Ozone˚˚ Therapy˚˚ in˚˚ Dentistry:˚˚ A˚˚ Systematic˚˚ Review · 2017-09-07 · 268...
Transcript of Ozone˚˚ Therapy˚˚ in˚˚ Dentistry:˚˚ A˚˚ Systematic˚˚ Review · 2017-09-07 · 268...
267
Int. J. Odontostomat.,7(2):267-278, 2013.
Ozone Therapy in Dentistry: A Systematic Review
Ozonoterapia en Odontología: Una Revisión Sistemática
Iris Jasmin Santos German*; Antonio de Castro Rodrigues*; Jesus Carlos Andreo*; Karina Torres Pomini*;Farooque Jamaluddin Ahmed*; Daniela Vieira Buchaim*; Geraldo Marco Rosa Júnior**; Jéssica Barbosa de
Oliveira Gonçalves* & Rogério Leone Buchaim*
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR,G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozone therapy in dentistry: A systematic review. Int. J. Odontostomat.,7(2):267-278, 2013.
ABSTRACT: The purpose of this systematic review was to verify the literature available regarding the effectivenessand the biological effects of ozone therapy in periodontics, orthodontics and dental implants. Studies were searched inSeptember 2012. Analyzed sources included the databases PubMed, Lilacs and SciELO, through a combination of keywords, dental implants, periodontics, orthodontics, therapeutics. Studies between 2002 and 2012 were included. In vitroand in vivo studies English and Spanish language publications, excluding posters, letters to the editors and conferences. InVitro and in Vivo studies showed the inactivation of the major periodontal pathogens by ozone. There were divergent resultsand lack of evidence for the activity of ozone on adhesion of orthodontic brackets, in implantology and orthodontics. Ozonecould be considered as a promissory alternative therapy in dentistry. However, well-designed studies are needed to assessthe application of ozone in order to evaluate its clinical effectiveness in the field of dentistry.
KEY WORDS: dental implants, periodontics, orthodontics, therapeutics.
INTRODUCTION
Ozone is a gas with the chemical formula O3,
and is the third most powerful oxidant. Medical ozoneis produced by oxygen and its passage through avoltage gradient, using ozone generators that react todioxygen molecules, forming ozone (O
2 + O→O
3)
(Ripamonti et al., 2011; Bocci, 2006; Swilling, 2004).
Several biological actions (Fig. 1) of medicalozone include the increase in the synthesis ofbiologically active substances such as interleukins,leukotrienes and prostaglandins that are beneficial inthe reduction of inflammation and in cicatrization, theactivation of aerobic processes (glycolysis, Krebs cycle,beta-oxidation of fatty acids), secretion of vasodilators(e.g. nitric oxide-NO), activation of the mechanism ofprotein synthesis and increase in the quantity ofribosome and mitochondria in the cells, thus raisingthe functional and potential activity of tissueregeneration (Seidler et al., 2008).
The ozone oxidant potential induces thedestruction of cellular walls and cytoplasmatic
membranes of bacteria (Thanomsub et al., 2002). Thegas was named ozone (a Greek word that means"smell") by the German chemist Christian FrederickSchonbein of the University of Basel in Switzerland1840 (Seidler et al.; Veranes et al., 1999).
During the First World War, ozone gas was usedfor the treatment of post-traumatic gangrene, infectedwounds, burns and fistulas and other anaerobicinfections, putrefied wounds, suppurations of bone frac-tures and various inflammations in German soldiers(Azarpazhooh & Limeback, 2008). By the middle of 1932, German dentist Edward A. Fisch, perceived thetherapeutic possibilities of using ozone as a medicaltherapy (Altman, 2007; Bocci, 2005).
Currently, there are divergences in thedeveloped studies regarding ozone therapy action.Therefore, the studies available in the literature mustbe reviewed in order to evaluate the obtained resultsand estimate the effectiveness of ozone therapy andthe methods used. The purpose of this study was to
* Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.** University of Sacred Heart, Bauru, São Paulo, Brazil.
268
perform a review regarding the effectiveness of ozonetherapy in the area of dentistry, with emphasis on thecurrent uses, focusing on the areas of periodontics,orthodontics and dental implants. The authors aimedat answering the following questions: “What is theaction of ozone on periodontal pathogens?” “What arethe effects of ozone on the adhesion of brackets todental enamel?” “How does ozone act in the boneintegration of dental implants?”
These questions are important for future studiesin order to understand the properties of ozone and itscontribution in clinical uses.
MATERIAL AND METHOD
Data sources. The literature review included studiesavailable in the databases, PubMed, LILACS andSciELO, utilizing the following descriptors: ozone,dentistry, periodontics, orthodontics and dentalimplants. Studies published between the years 2002and 2012 were included. A combination of the keywords was used, which helped to identify studiesrelated to ozone therapy in dentistry. Booksregarding ozone therapy were also referred to inorder to obtain more information on the theme
Fig. 1. Major biological effects of ozone therapy.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
269
(Altman; Bocci, 2002, 2005). The search was limitedto studies written in English and Spanish. Both in
vitro and in vivo studies regarding ozone therapy indentistry were selected (Fig. 2).
Fig. 2. Search strategy for literature review on the use of ozone therapy in dentistry.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
270
Study selection. Letters to the editor, abstracts,conferences, comments, books and panels were notincluded; however all of them were reviewed in orderto identify possible important data that could contributeto the development of this review. Data extraction. After reviewing the titles of theresearched studies, seven pertinent studies were foundrelated to the study objectives (accessed on September26, 2012). Several studies stemming from the searchwere read with the purpose of identifying relevantinformation on the theme in question.
RESULTS
Results are presented in three sectionsaccording to the purposes of the study. Action of ozone on periodontal pathogens. Threein vivo (Kshitish & Laxman, 2010; Martinez Abreu &Abreu Sardinas, 2005; de Ramon et al., 2004) and onein vitro study (Huth et al., 2011) evaluating the actionof ozone on periodontal microbiota were found.
In 2004, de Ramon et al., (Table IA) analyzedthe periodontal responses in terms of the clinical,microbiological and immunologic aspects in patientswith moderate and severe periodontal pockets,comparing the technique of scaling and root planning(control group) with the application of ozone (experi-mental group).
After 30 days, the average clinical evaluationshowed the following data: in the experimental group,initial periodontal index (Russell’s Index) was 5.72 andthe final index was 5.59. Initial supragingival plaqueindex was 31.30 and the final index was 49.99. Initialgingival bleeding index was 62.43 and the final 26.29.
In the experimental group the microbiologicalanalysis the reduction of periodontal pathogens(Aggregatibacter actinomycetencomitans (Aa),Bacteroides forsythus (Bf), and Porphyromonasgingivalis (Pg) was about 50%). In the immunologicanalysis, the initial TNF-a was 101.23 and at the end itdecreased to 36.01. Initial IL-1b also reported adecrease from an initial period of 96.12 to 34.28 after30 days of treatment.
Martínez Abreu & Abreu Sardiñas (Table IA)developed a randomized controlled clinical study. The
study was divided into two groups: the control (treatedwith 0.2% chlorhexidine) and the experimental group(treated with the ozonated oil Oleozon). Amicrobiological analysis was performed on the gingivaof the teeth with periodontitis after 21, 90 and 180 daysrespectively, during a nine-month postoperative period.
The microbiological and clinical evaluation wasdetermined to be:
Satisfactory: Absence or lack of gram-negativemicroorganisms.Unsatisfactory: Abundant presence or prevalence ofgram-negative microorganisms.
After the postoperative period of 180 days,microbiological results were satisfactory in 98% of thepatients in the experimental group and 78% in the con-trol group. Regarding the clinical evaluation,satisfactory results after 180 days were present in 98%of the patients in the experimental group and 95% inthe control group.
In 2010, Kshitish & Laxman (Table IB) developeda double-blind randomized study regarding the use ofozonated water in the treatment of periodontitis. Thecontrol group was irrigated with 0.2% chlorhexidine.Clinical parameters such as gingival index and gingivalbleeding index were analyzed, in addition to the ozoneactivity on oral microorganisms: Aggregatibacteractinomycetemcomitans (Aa), Porphyromonasgengivalis (Pg), Tannerella forsythensis (Tf), HerpesSimplex virus (HSV-1 and HSV-2), Epstein Barr virus(EBV) human cytomegalovirus (HCMV) and Candidaalbicans.
Results of the ozone irrigations showed 12% ofreduction of the plaque index. The gingival indexdecreased 29% and bleeding index 26%. After sevendays, ozone showed presence of Aa in 25%, Pg 50%,Tf 25%, HSV-1 62.5%, HSV-2 0%, HCMV 25%, EBV37.5% and Candida albicans 12.5% of the cases.
In an in vitro study, Huth et al. (2011) (Table IB)determined the efficacy of the use of gaseous/aqueousozone in the reduction of several periodontal pathogens(Aa, Pg, Tannerella forsythia (Tf) and Parvimonas mi-cra (Pm) in both planktonic state and biofilm. Aqueousozone in a concentration of 20 mg ml-1 resulted in thereduction of approximately 99% of the total A.actinomycetencomitans in planktonic state, and 70%in biofilm. Gaseous ozone (concentration of 1, 2, 4, 8,16 g m-3) was capable of reducing this pathogen by
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
271
Tabl
e IA
. Ozo
ne th
erap
y in
per
iodo
ntic
s.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
Aut
hor
(dat
e)P
urpo
seM
etho
dolo
gyR
esul
tsC
oncl
usio
nSt
udy
limit
atio
ns
Ebe
nsb
erg
er e
t al
.(2
002)
To
inve
stig
ate
the
effe
cts
of
irri
gati
ng
ozo
nate
dw
ater
on
the
prol
ifer
atio
nof
cel
ls i
n th
e pe
riod
onta
lli
gam
ent
atta
ched
to
root
sof
ex
trac
ted
hum
an te
eth
.
23
thir
d cu
spid
te
eth
w
ere
extr
acte
d fr
om
pati
ents
ag
edbe
twee
n 2
0-35
yea
rs.
Ozo
nate
dw
ate
r w
as
irri
gate
d
for
2m
inut
es
(Ozo
ne
gene
rato
rpr
otot
ype
Sir
ona
MI,
S
iron
a,B
ensh
eim
, G
erm
any
, in
conc
entr
atio
n of
2.5
-3-5
µg
ml-
1 )
and
the
expr
essi
on
of
the
mar
ker
of
Pro
life
rati
ng
Cel
lN
ucle
ar
Ant
igen
(P
CN
A)
was
eval
uate
d.
The
n
umbe
r o
f po
sitiv
e ce
llsco
mpa
red
to t
he t
otal
num
ber
ofce
lls
was
7.
8% a
fter
ir
riga
tion
wit
h oz
one
and
6.6
%
afte
rir
riga
tion
with
sa
lin
e so
luti
on.
Aqu
eous
oz
one
did
no
t h
ave
neg
ativ
e ef
fect
s on
the
cel
ls o
fth
e pe
riod
onti
um.
Posi
tive
mar
ker
cells
w
ere
foun
d al
one
or
in g
rou
ps i
n th
e ce
men
t or
in
the
rem
nan
t pe
riod
onta
lli
gam
ent.
Irri
gatio
n w
ith
ozon
ated
wat
er
show
ed
high
ra
tes
of c
ells
in
com
pari
son
tosa
line
so
lutio
n (c
ontr
olgr
oup)
, b
ut
with
n
osi
gnif
ican
t di
ffer
ence
s.T
here
wer
e no
dif
fere
nce
sin
th
e nu
mbe
r an
ddi
stri
buti
on
of
posi
tive
PC
NA
cel
ls i
n th
e co
rona
lan
d ap
ical
p
art
of
the
root
s of
the
cu
spid
teet
h.
In
situ
, th
e te
eth
wou
ld
be
subm
itte
dto
fu
ncti
onal
st
ress
,w
hich
cou
ld a
lter
the
expr
essi
on
offi
bro
blas
ts
and
the
DN
A s
ynth
esis
.
de
Ram
on e
t al
.(2
004)
To
anal
yze
the
clin
ical
,m
icro
biol
ogic
al
an
dim
mun
olog
ical
re
spon
ses
in
pati
ents
w
ith
mod
erat
e/se
vere
peri
odon
tal
pock
ets
usin
goz
one
ther
apy.
72
max
illa
ry
hem
iarc
hes
w
ere
anal
yzed
with
at
leas
t 4
teet
han
d 6
m
m
of
pro
bing
de
pth.
One
hem
iarc
h w
as t
reat
ed
wit
hoz
one
and
the
oth
er w
ith s
calin
gan
d
root
p
lani
ng
(Co
ntro
lgr
oup)
.
Init
ial
peri
odon
tal
inde
x(R
usse
ll)
was
5.7
2 an
d th
e fi
nal
was
5.5
9.
Initi
al
supr
agin
giva
lp
laq
ue i
ndex
was
31.
30
and
the
fina
l in
dex
wa
s 49
.99.
In
itial
gin
giva
l bl
eedi
ng
inde
x w
as6
2.43
and
the
fin
al
was
26.
29.
Init
ial T
NF-
α w
as 1
01.2
3 an
d at
the
end
it de
crea
sed
to 3
6.01
.
Ozo
ne h
ad n
o si
gnif
ican
tef
fect
on
the
re
mov
al
ofsu
prag
ing
ival
pl
aque
, bu
tre
duce
d
the
ging
ival
blee
din
g in
dex,
inc
lud
ing
TN
F-a
lfa
and
IL-1
_.
How
ever
, it
d
id
not
prod
uce
chan
ges
in
the
leve
l of
p
erio
dont
alin
sert
ion
and
p
ock
etde
pth.
The
dos
age
used
was
not r
epor
ted
.
Mar
tín
ez
Abr
eu&
Abr
eu S
ard
iñas
(200
5)
To
eval
uate
the
eff
ects
of
ozon
ated
oil
(O
leo
zon)
in
the
trea
tmen
t of
mod
erat
epe
riod
ontit
is.
App
licat
ion
of
Ole
ozo
n
inpe
riod
onta
l po
cket
s af
ter
21,
90an
d 1
80 d
ays
ove
r a
tota
l pe
riod
of 9
mon
ths.
n=
84 p
atie
nts
.
Mic
robi
olog
ical
ev
alua
tion
show
ed,
over
the
per
iod
of 1
80d
ays,
sca
rcity
or
lack
of
gram
-n
egat
ive
mic
roor
gani
sms:
98
%fo
r th
e ex
peri
men
tal
grou
p an
d7
8%
for
the
cont
rol
gro
up(0
.2%
aqu
eous
chl
orh
exid
ine)
.
Impr
ovem
ent
of t
he s
igns
and
sym
ptom
s w
as f
aste
rin
the
gro
up t
reat
ed w
ithoz
onat
ed
oil
than
in
the
cont
rol
grou
p.
Mic
robi
alle
vels
w
ere
mor
eco
mpa
tib
le
wit
h he
alth
ype
riod
ontiu
m
in
the
ozon
ated
gro
up.
The
do
se
of
ozon
eus
ed a
nd
the
tim
e of
each
app
licat
ion
wer
eno
t rep
orte
d.
Hut
h et
al.
(200
7)T
o in
vest
igat
e th
e ef
fect
sof
aq
ueo
us o
zone
on
the
NF-
kB s
yste
m.
Hum
an o
ral
epith
elia
l ce
lls
and
ging
ival
fi
brob
last
s w
ere
culti
vate
d.
Aqu
eous
ozo
ne w
asap
plie
d
to
the
cells
. A
queo
usoz
one
was
ge
ner
ated
w
ith
gase
ous
ozo
ne,
75µ
g/m
l fo
r 15
min
utes
(O
zono
san
-pho
toni
c)re
sulti
ng
in
the
fina
lco
ncen
trat
ion
of 2
0µg/
ml)
.
The
ac
tivi
ty o
f th
e N
F-k
B
onth
e o
ral
cell
s in
the
ra
dicu
lar
surf
aces
p
erio
dont
ally
com
prom
ised
w
as
inhi
bite
dw
hen
incu
bate
d w
ith
ozon
e, i
nad
ditio
n
IkB
α
pro
teol
ysis
,cy
toki
ne
expr
essi
on
and
kB-
dep
ende
nt
tran
scri
ptio
n w
ere
pre
ven
ted.
Aqu
eous
oz
one
h
adin
hibi
tory
ef
fect
s on
the
NF-
_B s
yste
m,
sugg
estin
git
ha
s an
ti-in
flam
mat
ory
prop
erti
es.
Onl
y o
neco
ncen
trat
ion
of
ozon
e an
d ti
me
ofex
posu
re
wer
e us
ed.
Hig
her
or
low
erco
ncen
trat
ion
an
dti
mes
m
ay
gen
erat
edi
ffer
ent r
esul
ts.
272
Tabl
e IB
. (C
ontin
uatio
n) O
zone
ther
apy
in p
erio
dont
ics.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
Aut
hor
(dat
e)P
urpo
seM
eth
odol
ogy
Res
ults
Con
clus
ion
Stu
dy li
mita
tion
s
Ksh
itis
h &
Lax
man
(20
10)
To
eval
uate
and
to
com
pare
the
effe
cts
of
irri
gatin
goz
onat
ed w
ater
(0.
082
mg/
hfo
r 5-
10 m
inut
es)
and
0.2%
chlo
rhex
idin
e
(Con
trol
grou
p) i
n cl
inic
al p
aram
eter
ssu
ch
as
ging
ival
in
dex
and
ging
ival
b
leed
ing
inde
x,
inad
diti
on
to
the
acti
on
ofoz
one
on
oral
mic
roor
gani
sms.
16
patie
nts
wit
h ch
roni
cge
nera
lize
d pe
riodo
ntit
is.
Stud
y pe
riod
w
as
for
18da
ys.
Irri
gat
ions
of
aqu
eous
ozon
e an
d ch
lorh
exid
ine
wer
e ra
ndom
ized
. A
nev
alua
tion
of
th
e cl
inic
alpa
ram
eter
s an
d or
alm
icro
orga
nism
s w
aspe
rfor
med
.
Ozo
nate
d w
ater
re
duce
dpl
aque
in
dex
in
12%
,gi
ngiv
al
inde
x in
29
% a
ndbl
eedi
ng
inde
x in
26
%
ofca
ses.
Aft
er 7
day
s th
e oz
one
gro
up
show
ed
pres
ence
of
Aa
in 2
5%,
Pg 5
0%,
Tf
25%
,H
SV
-1
62.5
%,
HS
V-2
0%
,H
CM
V
25%
, E
BV
37
.5%
and
Can
dida
alb
ican
s 1
2.5%
of c
ases
.
Red
ucti
on
of
the
ging
ival
inde
x an
d bl
eedi
ng i
ndex
in
the
ozon
e gr
oup
was
sig
nific
ant
in c
ompa
riso
n to
chlo
rhex
idin
e.
Ozo
ne
is
apo
wer
ful
agen
t in
th
ein
acti
vati
on
of
mic
roor
gani
sms
asso
ciat
edto
per
iodo
ntit
is.
Stu
dy p
erio
d w
as to
o sh
ort.
Sku
rska
et a
l. (
2010
)A
com
pari
son
of t
he c
lini
cal
cond
ition
and
sal
ivar
y le
vels
of
MM
P(M
atri
x m
etal
lopr
otei
nase
)af
ter
scal
ing
and
root
pla
ning
or o
zone
the
rapy
in
pati
ents
with
ag
gres
sive
or
chr
onic
peri
odon
titi
s.
52 p
atie
nts
wit
h ch
roni
c or
aggr
essi
ve
peri
odon
titis
,ag
ed
betw
een
25-6
8 ye
ars,
wer
e di
vide
d in
to 3
gro
ups:
a) C
P-S
: pa
tien
ts
wit
hch
roni
c pe
riod
ontit
issu
bmitt
ed t
o ro
ot s
calin
g. b
)C
P-O
: pa
tient
s w
ith c
hron
icpe
riod
onti
tis
treat
ed
wit
hsc
alin
g an
d ro
ot p
lani
ng a
ndoz
one
ther
apy.
c)
A
P:
pati
ents
wit
h ag
gres
sive
peri
odon
titi
s tre
ated
w
ith
root
sc
alin
g an
d oz
one
ther
apy.
Ozo
ne w
as a
ppli
ed3
tim
es
ever
y 2
days
(1
min
ute,
42.
2 µg
ozo
ne/m
l of
oxyg
en).
Aft
er 2
m
onth
s th
e hi
ghes
tsc
ores
in
de
ntal
pl
aque
redu
ctio
n w
ere
foun
d in
gro
up
AP
(A
PI-3
1.04
. PI
-0.
47).
T
he
low
est
wer
e in
gro
up C
P-S
(57
.77,
PI-
0.78
).L
evel
s of
MM
P-1
incr
ease
din
CP
-O a
nd A
P g
roup
. T
hehi
ghes
t le
vel
of M
MP
-1w
asfo
und
in
grou
p C
P-O
(0.1
85),
whe
rea
s C
P-S
decr
ease
d fr
om
0.17
5 to
0.10
7. T
he l
evel
s of
MM
P-8
decr
ease
d in
all
gro
ups,
but
gro
ups
CP
-O
and
AP
wer
ehi
gher
st
atis
tical
ly
than
in
the
cont
rol g
roup
.
The
sca
ling
and
roo
t pl
anin
g(S
RP
) co
mbi
ned
wit
hoz
onet
hera
py
does
no
tco
ntri
bute
to
fu
rthe
rim
prov
emen
t in
cl
inic
alpe
riodo
ntal
pa
ram
eter
s in
pati
ents
wit
h ag
gres
sive
and
chro
nic
peri
odon
titis
.O
zone
ther
apy
com
bine
dw
ith
SRP
lea
ds t
o a
decr
ease
of s
aliv
a M
MP
con
cent
rati
onin
pa
tien
ts
with
ag
gres
sive
perio
dont
itis
.
A
vacu
um
mou
ld
shou
ldha
ve b
een
used
not
onl
y to
avoi
d to
xici
ty
but
also
to
prov
ide
safe
ty
whe
n th
eco
ncen
trat
ion
used
w
asap
plie
d in
the
mou
th.
Hut
h et
al.
(201
1)T
o in
vest
igat
e th
ean
timic
robi
al
effe
ctiv
enes
sof
aq
ueou
s an
d ga
seou
soz
one
in c
ompa
riso
n to
the
antis
eptic
ch
lorh
exid
ine
digl
ucon
ate
on
peri
odon
tal
mic
roor
gani
sms
inpl
ankt
onic
st
ate
and
inbi
ofil
m.
The
m
icro
orga
nism
s w
ere
cult
ivat
ed a
nd s
ubm
erge
d in
10
ml
of
Bra
in
Hea
rtIn
fusi
on
(BH
I)
at
37ºC
for
48
hour
s.
The
oz
one
was
used
in
conc
entr
atio
n of
1-5
3gm
-3
for
one
min
ute.
T
heco
mbi
natio
n of
ga
seou
sA
queo
us o
zone
was
pre
par
edw
ith
bidi
stil
led
wat
er
and
gase
ous
ozon
e (7
5 µg
m
l-1
for
15 m
inut
es),
res
ulti
ng i
na
fina
l oz
one
conc
entr
atio
nof
20
µg
ml-1
.
Aqu
eous
ozo
ne r
educ
ed 9
9%of
th
e
tota
l A
.ac
tinom
ycet
emco
mita
ns
inpl
ankt
onic
sta
te a
nd 7
0% i
nbi
ofilm
. G
aseo
us o
zone
(1,
-16
g
m-3
) re
duce
dA
ggre
gatib
acte
rac
tinom
ycet
emco
mita
ns(A
.a)
99.7
% i
n is
olat
ed s
tate
and
70%
in
biof
ilm
(53
g m
-
3 ).
Gas
eous
oz
one
pre
sent
edgr
eate
r an
tim
icro
bial
act
ivit
yag
ains
t A
ggre
gat
ibac
ter
acti
nom
ycet
emco
mita
ns.
Ch
lorh
exid
ine,
aq
ueou
s an
dga
seou
s oz
one
show
ed d
ose-
depe
nden
t ef
fect
iven
ess;
how
ever
, th
ere
was
gre
ater
effi
cacy
in
pl
ankt
onic
bact
eria
than
in b
iofi
lm.
Ant
imic
robi
al
agen
ts
wer
ete
sted
on
bio
film
s w
ith o
nly
one
type
of
ba
cter
ia.
Incl
inic
al
cond
ition
s,
biof
ilm
sco
mpo
se
mul
tisp
ecie
s th
atco
uld
prod
uce
chan
ges
in th
eho
st a
nd l
ead
to c
hang
es i
nth
e en
viro
nmen
t.
273
99.7% in isolated state, and by approximately 70% inbiofilm at a concentration of 53 g m-3.
The complete elimination of P. gingivalis and T.forsythia in planktonic state was obtained through theconcentrations of gaseous ozone of 8 and 16 g m-3
and 2% chlorhexidine; in biofilm gaseous ozone of 53g m-3 and 2% chlorhexidine showed effectiveness of100%. Even in low concentrations (1, 2 and 4 g m-3),gaseous ozone reduced the levels of these pathogensby 99.7% in planktonic state.
Parvimonas micron, in isolated state, was totallyeliminated by all agents, with the exception of lowconcentrations of aqueous ozone at 1.25 mg ml-1(reduction of 78% in planktonic state). However, inbiofilm, P. micra presented greater susceptibility toozone gas (53 g m -3) and 2% chlorhexidine. Ozone effects on the adhesion of brackets to den-tal enamel. Two in vitro studies evaluating the effectsof ozone application on the adhesion of orthodonticbrackets were found.
In a randomized in vitro study, Cehreli et al.,(2010) (Table II) evaluated prophylactic pretreatmentwith ozone, applying shear tension to the bonding oforthodontic brackets. Moreover, it analyzed the bondingfailures in the interface using the modified adhesiveremnant index (ARI).
Vertical force was applied to the bracket base(1N/mm2=1MPa) at a speed of 1mm/min. Each toothwas washed, and polished with pumice and rubber cupsfor 10 seconds. The results of the shear bond strengthwere: Group 1: 10.48 MPa; Group 2: 8.89 MPa; Group3: 9.41MPa; Group 4: 9.82 MPa.
The results of modified adhesive remnant indexARI (0-3) were: Group 1: 2.38; Group 2: 1.31; Group3: 3.00; Group 4: 1.92.
Groups that were pretreated with ozone showedgreater shear strength over the bracket. The lowestshear strength was obtained in Group 2. Pretreatmentwith ozone in the enamel did not affect the adhesivesystem used to attach the brackets. Pithon & dos Santos (2010) (Table II)determined whether aqueous ozone reduces the bondstrength of orthodontic adhesives. In total, 120 bovinemandibular incisor teeth were selected randomly anddivided into 4 groups. Groups 1 and 3 were cleaned
with pumice and washed with water; groups 2 and 4were washed with ozonated water before adhesion tostainless orthodontic brackets with resin Transbond XT,3M Unitek, Monrovia, CA, USA (Group 1 and 2;) and amodified resin of glass ionometer cement (Groups 3and 4; Fuji Ortho LC, Japan).
Results showed, on average, shear bondstrength (SBS) of 22.07 Mpa for Group 1; 20.21 Mpain Group 2; approximately 20.06 Mpa in Group 3 andover 18.73 Mpa in Group 4. In terms of the adhesiveremnant index ARI (0-3), results showed: Absence ofadhesive remnant in the tooth (0): Group 1=3, Group2=9, Group 3=0, Group 4=0; less than half of theadhesive remnant in the tooth (1): Group 1=3, Group2=6, Group 3=3, Group 4=12; more than half of theadhesive remnant in the tooth (2): Group 1=15, Group2=12, Group 3=15, Group 4=18; total presence ofadhesive in the tooth (3): Group 1=9, Group 2=3, Group3=12, Group 4=0. Results showed that the SBS of thegroups washed with ozone (Group 2 and 4) wereslightly less than the brackets washed with tap water(Group 1 and 3) but with no significant differencesrelated to the shear bond strength in both groups.Ozone did alter the sites of the resin fracture whenFuji Ortho LC was used. The adhesive remnant index(ARI) in Groups 2 and 3 was significantly different fromGroups 3 and 4. Ozone did not reduce the shearstrength in orthodontic bracket debonding. Ozone action on the bone integration of dentalimplants. The search method used allowed us to findone in vivo study regarding the effects of ozonated oilon the bone integration of implants:
El Hadary et al. (2011) (Table III) evaluatedozonated oil (sunflower oil, 0.55 ml) under the influenceof cyclosporine A in the bone integration of dentalimplants. In total, 20 adult New Zealand rabbits aged9-12 months and weighing between 3 and 3.5 kg, wereadministered a subcutaneous daily dose of 10 mg ofcyclosporine per kg for a period of fourteen days.
Two groups were formed: Group A: ozonatedand Group B: non-ozonated (Control group). After eightweeks, in the ozonated group (A) the microscopic examshowed organization of the mature bone with intimatecontact between the implant surface and new bonewith numerous haversian systems. In group A, bonedensity values (± SD) was initially 126.7 ± 3.3; andafter eight weeks bone density was 134.1 ± 5.0; forGroup B (non-ozonated) bone density was initially117.7 ± 8.4; after eight weeks bone density was 124.0
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
274
Aut
hor
(dat
e)P
urpo
seM
etho
dolo
gyR
esul
tsC
oncl
usio
nSt
udy
lim
itat
ions
Kro
nenb
erg
et a
l. (
2009
)E
valu
atin
g w
heth
er
ther
e is
no d
iffe
renc
e in
the
ant
icar
ies
prot
ectio
n of
oz
one
and
cerv
itec
/flu
orin
e ar
ound
th
ebr
acke
ts,
in a
dditi
on t
o as
sess
whe
ther
Dia
gnod
ent
and
the
quan
tity
of i
nduc
edfl
uore
scen
t li
ght
are
not
supe
rior
to
th
e vi
sual
eval
uati
on
of
initi
al
cari
ous
lesi
ons.
20 r
ight
-han
ded
pati
ents
wit
hpe
rman
ent
dent
itio
n an
dde
fici
ent
oral
hyg
iene
(pl
aque
inde
x >
40%
) w
ho n
eede
d an
orth
odon
tic
appl
ianc
e w
ere
anal
yzed
fo
r 26
mon
ths.
All
quad
rant
s w
ere
trea
ted
wit
hoz
one
(2’1
00 ±
10%
for
30
seco
nds
ppm
) an
d th
e ot
her
grou
p w
ith
Cer
vite
c/fl
uori
ne(2
50 p
pm).
Vis
ible
pl
aque
in
dex
(VP
I)
in
all
quad
rant
s w
as
55.6
%.
Am
ong
the
quad
rant
s tr
eate
d w
ith
ozon
e, 3
.2%
dev
elop
ed n
ew a
reas
of
whi
te p
oint
sw
hile
in
th
e gr
oup
trea
ted
wit
hC
ervi
tec/
fluo
rine
pr
otec
tor
was
0.7%
of
the
area
s.
The
ant
icar
ies
prot
ecti
ve e
ffec
tof
Cer
vite
c/F
luor
ine
duri
ng t
hepl
acem
ent
of
the
orth
odon
tic
appl
ianc
e w
as
supe
rior
to
ozon
e.
Lac
k o
fco
mpa
risi
on
wit
hot
her
conc
entra
tion
san
d ti
mes
of
appl
icat
ion
Ceh
reli
et a
l. (2
010)
To
dete
rmin
e th
e ef
fect
of
pret
reat
men
t pr
ophy
lact
icoz
one
appl
ying
she
ar t
ensi
onto
the
bon
ding
of
orth
odon
tic
brac
kets
, as
wel
l as
eva
luat
ing
link
age
flaw
s in
the
int
erfa
ceus
ing
a m
odif
ied
adhe
sive
rem
nan
t ind
ex (
AR
I).
52 b
icus
pid
rand
omiz
ed t
eeth
wer
e us
ed a
nd d
ivid
ed i
nto
4gr
oups
(13
eac
h).
Eac
h to
oth
was
w
ashe
d,
and
then
polis
hed
wit
h pu
mic
e an
dru
bber
cu
ps
for
10
seco
nds.
For
li
ght
curi
ng,
a ha
loge
nla
mp
was
use
d fo
r 20
sec
onds
on t
he m
esia
l an
d di
stal
are
aof
eac
h to
oth.
She
ar s
tren
gth
resu
lts
wer
e: G
roup
1: 1
0.48
MP
a; G
roup
2:
8.89
MP
a;G
roup
3:
9.41
MP
a; G
roup
4:
9.82
MP
a.
P=0.
05
The
re
sults
of
th
em
odif
ied
adhe
sive
re
mna
nt
inde
xIA
R (
0-3)
wer
e:(0
) G
roup
1 =
3,
grou
p 2
= 9
, gr
oup
3 =
0; G
roup
4 =
0(1
) G
roup
1 =
3,
grou
p 2
= 6
, gr
oup
3 =
3, g
roup
4 =
12
(2)
Gro
up 1
= 1
5, g
roup
2
= 1
2,gr
oup
3 =
15,
gro
up 4
= 1
8(3
) G
roup
1 =
9,
grou
p 2
= 3
, gr
oup
3 =
12, g
roup
4 =
0.
Gro
ups
that
w
ere
pret
reat
edw
ith
ozon
e sh
owed
g
reat
ersh
ear
stren
gth
. T
he
low
est
stre
ngth
was
obt
aine
d in
gro
up2.
Pre
trea
tmen
t w
ith o
zone
on
the
enam
el d
id
not
affe
ct t
hesh
ear
stre
ngth
.
The
oz
one
conc
entra
tion
used
w
as
not
men
tion
ed.
Pit
hon
& d
os S
anto
s (2
010)
To
dete
rmin
e if
aq
ueou
soz
one
redu
ces
resi
stan
ce
toth
e fi
xati
on
of
orth
odon
tic
adhe
sive
s.
120
bovi
ne
m
andi
bula
rin
ciso
r te
eth
wer
e r
ando
mly
divi
ded
into
4 g
roup
s. G
roup
s1
and
3
wer
e cl
eane
d w
ithpu
mic
e an
d w
ashe
d w
ithw
ater
; gr
oups
2 a
nd 4
wer
ew
ashe
d w
ith
ozon
ated
wat
er(0
.6 m
g/L
).
Res
ults
sho
wed
mea
n sh
ear
stre
ngth
(Mpa
) fo
r gr
oup
1 of
22
.07
Mpa
;gr
oup
2:
20
.21
Mpa
; gr
oup
3:ap
prox
imat
ely
20.0
6 M
pa a
nd g
roup
4 ov
er 1
8.73
Mpa
.
The
re
wer
e no
si
gnif
ican
tdi
ffer
ence
s in
the
she
ar s
tren
gth
of b
rack
ets
debo
ndin
g fr
om t
heen
amel
and
was
hed
with
ozo
neor
tap
wat
er.
Adh
esiv
e re
mna
ntin
dex
(AR
I) i
n g
roup
s 2
and
3w
ere
sign
ific
ant
diff
eren
t fr
omgr
oups
3 a
nd 4
.
A
sing
le
ozon
eco
ncen
trati
on w
asus
ed.
Hig
her
orlo
wer
conc
entra
tion
sm
ay
gene
rate
diff
eren
t re
sults
.
Dhi
ngra
& V
anda
na (
2011
)T
o ev
alua
te
the
clin
ical
effe
cts
of a
sin
gle
subg
ingi
val
irrig
atio
n w
ith o
zona
ted
wat
erin
pat
ient
s w
ith g
ingi
vitis
and
fixe
d or
thod
onti
c ap
plia
nces
and
also
to
co
rrel
ate
the
clin
ical
ef
fect
s w
ith
the
lact
ate
dehy
drog
enas
e (L
DH
)ac
tivity
in
ging
ival
cre
vicu
lar
flui
d.
Sin
gle-
blin
d cl
inic
al
stud
yw
ith
15
subj
ects
ag
ing
17ye
ars
and
usin
g or
thod
onti
cap
plia
nce
and
pres
entin
g 50
%of
site
s w
ith
ging
ival
ble
edin
gan
d 50
% d
icho
tom
ous
plaq
uesc
ore.
Aft
er
28
days
pl
aque
in
dex
decr
ease
d fr
om 1
.93
± 0.
22 to
0.8
9 ±
0.24
. G
ingi
val
blee
ding
in
dex
redu
ced
from
87.
1 ±
6.2%
to
30.9
±4.
5%.
Poc
ket
dep
th
show
edre
duct
ion
from
3.1
0 ±0
.12
to 2
.92
±0.
10.
The
ac
tivi
ty
of
lact
ate
deh
ydro
gena
se
dec
reas
ed
fro
m10
2.7
± 5
9.2
to 1
8.9
± 5.
9 af
ter
28da
ys.
A s
ingl
e irr
igat
ion
wit
hoz
onat
ed
wat
er
in
aco
ncen
trat
ion
of
0.01
m
g l-1
sign
ific
antly
re
duce
d
all
clin
ical
pa
ram
eter
s af
ter
from
base
line
to
28
days
an
dsi
gnif
ican
tly
dec
reas
ed
th
eac
tivity
of
lact
ate
dehy
drog
enas
e in
th
e gi
ngiv
alcr
evic
ular
flu
id.
Abs
ence
of
cont
rol
grou
p.
Tabl
e II.
Ozo
ne th
erap
y in
ort
hodo
ntic
s.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
275
± 5.6. The studydemonstrated that theapplication of cyclosporine forshort term in combination withthe topical application ofozonated oil may significantlyinfluence bone density andbone integration qualityaround dental implants. Nostatistically significantdifferences were found relatedto bone density in bothgroups.
DISCUSSION The present literature reviewanalyzed the effects of ozoneon periodontal pathogens,bone integration of dentalimplants and adhesion oforthodontic brackets. The literature available relatedto ozone therapy in dentistryshowed relevance in terms ofthe properties of ozonetherapy, namely: therapeuticaction through the distributionof oxygen, expression ofgrowth factors and cytokinesand reduction of oxidativestress and acting as modifierof the biological response(Seidler et al.; Bocci, 2006;Estrela et al., 2006; Valacchiet al., 2002). Only one in vivo study(Martínez Abreu & AbreuSardiñas) regarding the actionof ozone against periodontalpathogens was performed fora larger period (six months),which represents a fragility ofthe studies alreadydeveloped. Additionally, theresults of this article alsoshowed reduction of 98% ofg r a m - n e g a t i v emicroorganisms in the grouptreated with ozone.A
utho
r (d
ate)
Pur
pose
Met
hodo
logy
Res
ults
Con
clus
ion
Stu
dy li
mit
atio
ns
El H
adar
y et
al.
(20
11)
To
eval
uate
the
eff
ects
of
ozo
nate
d oi
l un
der
the
infl
uenc
e of
Cy
clos
pori
neA
in
bone
int
egra
tion
of
den
tal i
mpl
ants
.
Tw
enty
whi
te a
dul
t m
ale
New
Z
eala
nd
ra
bbits
agin
g 9-
12
mon
ths
and
wei
ghin
g be
twee
n 3
-3.5
kg
w
ere
test
ed.
Dai
lysu
bcut
aneo
us d
ose
of
10m
g of
C
yclo
spor
ine
per
kg
fo
r 14
da
ys
was
adm
inis
trat
ed.
Gro
up
A:
trea
ted
with
oz
onat
ed
oil
(sun
flow
er o
il)
0.55
0 m
lin
gel
ap
plie
d to
fil
l ea
cho
steo
tom
y
site
fo
r th
eim
plan
t.
Gro
up
B:
non-
ozo
nate
d (C
ont
rol g
roup
).
In g
roup
s A
and
B
, th
ein
itia
l bo
ne
dens
ity
was
126.
7 ±
3.3
and
117
.7 ±
8.4
resp
ectiv
ely;
it
was
134.
1 ±
5.0
and
124
.0 ±
5.6
afte
r 2
mon
ths.
The
ligh
t
mic
rosc
opi
cex
amin
atio
nde
mon
stra
ted
evid
ence
of
new
ly
form
ed
mat
ure
bone
w
as
obse
rved
in
grou
p
B,
wh
erea
s in
cont
rol
grou
p
the
spec
imen
s de
mon
stra
ted
the
form
atio
n of
pri
mar
yos
teon
s.
The
ad
min
istr
atio
n
ofsh
ort-
term
cy
clos
pori
neto
geth
er
wit
h th
e to
pica
lap
plic
atio
n of
o
zona
ted
oil
m
ay
infl
uenc
e bo
ned
ensi
ty.
Ozo
ne c
onc
entr
atio
n w
asn
ot r
epor
ted
.
Hau
ser-
Ger
spac
h et
al
.(2
012)
To
in
vest
igat
e th
ean
timic
robi
al
effi
cacy
of
gas
eous
ozo
ne o
n ba
cter
iaad
here
d
to
seve
ral
surf
aces
of
titan
ium
an
dzi
rco
nium
, an
d al
so
toev
alua
te
the
adhe
sion
of
ost
eobl
ast-
like
MG
-63
cell
s to
sur
face
s th
at w
ere
trea
ted
with
ozo
ne.
Tit
aniu
m
and
zirc
oni
umd
isks
(5.
0 m
m
diam
eter
)w
ith
2 ty
pes
of
surf
aces
wer
e st
erili
zed
by
gam
ma
irra
diat
ion
and
incu
bate
din
a
solu
tion
of
ster
ile
saliv
a se
rum
fo
r 15
min
utes
at
35°C
, an
d us
edin
th
e m
icro
biol
ogi
cal
expe
rim
ent.
O
zone
trea
tmen
t w
as c
arri
ed o
utw
ith a
n O
zoto
p un
it, 1
40p
pm;
2L
/min
ute
fo
r 6-
24
seco
nds.
P.
Gin
giva
lis
was
elim
inat
ed i
n 2
4 se
cond
sw
ith o
zone
(>
99.9
4% o
fre
duct
ion)
. S.
sa
ngu
inis
was
m
ore
resi
stan
t an
dsh
owed
gre
ater
red
uctio
nin
zi
rcon
ium
su
bstr
ates
(>90
% re
duc
tion
).
Ozo
ne
did
not
affe
ct t
hesu
rfac
e st
ruct
ure
s of
the
test
sp
ecim
ens
and
did
not
inf
luen
ce o
steo
blas
tic
cell
s
pro
life
ratio
nn
egat
ivel
y.
Po
lishe
dti
tan
ium
an
d zi
rcon
ium
(aci
d
etch
ed
and
pol
ishe
d) p
rese
nted
low
erb
acte
rial
col
oniz
atio
n.
The
stu
dy d
id n
ot i
nclu
deas
pect
s of
th
ed
iffe
rent
iati
on
ofex
trac
ellu
lar
mat
rix
mat
urat
ion,
re
leas
e o
fg
row
th
fact
ors
and
expr
essi
on
of
spec
ific
ost
eobl
astic
mar
ker
s.
Tabl
e III
. Ozo
ne th
erap
y in
den
tal i
mpl
ants
.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
276
There was remarkable inactivation of the majorperiodontal pathogens, in both the analyzed in vivo andin vitro studies. The results obtained by de Ramon etal., confirm the effective action of ozone on gingivalbleeding, with a decrease of over 50% of the mainperiodontal pathogens: Aggregatibacteractinomycetencomitans, Bacteroides forsythus andPorphyromonas gingivalis. It showed a significantreduction of TNF-a and IL-1b. Furthermore, there wasno variation in the pocket depth, or the level ofperiodontal insertion, which reinforces the need formechanical removal of plaque for gingival control andperiodontal maintenance (Müller et al., 2007; Lindhe& Nyman, 1975).
Nevertheless, ozone had significantlyeffectiveness in eliminating gram-negativemicroorganisms, reducing periodontal pathogens,bleeding on probing (Kshitish & Laxman).
In one study (de Ramon et al.), ozone reducedplaque index over 25%. However in another article(Kshitish & Laxman) results demonstrated that dentalplaque was reduced by 12%.
Although therapeutic ozone is applied in severalforms, including aqueous, gaseous and oil, there isevidence of better biocompatibility in the cell with theuse of aqueous ozone (Huth et al., 2006). Ozone gashad greater antimicrobial activity in terms of the totalelimination of pathogens (Aa, Pg, Tf and Pm) inplanktonic state than in biofilm.
Regarding the effects of ozone therapy on theadhesion of orthodontic brackets, the results of thestudy of Cehreli et al., demonstrated that groupspretreated with ozone presented greater shear
strength. Although Pithon and dos Santos found thatthe shear bond strength of the brackets washed withozone were slightly less than the brackets washed withtap water after debonding but with no significantdifferences. According to the search strategy used, the only studyfound about ozone activity on bone integration of den-tal implants (El Hadary et al.) demonstrated an increasein bone density around dental implants in the ozonatedgroup, but no significant differences regarding the non-ozonated group were noticed. Nevertheless, the studywas carried out only for two months, under the influenceof an immunosuppressive drug and it also did not reportthe concentration and time of application of ozone,which renders the research irreproducible. Ozone’s biological and stimulatory effects couldbe useful in periodontal therapeutics, in orthodonticsand dental implants.
In conclusion, the studies analyzed showedseveral biological properties of ozone and could beconsidered as a promising therapy. Further studies areneeded for the analysis of the application of ozone indentistry, in order to assess its clinical effectiveness inthe field of dentistry.
ACKNOWLEDGEMENTS
The authors express their thanks to the AnatomyDepartment of the University of São Paulo (USP),Bauru, São Paulo, Brazil, for the additional informationoffered for the development of this review. The authorsreceived no financial support and declare no conflictsof interest related to the authorship of this study.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR,G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. J. Ozonoterapia en Odontologia: una revisión sistemática. Int. J.Odontostomat., 7(2):267-278, 2013.
RESUMEN: El objetivo de esta revisión sistemática fue verificar la literatura disponible relacionada a la efectividad yefectos biológicos de la ozonoterapia en periodoncia, ortodoncia e implantes dentales. Se realizó una revisión sistemáticaen septiembre del 2012 en las bases de datos PubMed, LILACS and SciELO por medio de la combinación de las palabrasclave dental implants, periodontics, orthodontics, therapeutics. Se evaluaron los artículos publicados entre los años 2002 y2012. Fueron incluidos estudios In vitro e in vivo y publicaciones en Inglés y Español, excluyendo pósters, carta al editor yconferencias. Estudios in vitro e in vivo mostraron inactivación de los principales patógenos periodontais con el uso delozono. Hubo resultados contradictorios y falta de evidencia sobre la acción del ozono en la adhesión de los bracketsortodónticos, así como también en la osteointegración de los implantes dentales. El ozono puede ser considerado comouna terapia alternativa promisoria en la Odontología. Sin embargo, es necesaria la realización de estudios bien diseñadospara, de ese modo, evaluar la aplicación del ozono y su efectividad clínica en el campo de la Odontología.
PALABRAS CLAVE: implantes dentales, periodoncia, ortodoncia, terapéutica.
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.
277
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Correspondence to:Iris Jasmin Santos GermanDepartment of Biological Sciences (Anatomy)Bauru School of DentistryAl. Dr. Octávio Pinheiro Brisola, 9-75Postal code: 17012-901University of São PauloFOB-USPBauru - BRAZIL Phone: +55 14 3235-8226Fax: +55 14 3235-8223
Email: [email protected]
Received: 27-04-2013Accepted: 15-06-2013
GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JÚNIOR, G. M.; GONÇALVES, J. B. O. & BUCHAIM, R. L. Ozonetherapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.