A quantitative approach to the effectiveness of ozone against microbiota organisms colonizing toothbrushes

Disinfection effect of ozonated water on SARS-CoV-2 in the presence of salivary proteins

BACKGROUND

Ozonated water is expected to be an effective disinfectant for SARS-CoV-2 present on environmental fomites; however, ozone is consumed by organic substances, resulting in attenuation of its effect. SARS-CoV-2 present in saliva can contaminate environmental surfaces; therefore, it is essential to understand the effect of organic substances in saliva on the disinfectant properties of ozonated water.

AIM

To assess organic factors in saliva and the extent to which they diminish the effect of ozonated water on SARS-CoV-2.

METHODS

Ozonated water was exposed to salivary organic factors and residual ozone concentrations were measured. SARS-CoV-2 was exposed to a salivary factor and virus inactivation by ozonated water was measured.

FINDINGS

Amylase and mucin consumed ozone in a concentration-dependent manner. Urea did not. Ozonated water appeared to inactivate SARS-CoV-2 within 30 sec. The amount of inactivated SARS-CoV-2 decreased as the protein concentration increased. Virus inactivation was stronger by 1.5 mg/L ozonated water than by 0.5 mg/L ozonated water.

CONCLUSION

This study suggests that the salivary amylase and mucin decay ozone in a concentration-dependent manner, thereby attenuating the disinfection properties of ozonated water for SARS-CoV-2. An increase of the initial amount of ozone can ameliorate the disinfection effect of ozonated water on SARS-CoV-2. Ozone consumption should be taken into consideration for virus infection control. These results provide fundamental information about the effect of ozonated water when used to decontaminate surfaces harbouring SARS-CoV-2 in saliva.

Manual toothbrushes, self-toothbrushing, and replacement duration to remove dental plaque and improve gingival health: A scoping review from recent research

OBJECTIVE

To investigate characteristics of manual toothbrushes, self-toothbrushing methods, and replacement duration of manual toothbrushes that effectively remove dental plaque, reduce gingivitis, and promote gingival health.

STUDY DATA AND SOURCES

PubMed-MEDLINE, Scopus and Central Register Cochrane of Controlled trials (CENTRAL) were searched for randomized control trials (RCTs) from 01 January 2018 to 12 December 2023. Articles were subjected for including participants aged six years and older with a study duration of at least four weeks to investigate the efficacy of manual toothbrushes used self-toothbrushing. To investigate the appropriate time to replace manual toothbrushes, this study was focused on the physical properties of the bristles and changes in the microorganisms present in the bristles over time.

STUDY SELECTION

Of 1520 retrieved articles, 26 studies were included after screening. The total number of manual toothbrushes was 40 and 5 kinds of self-toothbrushing techniques were selected in the review. 4 studies investigated the changes the physical properties bristles of manual toothbrushes.

CONCLUSIONS

Among manual toothbrushes, the cross-angle and indicator bristles were found to significantly improve dental plaque index and gingival condition. Most toothbrushes with soft bristles had a trend of superior dental plaque removal and gingivitis improvement efficacy. Toothbrush with end-round shape bristles tip has tended to reduce the dental plaque and gingival index scores. Studies reported that brushing twice a day for at least two minutes using the Bass method had a positive effect on the dental plaque and gingival index. Further research is required to investigate the relationships between property physical bristle and clinical intraoral indices to clarify the replacement duration of manual toothbrushes.

CLINICAL SIGNIFICANCE

The findings of this study could guide people's daily self-brushing habits, thereby aiding the prevention of periodontal disease. Moreover, our findings suggest the need for strategic clinical trial designs to verify the ideal timing to replace manual toothbrushes.

Comparison of ıntracanal ozone and low-level laser therapy on postoperative pain in vital teeth with symptomatic apical periodontitis:placebo-controlled randomize trial

The aim of this study was to compare the effect of ozone and low-level-laser therapy (LLLT) on postoperative pain after root canal treatment in symptomatic apical periodontitis on vital teeth. Eighty patients were divided into four groups using a web program as follows: LLLT placebo (mock laser therapy), LLLT, Ozone placebo (mock ozonated water irrigation), and Ozone. Postoperative pain levels for 7 days after treatment and percussion pain levels at the 7th day were recorded on the visual analog scale. A regression analysis, Cochran's Q test, Chi-square test, Kruskal-Wallis tests were performed to analyze the data (P=.05). A regression analysis demonstrated that the most effective variables are "group" and "jaw" (P=0.01). Pain in the lower jaw is higher than the upper jaw. There was difference between the groups on postoperative pain at the days 1, 2, and 3; however, there was no significant difference on other days. LLLT and ozone groups had less postoperative pain and pain on percussion. Low-level laser and ozone therapy are useful methods on postoperative-pain in vital symptomatic teeth ,but they don't have superiority to each other.

Ozone therapy in management and prevention of dental caries- A Review

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.

Technological Advances in Ozone and Ozonized Water Spray Disinfection Devices

To control infectious diseases such as the severe acute respiratory syndrome coronavirus (Covid-19) that caused the current pandemic, disinfection measures are essential. Among building measures, disinfection chambers can help to decrease the transmission rate through the sanitizing capacity of the disinfectant used, which can thereby clean surfaces or humans. Out of existing biocides, ozone is considered one of the safest for humans, but one of the most powerful oxidizers, making the substance a better alternative as the biocidal solution in disinfection chambers. Analyses were carried out by using all patented documents related to disinfection chambers that used ozone as a disinfectant. A Derwent Innovation Index (DII) database search was undertaken to find these patents. Patent prospecting resulted in 620 patent documents that were divided into 134 patent families. There was no technology related to protective barriers for individuals, and the majority of patents in the retrieved data aimed at sterilizing medical devices and surfaces. Given that the specific Cooperative Patent Classification (CPC) code for ozone dissolved in liquid was used in the methodology search, but not included among the 10 most used codes in the patents, the use of ozonized water may be an innovative approach in the technology landscape of sterilization chambers.

An In-vitro Assessment of the Physical and Chemical Properties of Toothbrush Bristle Following Decontamination by Three Different Methods: A Pilot Study

Background Toothbrushes are the most commonly used mechanical plaque control methods, and they are said to harbor microorganisms if not stored properly following usage. Objective An assessment of the influence of a decontaminating agent (sterile water (control)/chlorhexidine mouthwash/herbal mouthwash) on the properties of toothbrush bristles following storage for 24 hrs by means of scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Methodology The study involves a total of 24 slim soft toothbrushes (six samples per group) with different decontaminating agents: Group 1: Vented container, Group 2: Sterile water, Group 3: 0.2% Chlorhexidine mouthwash, and Group 4: Herbal mouthwash. The toothbrushes were stored in their respective containers for 24 hours, following which, snippets of toothbrush bristles were collected and tested for the evaluation of wear using SEM and the biochemical alteration occurring in the bristles was assessed using FTIR. Results and conclusion The Group 2 and Group 3 samples showed significant wear (Score 2) under SEM evaluation, and FTIR spectroscopy evaluation revealed that changes occur in the fingerprint region of infrared spectroscopy owing to chemical bond alteration following decontamination. Considering the benefits we acquire in terms of microbial load reduction, decontamination is recommended, though it might necessitate frequent changing of toothbrushes.

Fungal Infections of the Central Nervous System in Children

Although uncommon in children, fungal infections of the central nervous system can be devastating and difficult to treat. A better understanding of basic mycologic, immunologic, and pharmacologic processes has led to important advances in the diagnosis and management of these diseases, but their mortality rates remain unacceptably high. In this focused review, we examine the epidemiology and clinical features of the most common fungal pathogens of the central nervous system in children and explore recent advances in diagnosis and antifungal therapy.

The efficacy of gaseous ozone against different forms of Candida albicans

Background and Purpose:

Ozone is an inorganic molecule with effective antimicrobial properties. Clinical treatment of ozonated water was used for the elimination of Candida albicans, Enterococcus faecalis, endotoxins, and biofilms from root canals. In addition, its therapeutic effects for tinea pedis, ulcers, and leishmaniasis were investigated. The purpose of the present study was to evaluate the fungicidal effects of ozone on different forms of C. albicans. In addition, antifungal susceptibility profile of strains was assessed before and after exposure to ozone.

Materials and Methods:

Fifty strains of C. albicans were exposed to gaseous ozone at different times. Furthermore, biofilm formation and germ tube production were evaluated when yeast suspensions were exposed to ozone. In addition, antifungal susceptibility of ozone resistant colonies was investiagted as compared to controls.

Results:

Ozone was highly effective in killing C.albicans in yeast form and inhibition of germ tube formation during 210 and 180 s, respectively. Although with increasing exposure time biofilm production was considerably decreased, resistance to ozone was much higher among vaginal and nail isolates even after 60 min. All the strains were sensitive to fluconazole, caspofungin, and terbinafine pre- and post-ozone exposure. Resistance to amphotericin B was significantly enhanced after exposure to ozone.

Conclusion:

Although ozone was highly effective on the yeast form of C.albicans and it can inhibit the formation of germ tubes in C.albicans, the complete removal of biofilms did not happen even after 60 min. It seems that ozone therapy induces resistance to amphotericin B.

Experimental effect of ozone upon the microbial flora of commercially produced dairy fermented products

Ozone was used to control spoilage microorganisms during the manufacturing of dairy products. Ozone stream was applied onto the surface of freshly filled yoghurt cups just before storage for curd development in order to prevent cross contamination from spoilage airborne microorganisms. Accordingly, brine solution was bubbled with ozone for various periods of time and used for ripening of white (feta type) cheese. Both products were subjected to a continuous monitoring of microbial load and also tested for their sensorial properties. In ozonated yoghurt samples there was a reduction in mould counts of approximately 0.6Logcfu/g (25.1%) by the end of the monitoring period in relation to the control samples. In white cheese ripened with ozonated brine (1.3mg/L O₃, NaCl 5%) it seems that ozone treatment during the two months of observation reduced some of the mould load but without offering any advantages over the use of traditional brine (NaCl 7%). However, some sensorial alterations were observed, probably due to the organic load in the brine which deactivates ozone in early stages of application. It is concluded that, if the factors of time and concentration of ozone are configured properly, ozonation could be a promising approach safeguarding the production of some dairy products.

Análise da contaminação microbiológica de diferentes dentifrícios

Resumo Introdução A avaliação microbiológica em produtos de higiene pessoal constitui uma etapa importante no que se refere à segurança do usuário e à qualidade do produto, visto que a carga microbiana elevada pode acarretar problemas de saúde, especialmente em pessoas imunocomprometidas. Objetivo Verificar o cumprimento das exigências acerca da qualidade microbiológica de cremes e géis dentais adquiridos comercialmente. Material e método Realizou-se a contagem de bactérias e fungos viáveis totais e pesquisa dos patógenos E. coli, Salmonella sp., S. aureus e P. aeruginosa em 21 amostras. Resultado Das amostras analisadas, 52,0% apresentaram crescimento microbiano e 28,6% e 0,21% apresentaram contaminação fúngica e bacteriana, respectivamente, acima dos limites descritos na Farmacopeia Brasileira para preparações de uso tópico (máximo permitido 2 × 102 UFC/g de bactérias e 2 × 101 UFC/g de fungos). Nenhuma amostra apresentou os patógenos pesquisados E. coli, Salmonella sp., S. aureus e P. aeruginosa. Conclusão Estes resultados indicam que muitos produtos disponíveis no mercado apresentam qualidade inadequada, demonstrando falhas no controle de qualidade. Para prevenir esta situação, faz-se necessária fiscalização rigorosa e adoção de medidas regulamentadoras e educacionais aliadas ao seguimento das Boas Práticas de Fabricação pelas indústrias fabricantes.

Systemic antibiotics and the risk of superinfection in peri-implantitis

Peri-implantitis has emerged in the last few years as a complication difficult to resolve. The etiopathogenesis consensus is mainly attributed to bacteria. Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, a PubMed/Medline literature search was performed using the US National Library of Medicine database up to 2015 to analyze available scientific data on the rationale and risk of superinfection associated to systemic antimicrobials in human peri-implant disease. A hand search was also conducted on relevant medical and microbiology journals. The methodological index for non-randomized studies (MINORS) was independently assessed for quality on the selected papers. Proposed combined therapies use broad-spectrum antibiotics to halt the disease progression. A major associated risk, particularly when prescribed empirically without microbiological follow-up, is the undetected development of superinfections and overgrowth of opportunistic pathogens difficult to eradicate. Peri-implant superinfections with opportunistic bacteria, yeast and viruses, are plausible risks associated to the use of systemic antibiotics in immunocompetent individuals. Lack of microbiological follow-up and antibiotic susceptibility testing may lead to ongoing microbial challenges that exacerbate the disease progression. The increased proliferation of antimicrobial resistance, modern implant surface topography and indiscriminative empiric antibiotic regimens may promote the escalation of peri-implant disease in years to come. A personalized 3-month supportive therapy may help prevent risks by sustaining a normal ecological balance, decreasing specific pathogen proportions and maintaining ideal plaque control.

Application of ozonated piggery wastewater for cultivation of oil-rich Chlorella pyrenoidosa

Ozonated and autoclaved piggery wastewaters were compared for cultivation of oil-rich Chlorella pyrenoidosa by measuring nutrient removal from the medium and growth rate and lipid production of the microalgae. The removal rates of chemical oxygen demand, NH4(+)-N, total nitrogen and total phosphorus by C. pyrenoidosa were not influenced by both sterilisation methods. The specific growth rate and biomass of C. pyrenoidosa were determined by analysing the chlorophyll concentration for eliminating the disturbance of bacteria growth in culture system. Bacteria raised from the residue in the ozonated medium achieved 30% of the total microorganisms at the end of cultivation. They reduced the growth of C. pyrenoidosa by 10.4%, but contributed to a faster decline of the nutrient content on the first day. Lipid production and fatty acid profile did not change markedly in both sterilisation methods. The results suggest that ozonation is acceptable for piggery wastewater treatment for C. pyrenoidosa cultivation.

Ozone therapy in the management and prevention of caries

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.

Antimicrobial effects of ozonated water on the sanitization of dental instruments contaminated with E. coli, S. aureus, C. albicans, or the spores of B. atrophaeus

OBJECTIVES

Ozone has been used as an alternative method for the decontamination of water, food, equipment and instruments. The objective of this study was to evaluate the antimicrobial effects of ozonated water on the sanitization of dental instruments that were contaminated by Escherichia coli, Staphylococcus aureus, Candida albicans and the spores of Bacillus atrophaeus.

METHODS

A total of one hundred and twenty standardized samples of diamond dental burs were experimentally contaminated with E. coli (ATCC 25922), S. aureus (ATCC 6538) and C. albicans (ATCC 18804) and the spores of B. atrophaeus (ATCC 6633) for 30 min. After the contamination, the samples were exposed to ozonated water (10mg/L O(3)) for 10 or 30min. The control group was composed of samples that were exposed to distilled water for 30 min. After the exposure to the ozonated water, 0.1 mL aliquots were seeded onto BHI agar to count the colony-forming units per milliliter (CFU/mL) of E. coli, S. aureus, and B. atrophaeus. Sabouraud dextrose agar was used to count the CFU/mL of C. albicans. The results were subjected to an analysis of variance and the Tukey test.

RESULTS

For all of the microorganisms studied, the ozonated water reduced the number of CFU/mL after 10 and 30 min of sanitization, and this microbial reduction was dependent on the duration of the exposure to the ozonated water. E. coli exhibited the greatest reduction in CFU/mL (2.72-3.78 log) followed by S. aureus (2.14-3.19 log), C. albicans (1.44-2.14 log) and the spores of B. atrophaeus (1.01-1.98 log).

CONCLUSION

The ozonated water was effective in reducing the CFU of E. coli, S. aureus, C. albicans and B. atrophaeus spores, suggesting that ozonated water can be used for the sanitization of dental instruments.

The antibacterial effect of gas ozone after 2 months of in vitro evaluation

The aim of this study was to evaluate the effect of HealOzone on two microorganisms, 4 and 8 weeks after treatment, using a tooth cavity model. Four groups of caries-free third molars (n = 12) were used (A, B, C and D). Three cavities were prepared into each tooth. After sterilization, groups A and B were inoculated with Streptococcus mutans, and groups C and D, with Lactobacillus casei for 48 h. One cavity of each tooth was used to evaluate the infection. After inoculation, groups B and D were treated with ozone (60 s), and groups A and C were used as controls. Then, the two cavities of each tooth were filled with composite, and the teeth were stored in sucrose medium. The restorations were removed after 4 and 8 weeks, respectively; dentin chips were collected, and the amount of microorganisms was determined. Ozone treatment reduced significantly the amount of S. mutans compared to the control group (p ≤ 0.05). This antibacterial effect was able to be seen after 4 (p = 0.0005) and 8 (p = 0.0002) weeks. No significant difference was found between the control and treated group as far as L. casei is concerned (p > 0.05). HealOzone (60 s) can provide some antibacterial treatment against S. mutans even after 8 weeks. However, an elimination of the microorganisms through HealOzone seems not to be possible. L. casei was more resistant to ozone. Although ozone exerts a significant antibacterial effect against S. mutans, it is probably not enough as the only antibacterial method, during the fillings therapy.

Influence of ozone on the composite-to-composite bond

The study evaluated the effect of ozone application on the composite-to-composite bond. Three hundred and twenty cylindrical composite specimens were divided into two groups: group 1 was subjected to a 60 s ozone application, whereas group 2 remained untreated. Four subgroups were obtained from each group according to the intermediate repair agent: an adhesive, a silane, silane/adhesive combination, or flowable composite. Repair composite cylinders were built-up. The composite repair strength was tested after 24 h and after thermocycling with a shear test. Additionally, 4 mm × 4 mm × 2 mm composite specimens were prepared and stored 24 h in deionized water. Half of the specimens were subjected to ozone application and the other served as control. The elastic modulus (E) and the Vicker's hardness (VH) of the composite surfaces were tested immediately and after thermocycling. Significant differences among the experimental groups were detected (p < 0.001). The composite repair strength was affected by the pretreatment and by the intermediate agent, whereas, the thermocycling was not significant. The partial eta-squared statistics showed that the intermediate agent was the main factor affecting the composite repair strength, whereas the pretreatment played a minor role. No differences were observed between ozone and control groups when the same intermediate agent and the same aging conditions were applied. Repairing with flowable composite tended to achieve higher bond strengths (20.7 and 26.5 MPa in ozone and control groups, respectively, after 24 h). The use of silane coupling agent showed the lowest composite repair strengths. Ozone did not affect E and VH (p > 0.05) and the thermocycling affected only E (p < 0.05). In conclusion, the application of ozone does not impair the composite-to-composite bond.