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Veneri F, Filippini T, Consolo U, Vinceti M, Generali L. Ozone Treatment for the Management of Caries in Primary Dentition: A Systematic Review of Clinical Studies. Dent J (Basel) 2024; 12:69. [PMID: 38534293 DOI: 10.3390/dj12030069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/24/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the effectiveness of ozone applications for the treatment of caries in primary dentition. According to PRISMA guidelines, a systematic literature search was performed up to 6 January 2024. Clinical studies using ozone to treat caries of deciduous teeth were considered for inclusion. Out of the 215 records retrieved, seven studies were eventually included in the review, all of which used gaseous ozone. Four studies were judged at high risk of bias, two at low risk, and one of some concerns. The great heterogeneity of designs, outcomes, and protocols made it impossible to conduct a meta-analysis. Despite some limitations, the evidence yielded by the included studies suggests that ozone application, regardless of the protocol applied, is comparable to other interventions in terms of clinical outcomes and anti-bacterial activity, with no reported adverse effects and good patient acceptance. Therefore, ozone application may be a non-invasive approach to treat caries in primary dentition, especially in very young and poorly cooperative patients. Further standardized and rigorous studies are, however, needed to identify the best clinical protocols for this specific field.
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Affiliation(s)
- Federica Veneri
- Unit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA 94704, USA
| | - Ugo Consolo
- Unit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Luigi Generali
- Unit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy
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Scribante A, Gallo S, Pascadopoli M, Frani M, Butera A. Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial. Oral Dis 2023. [PMID: 38047757 DOI: 10.1111/odi.14829] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. MATERIALS AND METHODS 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). RESULTS For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. CONCLUSION Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.
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Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Monica Frani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Enhancing the Antimicrobial Effect of Ozone with Mentha piperita Essential Oil. Molecules 2023; 28:molecules28052032. [PMID: 36903277 PMCID: PMC10004731 DOI: 10.3390/molecules28052032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/08/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
This study aimed to obtain and analyse Mentha piperita essential oil (MpEO) for the prospect of being used as an enhancement agent for the antimicrobial potential of ozone against gram-positive and gram-negative bacteria and fungi. The research was done for different exposure times, and it gained time-dose relationships and time-effect correlations. Mentha piperita (Mp) essential oil (MpEO) was obtained via hydrodistillation and further analysed by using GC-MS. The broth microdilution assay was used to determine the strain inhibition/strain mass growth by using spectrophotometric optical density reading (OD). The bacterial/mycelium growth rates (BGR/MGR) and the bacterial/mycelium inhibition rates (BIR/MIR) after ozone treatment in the presence and absence of MpEO on the ATTC strains were calculated; the minimum inhibition concentration (MIC) and statistical interpretations of the time-dose relationship and specific t-test correlations were determined. The effect of ozone on the following tested strains at maximum efficiency was observed after 55 s of single ozone exposure, in order of effect strength: S. aureus > P. aeruginosa > E. coli > C. albicans > S. mutans. For ozone with the addition of 2% MpEO (MIC), maximum efficacy was recorded at 5 s for these strains, in order of effect strength: C. albicans > E. coli > P. aeruginosa > S. aureus > S. mutans. The results suggest a new development and affinity regarding the cell membrane of the different microorganisms tested. In conclusion, the use of ozone, combined with MpEO, is sustained as an alternative therapy in plaque biofilm and suggested as helpful in controlling oral disease-causing microorganisms in medicine.
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Ferreira LDAQ, Diniz IMA, Peixoto RTRDC, Gomes NA, Caneschi CDS, Spineli LM, Martins CC. Efficacy of antiseptics and chemomechanical methods for dentin caries lesions: A systematic review with GRADE approach. FRONTIERS IN ORAL HEALTH 2023; 4:1110634. [PMID: 36908693 PMCID: PMC9992646 DOI: 10.3389/froh.2023.1110634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
Objectives Selective caries removal aims to remove carious tissue in deep dentin lesions. However, a discussion stands on the value of antiseptics and chemomechanical adjuvant methods to reduce the bacterial load on residual caries lesions. This systematic review has addressed two main clinical questions to compare the antimicrobial efficacy of available methods using (1) antiseptic or (2) chemomechanical agents before restoring dentin carious lesions. Methods We included randomized and non-randomized controlled trials (RCTs/ NRCTs). We searched eight databases from inception to October 2021. Paired reviewers independently screened studies, extracted data, and assessed the risk of bias. The primary outcome was the reduction in the number of total bacterial in dentin, whereas secondary outcomes were reduction in the number of Lactobacillus and Streptococcus. We used the ratio of ratio of post-treatment to baseline means between two interventions in the logarithmic scale as a proper effect measure. Certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation approach. Results We included 14 RCTs and 9 NRCTs, with nine interventions. Regardless the method, the number of bacteria at baseline was similar or exceeded that after the intervention, particularly in NRCTs. The evidence was inconclusive for most comparisons. Among antiseptic agents, chlorhexidine (CHX) resulted in an average of 1.14 times [95% confidence interval (CI): 1.08-1.21] more total bacterial than photodynamic therapy in RCTs. Among NRCTS, the natural agents resulted in five times more total bacterial than CHX (95% CI: 2-11). For chemomechanical methods, the control resulted in eight times (95% CI: 4-17) more total bacterial than Carisolv (SHAA). Conclusions The certainty of the evidence was very low for all comparisons showing uncertainty whether one treatment could be more effective than another for dentin disinfection. So far, exclusively removing soft carious dentin would be enough to reduce the bacterial count.
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Affiliation(s)
| | - Ivana Márcia Alves Diniz
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Natália Aparecida Gomes
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Camila de Sousa Caneschi
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Loukia Maria Spineli
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Carolina Castro Martins
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Ferreira LDAQ, Anestino TA, Branco NTT, Diniz LA, Diniz MG, de Magalhães CS, Peixoto RTRDC, Moreira AN, Dias DR, Madeira MFM, Diniz IMA. Adjunctive therapies for in vitro carious lesions: Antimicrobial activity, activation of dentin metalloproteinases and effects on dental pulp cells. Photodiagnosis Photodyn Ther 2022; 40:103168. [PMID: 36265565 DOI: 10.1016/j.pdpdt.2022.103168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adjunctive therapies used before dental restorative procedures may encourage carious tissue removal. Beyond promising antimicrobial properties, treatments could positively modulate the dentin-pulp complex while not interfering with restoration survival. Herein, we evaluated a set of substances and their effects on carious lesions and the underlying dentin or pulp cells. METHODS Artificial caries lesions were developed in bovine teeth cavities immersed in Streptococcus mutans and Lactobacillus casei co-cultures. The cavities were treated according to the following groups: Phosphate Buffer Saline (PBS), Chlorhexidine (CHX), Papacárie® (Papain gel), Ozone (O3), and antimicrobial Photodynamic Therapy (aPDT). After treatments, samples were cultivated to count isolated microbial colonies. The zymography assay evaluated the activity of dentin metalloproteinases (MMP-2 and MMP-9). Cell viability was indirectly assessed on human dental pulp cells after 24, 72, or 120 h, whereas the odontodifferentiation potential was evaluated after ten days of cell culture. RESULTS CHX and aPDT led to around 1 log bacterial load reduction. PBS, CHX, and aPDT showed the eventual expression of MMP-2 and MMP-9. Cell viability was reduced (< 30%) after 120 h for all groups compared to the control. CHX, O3, and aPDT induced greater odontodifferentiation (≈ 20% higher) than PBS and papain gel. CONCLUSION Adjunctive therapies presented little or no biological significance in reducing bacterial load in artificial carious lesions. Although the activation of endogenous metalloproteinases may represent a possible concern for adhesive restorations, some of these treatments may have a positive role in dental pulp tissue repair.
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Affiliation(s)
- Luiza de Almeida Queiroz Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Thales Augusto Anestino
- Department of Microbiology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natália Teixeira Tavares Branco
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luiza Alves Diniz
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Gonçalves Diniz
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cláudia Silami de Magalhães
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Danilo Rocha Dias
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mila Fernandes Moreira Madeira
- Department of Microbiology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Ivana Márcia Alves Diniz
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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R Mithun D, Moses J, Sharanya. Ozone therapy in management and prevention of dental caries- A Review. INTERNATIONAL JOURNAL OF PEDODONTIC REHABILITATION 2022. [DOI: 10.56501/intjpedorehab.v7i2.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Dental caries is the irreversible microbial disease of teeth causing demineralization of inorganic and destruction of organic. It is of serious concern as it can lead to pain due to various pulpal and periapical pathologies. It is a tedious job to prevent this dental caries which is very common dental problem with each and everyone. With new concepts emerging in prevention and management of caries, Ozone therapy is tool to prevent and manage dental caries. The use of ozone (O3) gas as a therapy is skeptical due to unstable structure. The main beneficial effect of ozone is its antibacterial effect against various bacteria. These antibacterial effects are even attributed to the prevention and management of caries. This therapy is of controversy as some prove this to be less or no effective or some prove to be more effective. This article reviews various benefits of ozone therapy in prevention and management of caries and also discussion on controversies to it.
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Badhe H, Kalaskar R, Balasubramanian S, Kamki H, Kalaskar A. Antimicrobial Effect of Ozone Therapy in Deep Dentinal Carious Lesion: A Systematic Review. Int J Clin Pediatr Dent 2022; 15:S252-S260. [PMID: 35645523 PMCID: PMC9108844 DOI: 10.5005/jp-journals-10005-2168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim This systematic review aimed to answer the following focused question: Is ozone therapy more effective in reducing microbial count as compared to conventional methods in deep dentinal carious lesion? Objective The purpose of this systematic review was to perform a review on the effectiveness of ozone therapy in reduction of microbial count in deep dentinal carious lesion. Study eligibility criteria, participants, and interventions: The inclusion criteria comprised studies that compared effect on microbial count in deep dentinal carious lesion after treatments with ozone and other disinfectants in primary or permanent teeth in randomized clinical trials. Materials and methods This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) guidelines. The searched databases included Medline (via PubMed), Cochrane, and Google scholar. Articles published until 29 February 2020 without year restriction but only in English language were included. Results The search resulted in 359 published studies. After removal of duplicate studies and full-text analysis, seven studies were selected. Overall, the results demonstrated the promising effects of ozone therapy in reduction of microbial count as compared to other disinfectant. Conclusions Within the limitations of this review, it can be asserted that the ozone therapy is effective in reduction of microbial count in deep dentinal carious lesion. Clinical significance Ozone therapy can be a useful tool to reduce the microorganisms in deep dentinal carious lesion. How to cite this article Badhe H, Kalaskar R, Balasubramanian S, et al. Antimicrobial Effect of Ozone Therapy in Deep Dentinal Carious Lesion: A Systematic Review. Int J Clin Pediatr Dent 2022;15(S-2):S252–S260.
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Affiliation(s)
- Hemraj Badhe
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
- Hemraj Badhe, Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India, Phone: +91 9422277622, e-mail:
| | - Ritesh Kalaskar
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Shruti Balasubramanian
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Henpu Kamki
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Ashita Kalaskar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
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Ozone Therapy for Early Childhood Caries (ECC) Treatment: An In Vivo Prospective Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12041964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The present study aimed to evaluate the effectiveness of ozone therapy in (1) increasing the compactness of decayed dentin (main aim), (2) reducing dentin hypersensitivity, (3) decreasing the salivary bacterial count, and (4) improving the quality of life in ECC-affected children during a 3-month follow-up. A total of 20 subjects uncooperative with conventional restorative treatment were treated with a 60 s ozone application/week (OzoneDTA®) for 4 weeks. Patients were evaluated at T0 = baseline; T1 = after ozone cycle and T2, T3, T4 = 1, 2, 3-month follow-up, respectively. Dentin compactness was evaluated according to the Affected Dentine Scale (ADS) proposed by the authors; dentin hypersensitivity was recorded with the Wong–Baker Faces Pain Rating Scale (WBFPRS); salivary bacteria were measured with the Saliva Check Mutans Test and quality of life with the Early Childhood Oral Health Impact Scale (ECOHIS). ADS values and salivary bacteria count results were analyzed using non-parametric tests. Statistically significant differences were detected for both parameters between T0 and T1 (p < 0.01). At T1, dentin hypersensitivity was resolved and quality of life improved. Ozone therapy is a simple and painless approach, which might be useful for controlling caries’ progression in uncooperative children until appropriate cooperation is achieved.
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Application of Selected Nanomaterials and Ozone in Modern Clinical Dentistry. NANOMATERIALS 2021; 11:nano11020259. [PMID: 33498453 PMCID: PMC7909445 DOI: 10.3390/nano11020259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/14/2022]
Abstract
This review is an attempt to summarize current research on ozone, titanium dioxide (TiO2), silver (Ag), copper oxide CuO and platinum (Pt) nanoparticles (NPs). These agents can be used in various fields of dentistry such as conservative dentistry, endodontic, prosthetic or dental surgery. Nanotechnology and ozone can facilitate the dentist’s work by providing antimicrobial properties to dental materials or ensuring a decontaminated work area. However, the high potential of these agents for use in medicine should be confirmed in further research due to possible side effects, especially in long duration of observation so that the best way to apply them can be obtained.
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Santos GM, Pacheco RL, Bussadori SK, Santos EM, Riera R, de Oliveira Cruz Latorraca C, Mota P, Benavent Caldas Bellotto EF, Martimbianco ALC. Effectiveness and Safety of Ozone Therapy in Dental Caries Treatment: Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101472. [PMID: 33303100 DOI: 10.1016/j.jebdp.2020.101472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to investigate the effectiveness and safety of ozone therapy for treating dental caries. METHODS We searched for randomized controlled trials (RCTs) in 8 databases, from inception to April 4, 2020 (MEDLINE, EMBASE, CENTRAL, LILACS, Bibliografia Brasileira de Odontologia, ClinicalTrials.gov, WHO, and OpenGrey). Primary outcome measures were antimicrobial effect and adverse events. We used the Cochrane risk of bias tool to evaluate methodological quality of included RCTs and GRADE approach to evaluate the certainty of the evidence. We used the Review Manager software to conduct meta-analyses. RESULTS We included 12 RCTs comparing ozone therapy with no ozone, chlorhexidine digluconate, fissure sealants (alone and added to ozone), and fluoride. Considering primary outcomes, ozone therapy showed (a) lower reduction in the bacterial number than chlorhexidine digluconate in children (mean difference [MD]: -5.65 [-9.79 to -1.51]), but no difference was observed in adults (MD: -0.10 [-1.07 to 0.88]); (b) higher reduction in the bacterial number than sealant (MD: 12.60 [3.86-21.34]), but no difference was observed after final excavation (MD: -0.00 [-0.01 to 0.01]). Regarding safety of ozone therapy, results from individual studies presented no adverse events during or after treatment. Most of these results are imprecise and should be interpreted with caution because of clinical and methodological concerns, small sample size, and wide confidence interval, precluding to determine the real effect direction. CONCLUSION Based on a very low certainty of evidence, there is not enough support from published RCTs to recommend the use of ozone for the treatment of dental caries. Well-conducted studies should be encouraged, measuring mainly the antimicrobial effects of ozone therapy at long term and following the recommendations of the CONSORT statement for the reporting of RCTs.
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Affiliation(s)
| | - Rafael Leite Pacheco
- Centro Universitário São Camilo, São Paulo, São Paulo, Brazil; Cochrane Brazil Affiliate Center - Rio de Janeiro, Petrópolis, Rio de Janeiro, Brazil; Discipline of Evidence Based Health at Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | - Elaine Marcílio Santos
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, São Paulo, Brazil
| | - Rachel Riera
- Cochrane Brazil Affiliate Center - Rio de Janeiro, Petrópolis, Rio de Janeiro, Brazil; Discipline of Evidence Based Health at Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Centre of Health Technology Assessment, Hospital Sirio Libanês, São Paulo, São Paulo, Brazil
| | - Carolina de Oliveira Cruz Latorraca
- Cochrane Brazil Affiliate Center - Rio de Janeiro, Petrópolis, Rio de Janeiro, Brazil; Discipline of Evidence Based Health at Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Pamela Mota
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | | | - Ana Luiza Cabrera Martimbianco
- Cochrane Brazil Affiliate Center - Rio de Janeiro, Petrópolis, Rio de Janeiro, Brazil; Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, São Paulo, Brazil.
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Mese M, Tok YT, Kaya S, Akcay M. Influence of ozone application in the stepwise excavation of primary molars: a randomized clinical trial. Clin Oral Investig 2020; 24:3529-3538. [PMID: 32025883 DOI: 10.1007/s00784-020-03223-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 01/23/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this randomized, controlled, three-arm parallel-group, double-blinded clinical trial was to investigate the clinical and microbiological effects of the ozone application in stepwise excavation of primary molars. MATERIALS AND METHODS This study was conducted in in vivo conditions with 105 lower primary molars that had deep caries lesions. The teeth were randomly divided into three groups: (I) control group, conventional stepwise excavation with no disinfectants; (II) CHX (positive control) group, 2% chlorhexidine digluconate; and (III) experimental group, ozone application. Dentine samples were collected at 4 different time points (T0, at the first appointment, after partial removal of carious dentin; T1, at the first appointment, after applying disinfection procedure; T2, at the second appointment - at the end of the 4-month period - immediately after the removal of the temporary restoration; T3, at the second appointment, after the final excavation) for the microbiological analysis of mutans streptococci and lactobacilli and the total number of colony-forming units. Clinical changes including dentin color, humidity, and consistency were recorded. Data were analyzed using the Mann-Whitney U test, Friedman test, and chi-squared test (p = 0.05). RESULTS The dentin became harder and drier after 4 months in all the groups. There was a gradual reduction in the total number of microorganisms in all the three groups. Bacterial reduction was greater in the CHX group compared to the ozone group (p = 0.002) and was greater in the ozone group compared to the control group (p = 0.015) after 4 months (control, 78%; CHX, 93%; ozone, 82%). CONCLUSION Stepwise excavation of primary teeth provided successful outcomes in all the groups. Moreover, CHX, due to its practicality and cost-effectiveness, can be effectively used with one- or two-step indirect pulp therapies. CLINICAL RELEVANCE Usage of cavity disinfectants in the stepwise excavation procedure contributes to the reduction of bacterial population in the cavity, which may allow the avoidance of the second step of the indirect pulp therapy for primary teeth.
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Affiliation(s)
- Merve Mese
- Department of Pedodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Yesim Tuyji Tok
- Department of Medical Microbiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Selcuk Kaya
- Department of Medical Microbiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Merve Akcay
- Department of Pedodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.
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YEŞİLÖZ GÖKÇEN ESRA, KURUN AKSOY MERVE, ORHAN AYŞEIŞIL, ÖZÇELİK BERRİN, TULGA ÖZ FİRDEVS. ASSESMENT OF THE EFFECTIVENESS OF OZONE THERAPHY AND AN ANTIBACTERIAL BONDING AGENT ON THE CAVITY DISINFECTION OF DECIDUOUS TOOTH: AN IN VIVO STUDY. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.642787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fiorillo L. Chlorhexidine Gel Use in the Oral District: A Systematic Review. Gels 2019; 5:gels5020031. [PMID: 31212600 PMCID: PMC6631404 DOI: 10.3390/gels5020031] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 12/18/2022] Open
Abstract
Chlorhexidine compounds and their different formulations have been investigated several times, especially in the dentistry field. Chlorhexidine application for mouth rinsing immediately underwent oral contraindications, linked to the possibility of causing pigmentation to the teeth or relating to possible cytotoxic events after oral surgery. The positive effects, however, are considerable and its topical antiseptic action has been widely demonstrated by in vitro and clinical research. That’s the reason for its large application in different fields of dentistry. The aim of this study is to collect all the literature regarding the use of chlorhexidine gel in dentistry and all the numerous applications. The initial search on search engines obtained 232 results; then, following the application of the inclusion criteria there were 24 selected articles. The chlorhexidine gel appliance in the dental daily practice is direct to oral surgery, conservative endodontics, prevention and prophylaxis. The use of chlorhexidine has shown some positive effects, also in the case of systemic diseases prevention. Surely, this topical medicine used both professionally and prescribed for home use, can be considered a great help for the prevention of several oral pathologies with systemic implications too.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80100 Naples, Italy.
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Effects of photodynamic therapy with indocyanine green on Streptococcus mutans biofilm. Photodiagnosis Photodyn Ther 2019; 26:229-234. [DOI: 10.1016/j.pdpdt.2019.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 11/24/2022]
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Effectiveness of the ozone application in two-visit indirect pulp therapy of permanent molars with deep carious lesion: a randomized clinical trial. Clin Oral Investig 2019; 23:3789-3799. [PMID: 30759283 DOI: 10.1007/s00784-019-02808-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this randomized, three-arm parallel, single-blinded clinical trial was to evaluate the clinical and microbiological effectiveness of the ozone application in two-visit indirect pulp therapy. MATERIALS AND METHODS One hundred five lower first molar teeth with deep caries lesion were included and randomly assigned three groups to apply the two-visit indirect pulp therapy. Treatment procedure was applied without any disinfectant (control), with 60-s 2% chlorhexidine digluconate (CHX) or 60-s ozone application. In four different stages (after initial excavation, ozone/CHX application before the temporary restoration, 4 months later immediately after removing temporary restoration, and final excavation), dentin humidity, consistency, and color properties were recorded to evaluate the clinical characteristics of the tissue, and standard dentin samples were collected for the microbiological analysis of mutans streptococci, lactobacilli, and the total number of colony-forming units. The data were analyzed by using Mann-Whitney U test for multiple comparisons. RESULTS The remaining dentin became harder, drier, and darker after 4 months in all groups. However, CHX and ozone application were statistically better than the control group (p < 0.05). There was a gradual decrease in the total number of microorganisms in all groups. While cavity disinfectant applications were improved the antibacterial efficacy (control, 79.11%; CHX, 98.39%; ozone, 93.33%), CHX application exhibited a greater significant reduction than both groups (p = 0.000). CONCLUSION The two-visit indirect pulp therapy yielded successful results for all study groups. However, CHX would be conveniently preferable due to improving the treatment success. CLINICAL RELEVANCE The two-visit indirect pulp therapy applied with cavity disinfectant is a proper alternative treatment procedure in deep carious lesions, instead of conventional technique.
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Krunić J, Stojanović N, Đukić L, Roganović J, Popović B, Simić I, Stojić D. Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal. Clin Oral Investig 2018; 23:785-792. [PMID: 29858659 DOI: 10.1007/s00784-018-2495-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 05/24/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD). MATERIALS AND METHODS Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively. RESULTS Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp. CONCLUSIONS Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility. CLINICAL RELEVANCE Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.
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Affiliation(s)
- Jelena Krunić
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Studentska 5, 73300, Foca, Bosnia and Herzegovina.
| | - Nikola Stojanović
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Studentska 5, 73300, Foca, Bosnia and Herzegovina
| | - Ljiljana Đukić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka Popović
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Simić
- Department of Oral Rehabilitation, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Dragica Stojić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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17
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Microbiological Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation. J Clin Pediatr Dent 2018; 42:11-20. [PMID: 28937899 DOI: 10.17796/1053-4628-42.1.3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM To assess the microbial effect of ozone gas on dentinal lesions in young permanent molars using the stepwise excavation. STUDY DESIGN An experimental, controlled clinical trial was performed. The sample included 80 immature first permanent molars, showing deep occlusal carious cavities that were indicated for stepwise excavation. Following first step of dentin excavation, the sample was divided into test (ozone gas) and control (calcium hydroxide (Ca(OH)2) base material) groups. One half of the cases in each group were evaluated for microbiological changes after 6 months, and the other half after 12 months. RESULTS Mutans streptococci (MS), Lactobacilli, and Candida counts were significantly reduced immediately after ozone application in the test group (P ≤0.05). At the final assessment period, MS and Lactobacilli were significantly reduced in the test group (P ≤0.05). Meanwhile, the Candida counts were significantly reduced only in the test group of the 6 and 12 month-cases (P ≤0.05). Regarding the control group, the significant reduction in microbial count was observed with MS after 6 and 12 months (P ≤0.05). No significant differences were observed between test and control groups at different evaluation periods (P >0.05). CONCLUSIONS Ozone gas had a significant antimicrobial effect in deep class I carious lesions.
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Chaves RM, Estrela C, Cardoso PC, de Je Barata T, de Souza JB, de Torres ÉM, Estrela CR, Magalhães AP, Lopes LG. Ozone Gas Effect on Mineral Content of Dentin exposed to Streptococcus mutans Biofilm: An Energy-dispersive X-ray Evaluation. J Contemp Dent Pract 2017; 18:265-269. [PMID: 28349902 DOI: 10.5005/jp-journals-10024-2029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This study aims to assess the effect of ozone gas on dentin exposed to Streptococcus mutans biofilm by evaluation of mineral content [log calcium-to-phosphorus (Ca/P)] using energy-dispersive X-ray (EDX) spectroscopy. MATERIALS AND METHODS Five human third molars were sectioned into four slices of dentin and distributed in four groups: I - control (no treatment); II - ozone therapy; III - biofilm development; IV - ozone therapy followed by biofilm development. Mineral content (log Ca/P) was evaluated by EDX. Data were analyzed by analysis of variance and Tukey's test (p < 0.05). RESULTS Results showed that the mineral content of control group (I) was similar to ozone group (II), and was statistically higher than biofilm (III) and ozone + biofilm (IV). The lowest log Ca/P was determined in biofilm group (III). CONCLUSION It can be concluded that ozone gas did not grant preventive effects of demineralization by S. mutans biofilm on dentin surface. CLINICAL SIGNIFICANCE Ozone gas therapy may be an alternative noninvasive treatment aiming to reduce the levels of caries-associated microorganisms. This therapy may, thereby, be an alternative and/or complementary treatment strategy in preventive dentistry.
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Affiliation(s)
- Rafaella M Chaves
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
| | - Carlos Estrela
- Department of Stomatological Sciences, School of Dentistry Federal University of Goiás, Goiânia, Goiás, Brazil, e-mail:
| | - Paula C Cardoso
- Restorative Dentistry Department, Brazilian Dental Association Goiânia, Goiás, Brazil
| | - Terezinha de Je Barata
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
| | - João B de Souza
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
| | - Érica M de Torres
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
| | - Cyntia Ra Estrela
- Department of Stomatological Sciences, School of Dentistry Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Ana Pr Magalhães
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
| | - Lawrence G Lopes
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, Goiás Brazil
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Treatment effect of ozone and fluoride varnish application on occlusal caries in primary molars: a 12-month study. Clin Oral Investig 2013; 18:1785-92. [DOI: 10.1007/s00784-013-1160-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 11/26/2013] [Indexed: 11/28/2022]
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20
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Almaz ME, Sönmez IŞ. Ozone therapy in the management and prevention of caries. J Formos Med Assoc 2013; 114:3-11. [PMID: 23969041 DOI: 10.1016/j.jfma.2013.06.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/18/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022] Open
Abstract
The purpose of this article was to assess the effectiveness of ozone therapy in the management and prevention of caries, reviewing clinical and in vitro studies. Ozone has proven to be effective against gram-negative and gram-positive bacteria, viruses, and fungi. In dentistry, most of the published articles are based on ozone's antimicrobial effects and the treatment of caries. Most of the clinical studies reported ozone to be a promising alternative to conventional methods for caries management. However, a few studies have shown ozone to be insufficient for preventing caries and reducing microorganisms in open occlusal carious lesions. Ozone might be a useful tool to reduce and control oral infectious microorganisms in dental plaque and dental cavity. However, the results of in vitro studies are controversial; while some researchers reported that ozone therapy had a minimal or no effect on the viability of microorganisms, others suggested ozone to be highly effective in killing both gram-positive and gram-negative oral microorganisms. Therefore, more evidence is required before ozone can be accepted as an alternative to present methods for the management and prevention of caries.
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Affiliation(s)
- Merve Erkmen Almaz
- Kırıkkale University, Faculty of Dentistry, Department of Pedodontics, Kırıkkale, Turkey
| | - Işıl Şaroğlu Sönmez
- Adnan Menderes University, Faculty of Dentistry, Department of Pedodontics, Aydın, Turkey.
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L’ozonoterapia nella riduzione dell’edema a seguito di interventi di piccola chirurgia orale: studio clinico randomizzato. DENTAL CADMOS 2013. [DOI: 10.1016/s0011-8524(13)70062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Ozone, either in gaseous form or as ozonated water, has been available for use as a treatment for dental caries for a decade. This paper reviews the literature on the subject by examining the findings of publications in the peer review literature. Eighteen papers were identified by a literature search. From the review of these, it was concluded that, while some laboratory studies and some short duration clinical studies have suggested that ozone may be effective in the treatment of root caries or killing of oral micro-organisms, the clinical evidence for the use of ozone in treatment of caries is not compelling.
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Affiliation(s)
- F J Trevor Burke
- University of Birmingham, School of Dentistry, College of Medical and Dental Sciences, St Chad's Queensway, Birmingham 84 6NN, UK
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Koban I, Matthes R, Hübner NO, Welk A, Sietmann R, Lademann J, Kramer A, Kocher T. XTT assay of ex vivo saliva biofilms to test antimicrobial influences. GMS KRANKENHAUSHYGIENE INTERDISZIPLINAR 2012; 7:Doc06. [PMID: 22558040 PMCID: PMC3334957 DOI: 10.3205/dgkh000190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Many dental diseases are attributable to biofilms. The screening of antimicrobial substances, in particular, requires a high sample throughput and a realistic model, the evaluation must be as quick and as simple as possible. For this purpose, a colorimetric assay of the tetrazolium salt XTT (sodium 3'-[1-[(phenylamino)-carbony]-3,4-tetrazolium]-bis(4-methoxy-6-nitro)benzene-sulfonic acid hydrate) converted by saliva biofilms is recommended. Cleavage of XTT by dehydrogenase enzymes of metabolically active cells in biofilms yields a highly colored formazan product which is measured photometrically. MATERIALS AND METHOD The suitability of the XTT assay for detecting the vitality of ex vivo saliva biofilms was tested to determine the efficacy of chlorhexidine and ozone versus saliva biofilms grown on titanium discs. RESULTS The XTT method lends itself to testing the vitality of microorganisms in saliva biofilms. The sensitivity of the arrays requires a specific minimum number of pathogens, this number being different for planktonic bacteria and those occurring in biofilms. The antibacterial effect after treatment with chlorhexidine or ozone was measured by XTT conversion that was significantly reduced. The antimicrobial efficacy of 60 s 0.5% and 0.1% chlorhexidine treatment was equal and comparable with 60 s ozone treatment. CONCLUSION The XTT assay is a suitable method to determine the vitality in saliva biofilms, permitting assessment of the efficacy of antimicrobial substances. Its quick and easy applicability renders it especially suitable for screening.
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Affiliation(s)
- Ina Koban
- Unit of Periodontology, Dental School, University of Greifswald, Greifswald, Germany
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Role of intra-articular ozone gas injection in the management of internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:e10-4. [PMID: 22677023 DOI: 10.1016/j.tripleo.2011.08.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 07/05/2011] [Accepted: 08/03/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study was carried out to compare intra-articular ozone gas injection and drug therapy as conservative treatment modalities for internal derangement of the temporomandibular joint (TMJ). STUDY DESIGN Sixty patients (49 female and 11 male) with bilateral internal derangement of the TMJs, disc displacement with reduction, were included in this study. They were divided randomly into 2 equal groups. The first group was treated by a direct injection of ozone gas into the superior joint space. Each joint received 2 mL ozone-oxygen mixture (ozone gas concentration 10 μg/mL). The injections were repeated 2 times per week for 3 weeks. The second group received nonsteroidal antiinflammatory drugs and muscles relaxants. The clinical signs and symptoms before and after the treatment were assessed according to Helkimo's clinical dysfunction index. RESULTS The results showed that 87% of the patients who received ozone gas injections into the superior joint space (n = 26) either completely recovered (37%; n = 11) or improved (50%; n = 15). In the second group, 33% of the patients who were treated with nonsteroidal antiinflammatory drugs and muscle relaxants (n = 10) showed only an improvement in their clinical dysfunction indexes. CONCLUSIONS Based on the findings of the present study, we can consider that intra-articular ozone gas injection is a promising new treatment modality for internal derangement of the TMJ. However, further clinical and experimental studies are required to provide direct evidence for its mechanism of action and to substantiate our results.
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Bocci V, Zanardi I, Borrelli E, Travagli V. Reliable and effective oxygen-ozone therapy at a crossroads with ozonated saline infusion and ozone rectal insufflation. ACTA ACUST UNITED AC 2011; 64:482-9. [PMID: 22420654 DOI: 10.1111/j.2042-7158.2011.01427.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This review aims to highlight the advantages and safety of oxygen-ozone therapy (OOT) and to suggest ways to enhance its acceptance. KEY FINDINGS The treatment of a herniated disk by injecting a gaseous oxygen-ozone mixture inside the nucleus pulposus is a great clinical success. However, the use of OOT lags for a number of reasons, including lack of standardization, the need for numerous treatments, lack of knowledge and even denial. Anecdotally, several million treatments by OOT have been performed worldwide indicating its usefulness, mainly in peripheral arterial diseases and age-related macular degeneration. The scepticism that accompanies the systemic use of ozone can only be overcome by demonstrating the validity of OOT in controlled and randomized clinical trials. Cheaper and quicker methods, such as ozonating physiological saline with successive infusion as well as ozone rectal insufflations, are becoming popular, however, such alternative procedures are erratic, unstable and liable to be toxic, with deleterious consequences, and are likely to discredit the beneficial use of ozone. SUMMARY The approval of ozone in terms of both therapeutic efficacy and safety will depend on the results achieved by authoritative clinical trials.
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Affiliation(s)
- Velio Bocci
- Dip. di Fisiologia, Università degli Studi di Siena, Siena, Italy
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Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia. Clin Oral Investig 2011; 16:1049-59. [DOI: 10.1007/s00784-011-0603-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
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Rodrigues JA, Lussi A, Seemann R, Neuhaus KW. Prevention of crown and root caries in adults. Periodontol 2000 2010; 55:231-49. [DOI: 10.1111/j.1600-0757.2010.00381.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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