GINGIVAL DISEASES
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Martínez Abreu et al. (2006) [44 Martínez Abreu J, Arencibia YC, Ruiz TP. Oleozón em el zonized o de la gingivitis crónica edematosa. Ver Med Electrón. 2006;28(6): 541-548.] Cuba |
100 patients with chronic edematous gingivitis
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N = 50 Scaling, root planing, and application of ozonated oil in the affected region. |
N = 50 Scaling, root planing, and 0.2% chlorhexidine mouthwash. |
Patients in the intervention group had faster remission compared to those in the control group (p=0.004). |
Rosell et al. (2019) [2020 Rosell AP, Femen�as JLC, Capote NJ. Utilidad del oleoz�n t�pico en la gingivitis cr�nica fibroedematosa. Rev Med Electron. 2019;41(1):54-62.] Cuba |
60 patients with chronic edematous gingivitis
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N = 30 Application of ozonated oil in the gingival sulcus or pocket twice a week. |
N = 30 Rinse with 0.2% aqueous chlorhexidine for 1 minute, once a day for 2 weeks. |
No significant differences were found between groups of patients treated with ozonated oil and chlorhexidine, with remission of the condition in both groups. |
Talmaç & Çalişir (2021) [2121 Talmaç AC, Çalişir M. Efficacy of gaseous ozone in smoking and non-smoking gingivitis patients. Ir J Med Sci. 2021;190(1):325-333. https://doi.org/10.1007/s11845-020-02271-x https://doi.org/10.1007/s11845-020-02271...
] Turkey |
40 patients with gingivitis |
N=40 Scaling and application of gaseous ozone for 60 seconds on each tooth every 2 days for 1 week. |
N=40 Scaling and dental polishing. |
No statistically significant difference was observed between intervention and control groups in terms of plaque index, gingival index, and probing depth (p>0.05). Statistically significant difference was observed only in the gingival bleeding time index between groups (p=0.0436). |
PERIODONTITIS
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Martínez Abreu & Sardinas (2005) [1515 Mart�nez Abreu J, Sardinas MA. Oleoz�n em el tratamiento de la periodontitis simples moderada. Rev Med Electron. 2005;-27(3).] Cuba |
84 patients with moderate chronic periodontitis |
N = 42 Application of ozonated oil. |
N = 42 0.2% aqueous chlorhexidine irrigation. |
The reduction of signs and symptoms was faster in the group treated with ozone. The treatment efficacy at 180 days was considered good in 98% of patients in the experimental group and in 78% in the control group (p=0.00239). |
Kshitish & Laxman (2010) [99 Kshitish D, Laxman VK. The use of ozonated water and 0.2% chlorhexidine in the treatment of periodontitis patients: A clinical and microbiologic study. Indian J Dent Res. 2010;21(3):341-348. https://doi.org/10.4103/0970-9290.70796 https://doi.org/10.4103/0970-9290.70796...
] India |
16 patients with generalized chronic periodontitis and aggressive periodontitis |
N = 16 Ultrasound scaling and irrigation with ozonated water for 5 to 10 minutes (2nd and 3rd quadrants). |
N = 16 Ultrasound scaling and irrigation with 0.2% aqueous chlorhexidine (1st and 4th quadrants). |
Higher reduction percentage was observed in the plaque index (12%) (p=0.23), gingival index (29%) (p=0.042), and bleeding index (26%) (p=0.03) using ozone irrigation. The percentage reduction of Actinobacillus actinomycetemcomitans using ozone was 25% compared to no change using chlorhexidine. No antibacterial effect was observed on Porphyromonas gingivalis and Tannerella forsythensis with ozone or chlorhexidine. In addition, ozone had antifungal effect at baseline (37%) and on the 7th day (12.5%), unlike chlorhexidine, which showed no antifungal effect. |
Skurska et al. (2010) [66 Skurska A, Pietruska MD, Paniczko-Drężek A, Dolińska E, Zelazowska-Rutkowska B, Zak J et al. Evaluation of the influence of ozonotherapy on the clinical parameters and MMP levels in patients with chronic and aggressive periodontitis. Adv Med Sci. 2010;55(2):297-307. https://doi.org/10.2478/v10039-010-0048-x https://doi.org/10.2478/v10039-010-0048-...
] Poland |
52 patients with chronic or aggressive periodontitis |
Group 2 (N= 25 patients with chronic periodontitis) and Group 3 (N=15 patients with aggressive periodontitis): Scaling and gaseous ozone application. |
Group 1 (N= 12 patients with chronic periodontitis): Scaling Group 4 (N= 14 patients without periodontal problems). |
All clinical parameters evaluated in the study groups were reduced after treatment. Scaling with ozone therapy provided increase in MMP levels in patients with chronic periodontitis and reduction in MMP levels in patients with aggressive periodontitis. Scaling followed by ozone therapy does not lead to further improvement in clinical periodontal parameters in patients with chronic and aggressive periodontitis. |
Hayakumo et al. (2013) [88 Hayakumo S, Arakawa S, Mano Y, Izumi Y. Clinical and microbiological effects of ozone nano-bubble water irrigation as an adjunct to mechanical subgingival debridement in periodontitis patients in a randomized controlled trial. Clin Oral Invest. 2013;17(2):379-388. https://doi.org/10.1007/s00784-012-0711-7 https://doi.org/10.1007/s00784-012-0711-...
] Japan |
22 patients with mild to moderate chronic periodontitis |
N = 11 Mechanical debridement and irrigation with nano ozonated water bubbles. |
N = 11 Mechanical debridement and water irrigation. |
Significant improvements in all clinical parameters were observed after 4 weeks in both groups. Reduction in pocket depth and clinical attachment gain after 4 and 8 weeks in the intervention group were significantly greater than in the control group. Only the intervention group showed statistically significant reductions in the mean total number of bacteria in the subgingival plaque during the study period. |
Yilmaz et al. (2013) [1616 Yilmaz S, Algan S, Gursoy H, Noyan U, Kuru BE, Kadir T. Evaluation of the clinical and antimicrobial effects of the er: yag laser or topical gaseous ozone as adjuncts to initial periodontal therapy. Photomed Laser Surg. 2013;31(6):293-298. https://doi.org/10.1089/pho.2012.3379 https://doi.org/10.1089/pho.2012.3379...
] Turkey |
30 patients with chronic periodontitis |
N = 10 Scaling and root planing and gaseous topical ozone. |
Group 1 (n=10): Scaling and planing and laser application. Group 3 (n=10): Scaling. |
Statistically significant improvements in clinical parameters were observed within each group. All treatments reduced the number of total bacteria and the proportion of obligately anaerobic microorganisms. Although intergroup comparisons of microbiological parameters did not show significant differences, the clinical findings, including attachment gain and pocket depth reduction, were statistically significant in group 1. |
Al Habashneh et al. (2015) [2222 Al Habashneh R, Alsalman W, Khader Y. Ozone as an adjunct to conventional nonsurgical therapy in chronic periodontitis: a randomized controlled clinical trial. J Periodontal Res. 2015;50(1):37-43. https://doi.org/10.1111/jre.12177 https://doi.org/10.1111/jre.12177...
] Jordan |
41 patients with chronic periodontitis |
N = 20 Non-surgical treatment and irrigation with ozonated water for 30/60 seconds. |
N = 21 Non-surgical treatment and irrigation with distilled water for 30/60 seconds. |
The use of ozonated water as adjunctive therapy for subgingival scaling did not produce statistically significant benefits compared to subgingival scaling with distilled water irrigation in terms of clinical outcome and hs-CRP level. |
Shoukheba & Ali (2014) [1111 Shoukheba MYM, Ali SA. The effects of subgingival application of ozonated olive oil gel in patient with localized aggressive periodontitis. A clinical and bacteriological study. Tanta Dent J. 2014;11(1): 63-73. https://doi.org/10.1016/j.tdj.2014.04.001 https://doi.org/10.1016/j.tdj.2014.04.00...
] Egypt |
30 patients with aggressive periodontitis |
N = 15 Scaling, root planing, and application of ozonated oil. |
N = 15 Scaling and root planing. |
The results showed improvement in all clinical parameters of the intervention group, which was maintained for up to 6 months (P < 0.05). However, this improvement was more perceived after one month, gradually decreasing at 3 and 6 months. Scaling alone resulted in significant improvement only in the first month for parameters bleeding on probing, probing depth, and attachment level, and up to 3 months for parameters plaque index and gingival index, compared to baseline values. |
Sisto et al. (2015) [1717 Sisto MP, Mazo LDD, Gonz�lez SF, Vallejo MIA, Toledo LS. Eficacia del Oleozon� en pacientes con periodontitis del adulto. Medisan. 2015;19(11):1330-1337.] Cuba |
48 patients with periodontitis |
N = 24 Subgingival application of ozonated oil for 7 consecutive days topically and inside the pocket. |
N = 24 Subgingival irrigation with 0.02% chlorhexidine for the same period as the experimental group. |
Ozonated oil was statistically significant only for the clinical parameter evolution of periodontal pocket depth (p = 0.0376). |
Chaudhari et al. (2016) [77 Chaudhari S, Patil V, Mali R, Mali A, Patil P, Lele P. Comparative evaluation of ozone therapy as an adjunct to scaling and root zonized with scaling and root ozonized alone in cases of chronic Periodontitis – a clinical and microbiological study. Int J Curr Med Pharm Res. 2016;2(8): 539-543.] India |
20 patients with chronic periodontitis |
N = 20 Scaling, root planing, and irrigation with aqueous ozone. |
N = 20 Scaling and root planing without irrigation. |
In the experimental group, statistically significant reduction in the gingival bleeding index, probing depth, and total microbial count was observed. It could be concluded that the application of ozone can be effectively used to treat periodontal diseases non-surgically. |
Pandya et al. (2016) [55 Pandya DJ, Manohar B, Mathur LK, Shankarapillai R. Comparative evaluation of two subgingival irrigating solutions in the management of periodontal disease: a clinicomicrobial study. J Indian Soc Periodontol. 2016;20(6):597-602. https://doi.org/10.4103/jisp.jisp_328_16 https://doi.org/10.4103/jisp.jisp_328_16...
] India |
10 patients with severe periodontitis |
Group 2 (N = 10): Scaling and subgingival irrigation with ozonated water (2nd quadrant). |
Group 1 (N = 10): Scaling and irrigation with 0.2% chlorhexidine (1st quadrant). Group 3 (N = 10): Scaling and irrigation with saline solution (3rd quadrant). Group 4 (N = 10): Scaling and root planing (4th quadrant). |
Chlorhexidine 0.2% is more effective than ozonated water and can be used as adjunct to mechanical therapy to achieve significant reduction in inflammatory periodontal changes and also in the reduction of periodontopathogenic microflora. |
Saeed et al. (2017) [11 Saeed SSM, Afify O, El-Moula EM, El-ZamaranY EA. Clinical and Microbiological Evaluation of Oleozone Gel in the Treatment of Chronic Periodontitis. EC Dental Science. 2017;12(6):227-236.] Egypt |
16 patients with moderate chronic periodontitis |
N = 8 Scaling, root planing, and application of ozonated oil gel in the subgingival region. |
N = 8 Scaling, root planing, and application of placebo gel. |
Intergroup comparison revealed that the group treated with ozonated oil showed more favorable clinical and microbiological results, with continuous and highly significant reduction in P. gingivalis counted up to 3 months and with non-significant deterioration at 6 months. |
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Uraz et al. (2019) [2323 Uraz A, Karaduman B, Isler SÇ, Gönen S, Çetiner D. Ozone application as adjunctive therapy in chronic periodontitis: clinical, microbiological and biochemical aspects. J Dent Sci. 2019;14(1):27-37. https://doi.org/10.1016/j.jds.2018.06.005 https://doi.org/10.1016/j.jds.2018.06.00...
] Turkey |
18 patients with chronic generalized periodontitis |
N = 18 Scaling, root planing, and gaseous ozone application 3 times for 30 s (every 3 days)for 1 week. |
N = 18 Scaling and root planing. |
Adjuvant ozone therapy did not provide additional benefits to clinical, microbiological, and biochemical parameters in relation to scaling and root planing without irrigation in patients with chronic periodontitis. |
Dengizek et al. (2019) [2424 Dengizek ES, Serkan D, Abubekir E, Bay KA, Onder O, Arife C. Evaluating clinical and laboratory effects of ozone in non-surgical periodontal treatment: a randomized controlled trial. J Appl Oral Sci. 2019;27(e20180108):1-8. http://dx.doi.org/10.1590/1678-7757-2018-0108 https://doi.org/10.1590/1678-7757-2018-0...
] Turkey |
40 patients with chronic periodontitis |
N = 20 Scaling, root planing, and gaseous ozone application in the gingival sulcus on days 3 and 8, after periodontal treatment. |
N = 20 Scaling and root planing plus placebo. |
The findings indicate that gaseous ozone-associated scaling is not associated with significant improvement in periodontal recovery compared to scaling and root planing treatment without ozone therapy. |
Kaur et al. (2019) [1010 Kaur A, Bhavikatti SK, Das SS, Khanna S, Jain M, Kaur A. Efficacy of zonized water and 0.2% chlorhexidine gluconate in the management of chronic periodontitis when used as an irrigant in conjugation with phase I therapy. J Contemp Dent Pract. 2019;20(3):318-323. https://doi.org/10.5005/jp-journals-10024-2516 https://doi.org/10.5005/jp-journals-1002...
] India |
20 patients with chronic periodontitis |
N = 20 Irrigation with ozonated water for two hours and 30 minutes. |
N = 20 Irrigation with 0.2% Chlorhexidine was performed for two hours and 30 minutes with the same pressure as the other group. |
The present study showed significant results in both groups regarding the improvement of clinical parameters. When comparison was made between the two groups, the ozonated water group showed slightly higher improvement than the chlorhexidine group. However, statistically significant difference was observed only for the plaque index. |
Tasdemir et al. (2019) [2525 Tasdemir Z, Oskaybas MN, Alkan AB, Cakmak O. The effects of ozone therapy on periodontal therapy: a randomized placebo-controlled clinical trial. Oral Dis. 2019;25(4):1195-1202. http://dx.doi.org/10.1111/odi.13060 https://doi.org/10.1111/odi.13060...
] Turkey |
36 patients with moderate to severe generalized periodontitis |
N = 36 Scaling and root planing with topical gaseous ozone applied to periodontal pockets twice a week for 2 weeks. |
N = 36 Scaling and root planing with ozone application simulation. |
Ozone therapy had no additional effect on periodontal parameters. All inflammatory parameters, PTX-3, Hs-CRP, and IL-1β, were reduced at 3 months of follow-up. However, only PTX-3 levels were significantly lower at ozone sites compared to those at control sites at three-months. |
Verma & Indurkar (2019) [1818 Verma R, Indurkar MS. Ozone versus chlorhexidine in the treatment of chronic periodontitis. Paripex Indian J Res. 2019;8(6):148-152.] India |
22 patients with moderate to severe chronic periodontitis |
N = 11 Scaling, root planing, and irrigation with ozonated water (4 mg/L) in the subgingival region. |
N = 11 Scaling, root planing, and irrigation with 0.2% chlorhexidine. |
Statistically significant reduction was observed in the mean values of plaque index, gingival index, probing depth, clinical attachment level, and in the four periodontal pathogens analyzed in both groups. However, differences were not statistically significant when control and intervention groups were compared. |
Ameyaroy et al. (2020) [2626 Ameyaroy DK, Ramabhadran BK, Emmatty R, Paul TP, Jose P. Comparative evaluation of the effect of Ozone therapy and Photodynamic therapy in non-surgical management of Chronic periodontitis: A split mouth longitudinal study. J Indian Soc Periodontol. 2020;24(5):447-453. https://doi.org/10.4103/jisp.jisp_381_19 https://doi.org/10.4103/jisp.jisp_381_19...
] India |
22 patients with chronic generalized periodontitis |
N = 22 Scaling, root planing, and subgingival irrigation with ozonated water. |
N = 22 Scaling, root planing, and photodynamic therapy. |
Both subgingival ozonated water therapy and photodynamic therapy improved clinical outcomes after scaling. No statistically significant difference was observed in clinical parameters between ozone therapy and photodynamic therapy when evaluated after 2 months, 4 months, and 6 months, although slightly better clinical outcome was observed with ozone therapy. |
Nardi et al. (2020) [2727 Nardi GM, Cesarano F, Papa G, Chiavistelli L, Ardan R, Jedlinski M. Evaluation of salivary matrix metalloproteinase (mmp-8) in periodontal patients undergoing non-surgical periodontal therapy and mouthwash based on ozonated olive oil: a randomized clinical trial. Int J Environ Res Public Health. 2020;17(18):6619. https://doi.org/10.3390/ijerph17186619 https://doi.org/10.3390/ijerph17186619...
] Italy |
96 patients with periodontitis |
N = 48 Scaling, root planing, and mouthwash based on ozonated olive oil. |
N = 48 Scaling and root planing. |
Non-surgical periodontal treatment associated with the use of ozonated oil led to significant and faster reduction in MMP-8 concentrations in the saliva in patients with periodontitis. Periodontal indices decreased both in the study group and in the control group, without statistical significance. |
Vasthavi et al. (2020) [1919 Vasthavi C, Babu HM, Rangaraju VM, Dasappa S, Jagadish L, Shivamurthy R. Evaluation of ozone as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A randomized clinico-microbial study. J Indian Soc Periodontol. 2020;24(1):42-46. https://doi.org/10.4103/jisp.jisp_162_19 https://doi.org/10.4103/jisp.jisp_162_19...
] India |
24 patients with chronic periodontitis |
N = 12 Scaling, root planing, and subgingival irrigation with ozonated water. |
N = 12 Scaling, root planing, and subgingival irrigation with distilled water. |
Statistically significant difference in clinical and microbiological parameters was observed in the study group and in the control group from baseline to 2 months. However, no statistically significant difference was observed in clinical and microbiological parameters between groups. |
PERI-IMPLANT DISEASES
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McKenna et al. (2013) [2828 McKenna DF, Borzabadi-Farahani A, Lynch E. The effect of subgingival ozone and/or hydrogen peroxide on the development of peri-implant mucositis: a double-blind randomized controlled trial. Int J Oral Maxillofac Implants. 2013;28(6):1483-1489. https://doi.org/10.11607/jomi.3168 https://doi.org/10.11607/jomi.3168...
] UK |
20 subjects with 80 implants (4 each) |
Group 1 (N = 20): Ozone and saline solution (NaCl 0.9%). Group 3 (N = 20): Ozone and hydrogen peroxide. |
Group 2 (N = 20): Hydrogen peroxide (3%) and oxygen. Group 4 (N = 20): oxygen and saline solution. |
The trends for significant benefits were in increasing order of effectiveness: oxygen + NaCl; oxygen + hydrogen peroxide; ozone + NaCl, and ozone + hydrogen peroxide. Ozone with or without hydrogen peroxide can reduce the development of peri-implant mucositis and should be considered in clinical trials to assess its effect in the treatment of peri-implantitis. |
Isler et al. (2018) [2929 Isler SC, Unsal B, Soysal F, Ozcan G, Peker E, Karaca IR. The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis. J Periodontal Implant Sci. 2018;48(3):136-151. https://doi.org/10.5051/jpis.2018.48.3.136 https://doi.org/10.5051/jpis.2018.48.3.1...
] Turkey |
41 patients with 60 implants |
N = 20 Mechanical debridement, implant surface decontamination with saline solution (3 minutes) and ozone (30 seconds per surface) + surgical regenerative therapy. |
N=21 Mechanical debridement, surface decontamination of implants with saline solution (3 minutes) + surgical regenerative. |
At 12-month follow-up, Plaque index and Gingival index values were significantly higher in the ozone group (P < 0.05). Probing depth decreased from 6.27 ± 1.42 mm and 5.73 ± 1.11 mm at baseline to 2.75 ± 0.7 mm and 3.34 ± 0.85 mm at the end of the 12-month observation period in the ozone and control groups, respectively. Likewise, the clinical attachment level values changed from 6.39 ± 1.23 mm and 5.89 ± 1.23 mm at baseline to 3.23 ± 1.24 mm and 3.91 ± 1. 36 mm in the 12-month follow-up, in the ozone and control groups, respectively. According to radiographic evidence, defect filling between baseline and 12 months postoperatively was 2.32 ± 1.28 mm in the ozone group and 1.17 ± 0.77 mm in the control group, which was a statistically significant difference between groups (P < 0.05). |