Ozoniotherapy as a coadjuvant in the irrigation of the radicular channels system
Keywords:Ozone; Endodontics; Disinfection.
In the clinical practice of dentistry, it is evident that despite advances in the area of endodontics, microbial agents and technical errors are the main factors responsible for endodontic failure. The mechanical chemical preparation aims to remove necrotic, vital tissue, microorganismos and their by-products from the root canal system. However, this preparation is not sufficient for satisfactory cleaning due to the anatomical complexity of the root canal system, which can generate the permanence of microorganisms that may remain viable and active, interfering in the repair process of periradicular tissues. Thus, it is necessary to search for ideal irrigating chemical solutions that can provide better results in endodontic treatment. Within this context, the objective of this study is to provide, through a narrative review, an understanding of the current available evidence on the importance of using ozone O3, as an adjunct to irrigation of the root canal system in endodontic therapy. The research carried out characterizes as exploratory-descriptive, in terms of the approach, it consists of a qualitative research. The searches were carried out in the bibliographic databases of PubMed / MEDLINE, Virtual Health Library (VHL), Web of Science and SciELO. In this study, they state that ozone is capable of inactivating microorganisms through the direct oxidation of its structural components, and can be proposed as an adjunct in endodontic treatments against microorganisms (Gram positive and Gram negative) present in the oral cavity and root canals. If necessary, controlled and randomized clinical trials to endorse its efficacy and dosimetry in prevention and endodontic treatments.
Boch, T., Tennert, C., Vach, K., Al-ahmad, A., Hellwig, E., & Polydorou, O. (2016). Effect of gaseous ozone on Enterococcus faecalis biofilm-an in vitro study. Clinical Oral Investigations, 20, 1733–1739. https://doi.org/10.1007/S00784-015-1667-1
Busanello-Costa, M., Rennó, A. C. M., Martignago, C. C. S., Tim, C. R., Muniz, T. M. Q. & Marcelino, C. C. C. (2020). Benefícios do Fator de Crescimento Epidérmico (EGF) associado a terapia de fotobiomodulação a LED no reparo tecidual de feridas cutâneas. Research, Society and Development, 9(10), 1-28. DOI: http://dx.doi.org/10.33448/rsd-v9i10.9369
Case, P. D., Bird, P. S., Kahler, W. A., George, R., & Walsh, L. J. (2012). Treatment of root canal biofilms of Enterococcus faecalis with ozone gas and passive ultrasound activation. Journal of Endodontics. Chicago, 38(4), 523-526. https://doi.org/10.1016/j.joen.2011.12.020
Dantas, E. P. V., Martignago, C. C. S., Tim, c. R., Barros Filho, R. J. S., Neves, T. M. A. & Assis, L. (2020). Fotobiomodulação como coadjuvante no tratamento na lesão pulmonar aguda decorrente da sepse. Research, Society and Development, 9(10), 1-20. DOI: http://dx.doi.org/10.33448/rsd-v9i10.9024
Ding, W., Jin, W., Cao, S., Zhou, X., Wang, C., Jiang, Q., Huang, H., Tu, R. S. F., & Wang, Q. (2019). Ozone disinfection of chlorine-resistant bacteria in drinking water. Water Research, 339-349. https://doi.org/10.1016/j.watres.2019.05.014
Dioguardi, M., Di Gioia, G. D., Illuzzi, G., Laneve, E., Cocco, A., & Troiano G. (2018). Endodontic irrigants: Different methods to improve efficacy and related problems. European Journal of Dentistry, 12 / Issue 3. https://doi.org/10.4103/ejd.ejd_56_18
Eslami, L. M., Vatanpour, M., Aminzadeh, N., Mehrvarzfar, P., & Taheri S. (2019). The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system (ex-vivo study). Photodiagnosis and Photodynamic Therapy, 157–161. https://doi.org/10.1016/j.pdpdt.2019.01.033
Estrela, C., Estrela, C. R. A., Decurcio, D. A., Hollanda, A. C. B., & Silva, J. A. (2007). Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. International Endodontic Journal. Oxford,40(2), 85-93. https://doi.org/10.1111/j.1365-2591.2006.01185.x
Estrela, C., Holland, R., Estrela, C. R. A., Alencar, A. H. G., Sousa-Neto M.D., & Pécora J. D. (2014). Characterization of successful root canal treatment. Brazilian Dental Journal, 25(1), 3-11. http://dx.doi.org/10.1590/0103-6440201302356
Farac, R. V., Pizzolitto, A. C., Tanomaru, J. M. G., Morgental, R. D., Lima, R. K. P., & Bonetti-Filho, I. (2013). Ex-vivo effect of intracanal medications based on Ozone and calcium hydroxide in root canals contaminated with Enterococcus faecalis. Brazilian Dental Journal, 24(2), 103-106. http://dx.doi.org/10.1590/0103-6440201301992
Fidalgo, T. K. S., Barcelos, R., Portela, M. B., Soares, R. M. A., Gleiser, R., & Silva-Filho, F. C. (2010). Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus. https://doi.org/10.1590/S1806-83242010000400006
Filippi, A. (2001). The effects of ozonized water on epithelial wound healing (in German). Deutsche Zahna¨rztliche Zeitschrift, 56, 104–8. https://www.researchgate.net/publication/237555230
Gonçalves, S. R., Tim, C. R., Martignago, C. C. S., Silva, M. C. P., Anaruma, C. A., & Garcia L. A. (2021). Potencial da terapia por fotobiomodulação no tratamento da atrofia do músculo esquelético. Research, Society and Development, 10(1), 1-12. DOI: http://dx.doi.org/10.33448/rsd-v10i1.8527
Gomes, B., & Herrera, D. R. (2018). Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Brazilian Oral Research, 32, e69. https://doi.org/10.1590/1807-3107bor-2018.vol32.0069
Hems, R. S., Gulabivala, K., -L. Ng, Y., Ready, D., & Spratt, D. A. (2005). An in vitro evaluation of the ability of ozone to kill a strain of Enterococcus faecalis. International Endodontic Journal, 38, 22–29. https://doi.org/ 10.1111/j.1365-2591.2004.00891.x.
Hyslop, P. A., Hinshaw, D. B., & Halsey, W. A. Jr, et al. (1988). Mechanisms of oxidant-mediated cell injury. The glycolytic and mitochondrial pathways of ADP phosphorylation are major intracellular targets inactivated by hydrogen peroxide. The Journal of Biological Chemistry, 263, 1665–1675.
Hubbezoglu, I. (2014). Antibacterial efficacy of aqueous ozone in root canals infected by enterococcus faecalis. Jundishapur J Microbiol, 7(7), e11411. https://doi.org/10.5812/jjm.11411
Kaya, B. U., Kececi, A. D., & Guldas, H. E., et al. (2014) Efficacy of endodontic applications of ozone and low-temperature atmospheric pressure plasma on root canals infected with enterococcus faecalis. Letters in Applied Microbiology, 58, 8–15. https://doi.org/10.1111/lam.12148
Martinho, F. C., Chiesa, W. M. M., Leite, F. R. M., Cirelli, J. A., & Gomes, B. P. F. A. (2010). Antigenic Activity of Bacterial Endodontic Contents from Primary Root Canal Infection with Periapical Lesions against Macrophage in the Release of Interleukin-1b and Tumor Necrosis Factor a. JOE, 36(9). https://doi.org/10.1016/j.joen.2010.06.012
Martinho, F. C., Chiesa, W. M. M., Leite, F. R. M., Cirelli, J. A., & Gomes B. P. F. A. (2010). Antigenicity of Primary Endodontic Infection against Macrophages by the Levels of PGE2 Production. JOE, 37(5). https://doi.org/10.1016/j.joen.2010.12.005
Muller, P., Guggenheim, B., & Schmidlin, P. R. (2007). Efficacy of gasiform ozone and photodynamic therapy on a multispecies oral biofilm in vitro. Eur J Oral Sci, 115, 77–80. https://doi.org/10.1111/j.1600-0722.2007.00418.x
NagayoshI, M., Fukuizumi, T., Kitamura, C., Yano, J., Terashita, M., & Nishihara, T. (2004). Efficacy of ozone on survival and permeability of oral microorganisms. Oral Microbiology and Immunology. Kitakyushu, 19(4), 240-246. https://doi.org/10.1111/j.1399-302X.2004.00146.x
Neelakantan. P., Herrera, D. R., Pecorari, V. G. A., & Gomes B. P. F. A. (2019). Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. International Endodontic Journal, 52, 19–27. https://doi.org/10.1111/iej.12963
Nogales, C. G., Ferrari, P. H., Kantorovich, E. O., & Lage-Marques, J. L. (2008). Ozone therapy in medicine and dentistry. The Journal of Contemporary Dental Practice. São Paulo, 9(4), 75-84.
Nogales, C. G., Ferreira, M. B., Lage-Marques, J. L., & Antoniazzi, J. H. (2014). Comparison of the antimicrobial activity of three different concentrations of aqueous ozone on Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis – in vitro study. Revista Española de Ozonoterapia, 4(1), 9-15.
Noites, R., Pina-Vaz, C., Rocha, R., Carvalho, M. F., Gonçalves, A., & Pina-Vaz, I. (2014). Synergistic Antimicrobial Action of Chlorhexidine and Ozone in Endodontic Treatment. Hindawi Publishing Corporation BioMed Research International. http://dx.doi.org/10.1155/2014/592423
Pereira A.S.; Shitsuka D. M. ; Pereira F. J. & Shitsuka R. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed.UAB/NTE/UFSM.https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1
Rojas-Valencia, M. N. (2011). Research on ozone application as disinfectant and action mechanisms on wastewater microorganisms. In: Mendez-Vilas A, (Ed.), Science Against Microbial Pathogens: Communicating Current Research and Technological Advances. (pp. 263–71). Badajoz: Formatex,. https://www.researchgate.net/publication/265050308
Tiwari, S., Avinash, A., Katiyar, S., Aarthi Iyer, A., & Jain, S. (2017). Dental applications of ozone therapy: A review of literature. The Saudi Journal for Dental Research, 8, 105-111. http://dx.doi.org/10.1016/j.sjdr.2016.06.005
Silva, E. J. N. L., Prado, M. C., Soares, D. N., Hecksher, F., Martins, J. N. R. & Fidalgo, T. K. S. (2020). The effect of ozone therapy in root canal desinfection: a systematic review. International Endodontic Journal, 53, 317–332. https://doi.org/10.1111/iej.13229
Siqueira Junior, J. F., Rôças, I. N. (2009). Diversity of endodontic microbiota revisited. J Dent Res, 88(11), 969-81.
Siqueira Junior, J. F., Rôças, I. N., Marceliano-Alves, M. F., Pérez, A. R., & Ricucci, D. (2018). Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Critical Review Endodontic Therapy, 32(suppl), e65. https://doi.org/10.1590/1807-3107bor-2018.vol32.0065
Plotino, G., Cortese, T., Grande, N. M., Leonardi, D. P., Giorgio, G. D., Testarelli, L., & Gambarini, G. (2016). New Technologies to Improve Root Canal Disinfection. Brazilian Dental Journal, 27(1), 3-8. http://dx.doi.org/10.1590/0103-6440201600726
Zehnder, M. (2006). Root canal irrigants. J Endod, 32(5), 389-98. https://doi.org/10.1016/j.joen.2005.09.014
How to Cite
Copyright (c) 2021 Karina Gonzalez Camara Fernandes; Dora Inés Kozusny Andreani; Carla Roberta Tim; Lara Gimenez Bazan; Lucieni Cristina Trovati Moreti; Luciana Estevam Simonato; Lívia Assis Garcia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.