Ozone as adjuvant in surgical and non-surgical periodontal therapy: an integrative review
Keywords:Ozone; Periodontics; Dentistry.
Given the complexity of the etiopathogenesis of the diseases that affect the periodontium, several mechanisms to support conventional periodontal therapy, based on non-surgical and surgical steps have been studied in the literature, including ozone in its various vehicles and with various purposes. The aim of this study was to describe the applications of ozone therapy in Periodontology, in the areas of surgical and non-surgical therapy from the viewpoint of molecular, cellular and tissue effects focused on the repair process. An integrative literature review was conducted using the Pubmed/MEDLINE and SciELO databases with the search terms ozone, periodontal disease and periodontal surgery associated with the Boolean operator and. After applying the eligibility criteria listed by the PRISMA-ScR strategy, 15 articles were selected for qualitative analysis in order to answer the following study question, developed by the PICO strategy: "What are the advantages of ozone therapy in periodontics from the microbiological, cellular and tissue repair points of view? It is perceived that ozone is a good adjunct to conventional periodontal therapy, due to its hemostatic, angiogenic, analgesic, anti-hypoxic and antimicrobial effects, in addition to impacts on the molecular signaling pathways of the inflammatory response, Although further studies are needed so that protocols for its application can be standardized based on clinical practice based on scientific evidence, given the potential for improvement in tissue repair and consequently in periodontal surgical recovery time, which unfolds to the quality of life of patients affected by periodontitis.
Alinca, S. B., Saglam, E., Celik, T. Z., Hacisalihoglu, P., & Dogan, M. A. (2020). Is low level laser therapy or ozone therapy more effective for bone healing? Understanding the mechanisms of HIF-1α, RANKL and OPG. Biotechnic Histochemistry, 95 (8), 597-604. https://doi.org/10.1080/10520295.2020.1743360
Alsherif, A. A., Eltokhey, H M., & Taiema D. A. (2020). Platelet rich fibrin versus ozone gel for periodontal regeneration in induced rats' intrabony three-wall periodontal defects. Journal of Oral Biology and Craniofacial Research, 10 (4), 639-49. https://doi.org/10.1016/j.jobcr.2020.09.001.
Chen, B., Wu, W., Sun, W., Zhang, Q., Yan, F., & Xiao, Y. (2014). RANKL expression in periodontal disease: where does RANKL come from?.BioMedresearchinternational, 2014, 731039. https://doi.org/10.1155/2014/731039.
Dengizek E., Serkan D., Abubekir E., Aysun Bay K., Onder O., & Arife C. (2019). Evaluating clinical and laboratory effects of ozone in non-surgical periodontal treatment: a randomized controlled trial. Journal of Applied Oral Science, 27, e20180108.http://dx.doi.org/10.1590/1678-7757-2018-0108.
Ferreira, M. J. F., Marques, T. P., Nogueira, L. M., Pimenta, Y. S., Carlos, A. M., & Nascimento, J. R., (2020). The use of ozonized oil in the healing process after dental implant surgery: literature review. Brazilian Journal of Development, 6 (11), 93559- 67. https://doi.org/10.34117/bjdv6n11-682
Isler, S. C, Unsal, B., Soysal, F., Ozcan, G., Peker, E., & Karaca, I. R. (2018). The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis. Journal of Periodontal & Implant Science, 48 (3), 136-51. https://doi.org/10.5051/jpis.2018.48.3.136.
Leewananthawet, A., Arakawa, S., Okano, T., Kinoshita, R. D., Ashida, H., Izumi, Y., & Suzuki, T. (2019). Ozone ultrafine bubble water induces the cellular signaling involved in oxidative stress responses in human periodontal ligament fibroblasts. Science and Technology of Advanced Materials, 20(1), 589-98. https://doi.org/10.1080/14686996.2019.1614980.
Makeeva, M. K., Daurova, F. Y., Byakova, S. F., & Turkina, A. Y. (2020). Treatment of an endo-perio lesion with ozone gas in a patient with aggressive periodontitis: a clinical case report and literature review. Clinical, Cosmetic and Investigational Dentistry, 12, 447-64.
Moraschini, V., Kischinhevsky, I. C., Calasans-Maia, M. D., Shibli, J. A., Sartoretto, S. C., Figueredo, C. M., & Granjeiro, J. M. (2020). Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. Clinical Oral Investigations, 24, 1877-88. https://doi.org/10.1007/s00784-020-03289-2.
Naik S.V., Rajeshwari K., Kohli S., Zohabhasan S., & Bhatia S. (2016). Ozone - a biological therapy in dentistry: reality or myth?. The Open Dentistry Journal, 10 (1),196-206. DOI: 10.2174/1874210601610010196.
Nicolini, A. C., Rotta, I. S., Langa, G. P., Friedrich, S. A., Arroyo-Bonilla, D. A., Wagner, M. C., Weidlich, P., Rosing, C. K., & Cavagni, J. (2020). Efficacy of ozonated water mouthwash on early plaque formation and gingival inflammation: a randomized controlled crossover clinical trial. Clinical Oral Investigations, 25, 1337- 44. https://doi.org/10.1007/s00784-020-03441-y.
Pietrocola, G., Ceci, M., Preda, F., Poggio, C., & Colombo, M. (2018). Evaluation of the antibacterial activity of a new ozonized olive oil against oral and periodontal pathogens. Journal of Clinical and Experimental Dentistry,10 (11), 1103-8. DOI: 10.4317/jced.54929.
Rapone, B., Ferrara, E., Corsalini, M., Converti, I., Grassi, F. R., & Santacroce, L. (2020) The effect of gaseous ozone therapy in conjunction with periodontal treatment on glycated hemoglobin level in Subjects with Type 2 Diabetes Mellitus: An Unmasked Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 17(15), 5467-78. https://doi.org/10.3390/ijerph17155467.
Roman-Torres, C. V., Bryington, M. S., Kussaba, S. T., Pimentel, A. C., Jimbo, R., & Cortelli, J. R. (2018). Comparison of full-mouth scaling and quadrant wise scaling in the treatment of adult chronic periodontitis. Brazilian Denalt Journal, 29 (3), 296-300. http://dx.doi.org/10.1590/0103-6440201801715.
Saglam, E., Alinca, S. B., Celik, T. Z., Hacisalihoglu, U. P., & Dogan, M. A., (2020). Evaluation of the effect of topical and systemic ozone application in periodontitis: an experimental study in rats. Journal of Applied Oral Science, 28, e20190140.http://dx.doi.org/10.1590/1678-7757-2019-0140.
Silva C.A., Pereira T.S., Quirino E.C., Ibiapina I.M., & Fernandes A.U. (2021). Análise da eficácia da ozônioterapia no tratamento da peri-implantite: uma revisão de escopo. Research, Society and Development, 10 (1), e30210111465. http://dx.doi.org/10.33448/rsd-v10i1.11465
Silva, C. B., Paschoalotto, I. G., Dalto, B. L., Paschoalotto, I. G., Brancini, M. L., & Alberghini, J. F. (2020). Ozone therapy in dentistry: review of major scientific considerations. International Journal of Development Research, 10 (04), 35060-3.
Suh, Y., Patel, S., Re, K., Gandhi, J., Joshi, G., Smith, N. L., & Khan, S. A. (2019). Clinical utility of ozone therapy in dental and oral medicine. Medical Gas Research, 9 (3),163-7. DOI: 10.4103/2045-9912.266997.
Tasdemir, Z., Alkan, B. A., & Albayrak, H., (2016). The effects of ozone therapy on the early healing period of de-epithelialized gingival grafts: a randomized placebo-controlled clinical trial. Journal of Periodontology, 87, 663–671. https://doi.org/10.1902/jop.2016.150217.
Tasdemir, Z., Oskaybas, M. N., Alkan, A. B., & Cakmak, O., (2019). The effects of ozone therapy on periodontal therapy: A randomized placebo controlled clinical Trial. Oral Diseases, 25, 1195–202. https://doi.org/10.1111/odi.13060.
Uslu, M. O., & Akgul, S., (2020). Evaluation of the effects of photobiomodulation therapy and ozone applications after gingivectomy and gingivoplasty on postoperative pain and patients’ oral health-related quality of life. Lasers in Medical Science, 35, 1637-47. https://doi.org/10.1007/s10103-020-03037-8.
Walsh, N. C., Alexander, K. A., Manning, C. A., Karmakar, S., Wang, J. F., Weyand, C. M., Pettit, A. R., & Gravallese, E. M., (2013). Activated human T cells express alternative mRNA transcripts encoding a secreted form of RANKL. Genes & Immunity, 14 (4), 336–45.
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Copyright (c) 2021 Anisio Rodiney Souza Júnior; Carolina Silva Pereira; Gabriel Borges Di Paolo; Fabrício Campos Machado; Thiago de Amorim Carvalho
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