Ozone at the Dentist — Can Gas Treat Teeth Without Drilling?

Aim of the study: To evaluate the local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as a control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).

Results: Ozone application decreased the number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. VEGF (p < 0.001) and nNOS (p = 0.012) levels in the dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) than in control pulp. The antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Ozone’s effect on pulp VEGF, nNOS, and SOD indicated its biocompatibility.

Aim of the study: The aim of the study was to assess the efficacy of three methods of enamel remineralization for initial approximal caries: (1) a nano-hydroxyapatite gel, (2) gaseous ozone therapy, and (3) a combination of nano-hydroxyapatite gel and ozone.

Results: In group III, significant remineralization was observed after 1 year, followed by demineralization after 2 years. Thus, nano-hydroxyapatite gel and ozone therapy have some capacity to remineralize approximal enamel and subsurface dentin lesions in premolar and molar teeth. Moreover, combining the two methods produces the best effect compared with using nano-hydroxyapatite or ozone therapy alone. However, treatment should be continued for a long time to achieve non-restorative recovery from caries.

Aim of the study: This systematic review and meta-analysis aimed to investigate the effectiveness and safety of ozone therapy for treating dental caries.

Results: We included 12 RCTs comparing ozone therapy with no ozone, chlorhexidine digluconate, fissure sealants (alone and combined with ozone), and fluoride. Considering the primary outcomes, ozone therapy showed (a) a smaller reduction in bacterial numbers 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) a greater reduction in bacterial numbers 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 the safety of ozone therapy, individual studies reported 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 sizes, and wide confidence intervals, which make it impossible to determine the true direction of the effect.

Aim of the study: The paper aims to study the impact of ozone (O3) treatment on microstructural changes in tooth enamel at different time intervals after treatment. Ozonation was performed with gaseous O3 produced by HealOzone X4, the level of demineralization was measured with the DiagnoDent Pen 2190 device, and changes in the enamel surface microstructure were observed using scanning electron microscopy (SEM) analysis.

Results: The paper aims to study the impact of ozone (O3) treatment on microstructural changes in tooth enamel at different time intervals after treatment. Ozonation was performed with gaseous O3 produced by HealOzone X4, the level of demineralization was measured with the DiagnoDent Pen 2190 device, and changes in the enamel surface microstructure were observed using scanning electron microscopy (SEM) analysis. The results showed that exposure to O3 for 40-50 seconds increased enamel microhardness and achieved a remineralization rate of 96.82-97.38%. In conclusion, as part of the search for new minimally invasive solutions for treating caries and providing antimicrobial support in the oral cavity, using O3 as an alternative to traditional approaches may be a viable option in dentistry.

Aim of the study: Early childhood caries (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the effect of ozone (O3), and of sodium fluoride (NaF) combined with chlorhexidine (CHX), on bacteria associated with ECC.

Results: The data from the O3 test were analyzed using ANOVA and Tukey's test (p < 0.05). The data from NaF-CHX were analyzed using two-way ANOVA and Bonferroni's test (p < 0.05). The number of CFU/mL showed bacterial death of > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the NaF-CHX combination was more effective (p < 0.001) than each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all the bacteria tested; O3 appeared to be a good alternative for controlling the progression of carious lesions, while the NaF-CHX combination proved to be an effective antimicrobial treatment that is easy and inexpensive to apply.

Aim of the study: Background: Autologous platelet concentrates, including platelet-rich fibrin (PRF) matrices, have been proposed as biologically active scaffolds for vital pulp therapy. Evidence on the clinical use of different solid PRF matrices for direct pulp capping remains limited.

Results: In both cases, pulp vitality was maintained, and no clinical symptoms or periapical changes were detected during the 12-month follow-up. Conclusions: These two cases suggest that direct pulp capping using PRF membranes (A-PRF+ or H-PRF), combined with ozone-assisted dentin disinfection and adequate coronal sealing, may be associated with maintained pulp vitality and hard-tissue repair after carious pulp exposure diagnosed as reversible pulpitis. Because this is a descriptive two-case study and there are major confounding factors (including age and lesion characteristics), no comparative conclusions can be drawn. Prospective controlled clinical studies with standardized protocols are warranted.