group III – standard protocol + ozone gas at 40 µg/mL; and Group IV – standard protocol + aqueous ozone at 8 µg/mL. In parallel, human gingival fibroblasts were submitted to the MTT test. Cells were plated, then ozone was applied as follows: Group I (control) – broth medium; Group II – aqueous ozone at 2 µg/mL; Group III – aqueous ozone at 5 µg/mL; and Group IV – aqueous ozone at 8 µg/mL. Data were submitted to the Kruskal Wallis test and Bonferroni post hoc analyses to assess microbiology and cytotoxicity, respectively (p<0.05%). Results The results revealed antimicrobial efficacy by Group IV with no CFU count. The cytotoxicity assay showed Groups III and IV to be the most aggressive, providing a decrease in cell viability at hour 0 from 100% to 77.3% and 68.6%, respectively. Such a decrease in cell viability was reverted, and after 72 hours Groups III and IV provided the greatest increase in cell viability, being statistically different from Groups I and II. Conclusion According to the applied methodology and the limitations of this study, it was possible to conclude that ozone therapy improved the decontamination of the root canal ex vivo. Ozone was toxic to the cells on first contact, but cell viability was recovered. Thus, these findings suggest that ozone might be useful to improve root canal results.

/pdf/ozone-therapy-as-an-adjuvant-for-endondontic-protocols-8m9s136ocz.pdf

Carlos Goes Nogales

Papers

Ozone therapy in medicine and dentistry.

Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy.

Comparison of the antimicrobial activity of three different concentrations of aqueous ozone on Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis – in vitro study

Ozone therapy as an adjuvant for endondontic protocols: microbiological - ex vivo study and citotoxicity analyses.

Next-Generation Sequencing to Assess Potentially Active Bacteria in Endodontic Infections.