Evaluating clinical and laboratory effects of ozone in non-surgical periodontal treatment: a randomized controlled trial

Eltas Seydanur Dengizek, Dundar Serkan, Eltas Abubekir, Karabulut Aysun Bay, Otlu Onder, Cicek Arife, Eltas Seydanur Dengizek, Dundar Serkan, Eltas Abubekir, Karabulut Aysun Bay, Otlu Onder, Cicek Arife

Abstract

Objective: This study aims to evaluate the clinical and biochemical (oxidative stress and pro-inflammatory mediators) effects of the gaseous ozone use accompanied by scaling and root planning (SRP) in periodontal treatment.

Material and methods: The study population consisted of 40 patients with chronic periodontitis (CP) randomly sorted into two groups of 20. The experimental group received SRP plus 3 watts gaseous ozone in two separate applications five days apart, whereas the control group received SRP plus placebo. Clinical periodontal parameters were assayed and saliva samples were taken before the initial and one month after the second treatment. Periodontal examination assessed plaque index (PI), gingival index (GI), probing depth, and clinical attachment level (CAL). Total antioxidant status (TAS), total oxidant status (TOS), nitric oxide (NO), 8-hydroxy-2'-deoxyguanosine (8-OHdG), myeloperoxidase (MPO), glutathione (GSH), malondialdehyde (MDA), and transforming growth factor-beta (TGF-β) levels were evaluated from saliva samples.

Results: Changes following treatment in PI, GI, probing depth, and CAL scores were similar for both groups (p>0.05). Of note, TGF-β levels were observed to be higher in the treatment group than in controls (p<0.05). Changes in 8-OHdG, TAS, TOS, NO, MPO, GSH and MDA levels, however, were not significantly different between groups (p>0.05).

Conclusion: The findings of this study indicate that SRP plus gaseous ozone versus SRP alone does not correlate to a significant improvement in periodontal recovery.

Trial registration: ClinicalTrials.gov NCT03444350.

Conflict of interest statement

Conflict of Interest

There is no conflict of interest for this study.

Figures

Figure 1. Research outline
Figure 1. Research outline
Figure 2. Ozone device used in the…
Figure 2. Ozone device used in the study

References

    1. Graves D. Cytokines that promote periodontal tissue destruction. J Periodontol. 2008;79(8 Suppl):1585–1591.
    1. Chapple IL. Role of free radicals and antioxidants in the pathogenesis of the inflammatory periodontal diseases. Clin Mol Pathol. 1996;49(5):M247–M255.
    1. Ejeil AL, Gaultier F, Igondjo-Tchen S, Senni K, Pellat B, Godeau G, et al. Are cytokines linked to collagen breakdown during periodontal disease progression? J Periodontol. 2003;74(2):196–201.
    1. Chapple IL, Mason I, Garner I, Matthews JB, Thorpe GH, Maxwell SR, et al. Enhanced chemiluminescent assay for measuring the total antioxidant capacity of serum, saliva and crevicular fluid. Ann Clin Biochem. 1997;34(Pt 4):412–421.
    1. Baltacioğlu E, Akalin FA, Alver A, Balaban F, Unsal M, Karabulut E. Total antioxidant capacity and superoxide dismutase activity levels in serum and gingival crevicular fluid in post-menopausal women with chronic periodontitis. J Clin Periodontol. 2006;33(6):385–392.
    1. Battino M, Ferreiro MS, Gallardo I, Newman HN, Bullon P. The antioxidant capacity of saliva. J Clin Periodontol. 2002;29(3):189–194.
    1. Onder C, Kurgan Ş, Altıngöz SM, Bağış N, Uyanık M, Serdar MA, et al. Impact of non-surgical periodontal therapy on saliva and serum levels of markers of oxidative stress. Clin Oral Investig. 2017;21(6):1961–1969.
    1. Kepic TJ, O'Leary TJ, Kafrawy AH. Total calculus removal: an attainable objective? J Periodontol. 1990;61(1):16–20.
    1. Darby I. Non-surgical management of periodontal disease. Aust Dent J. 2009;54(Suppl 1):S86–S95.
    1. Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol. 1988;59(8):493–503.
    1. Huth KC, Saugel B, Jakob FM, Cappello C, Quirling M, Paschos E, et al. Effect of aqueous ozone on the NF-kappaB system. J Dent Res. 2007;86(5):451–456.
    1. Paraskeva P, Graham NJ. Ozonation of municipal wastewater effluents. Water Environ Res. 2002;74(6):569–581.
    1. Grootveld M, Baysan A, Sidiiqui N, Sim J, Silwood C, Lynch E. History of the clinical applications of ozone. In: Lynch E, editor. Ozone: the revolution in dentistry. London: Quintessence Publishing Co; 2004. pp. 23–30.
    1. Das E, Gurakan GC, Bayindirli A. Effect of controlled atmosphere storage, modified atmosphere packaging and gaseous ozone treatment on the survival of Salmonella enteritidis on cherry tomatoes. Food Microbiol. 2006;23(5):430–438.
    1. Martínez-Sánchez G, Al-Dalain SM, Menéndez S, Re L, Giuliani A, Candelario-Jalil E, et al. Therapeutic efficacy of ozone in patients with diabetic foot. Eur J Pharmacol. 2005;523(1-3):151–161.
    1. Monte A, van der Zee H, Bocci V. Major ozonated auto hemotherapy in chronic limb ischemia with ulcerations. J Altern Complemen Med. 2005;11(2):363–367.
    1. Baysan A, Lynch E. Antimicrobial effects of ozone on caries. In: Lynch E, editor. Ozone: the revolution in dentistry. London: Quintessence Publishing Co; 2004. pp. 165–172.
    1. Bocci V. Ozone as Janus: this controversial gas can be either toxic or medically useful. Mediators Inflammation. 2004;13(1):3–11.
    1. Baysan A, Lynch E. Effect of ozone on the oral microbiota and clinical severity of primary root caries. Am J Dent. 2004;17(1):56–60.
    1. Huth KC, Paschos E, Brand K, Hickel R. Effect of ozone on noncavitated fissure carious lesions in permanent molars – a controlled prospective clinical study. Am J Dent. 2005;18(4):223–228.
    1. Nagayoshi M, Kitamura C, Fukuizumi T, Nishihara T, Terashita M. Antimicrobial effect of ozonated water on bacteria invading dentinal tubules. J Endod. 2004;30(11):778–781.
    1. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. Periodontol 2000. 2004;34:9–21.
    1. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964;22:121–135.
    1. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21:533–551.
    1. Adriaens PA, Adriaens LM. Effects of nonsurgical periodontal therapy on hard and soft tissues. Periodontol 2000. 2004;36:121–145.
    1. Hallmon W, Rees TD. Local anti-infective therapy: mechanical and physical approaches. A systematic review. Ann Periodontol. 2003;8(1):99–114.
    1. Seidler V, Linetskiy I, Hubálková H, Stanková H, Smucler R, Mazánek J. Ozone and its usage in general medicine and dentistry. A review article. Prague Med Rep. 2008;109(1):5–13.
    1. Nagayoshi M, Fukuizumi T, Kitamura C, Yano J, Terashita M, Nishihara T. Efficacy of ozone on survival and permeability of oral microorganisms. Oral Microbiol Immunol. 2004;19(4):240–246.
    1. Müller P, Guggenheim B, Schmidlin PR. Efficacy of gasiform ozone and photodynamic therapy on a multispecies oral biofilm in vitro . Eur J Oral Sci. 2007;115:77–80.
    1. Ramzy MI, Gomaa HE, Mostafa MI, Zaki BM. Management of aggressive periodontitis using ozonized water. Egypt Med JNRC. 2005;6(1):229–245.
    1. 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.
    1. Yılmaz 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.
    1. 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.
    1. Bezrukova IV, Petrukhina NB, Voinov PA. Experience in medical ozone use for root canal treatment. Stomatologia. 2005;84(6):20–22.
    1. Huth KC, Quirling M, Lenzke S, Paschos E, Kamereck K, Brand K, et al. Effectiveness of ozone against periodontal pathogenic microorganisms. Eur J Oral Sci. 2011;119(3):204–210.
    1. Hauser-Gerspach I, Vadaszan J, Deronjic I, Gass C, Meyer J, Dard M, et al. Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia. Clin Oral Investig. 2012;16(4):1049–1059.
    1. Huth KC, Jakob FM, Saugel B, Cappello C, Paschos E, Hollwech R, et al. Effect of ozone on oral cells compared with established antimicrobials. Eur J Oral Sci. 2006;114(5):435–440.
    1. Ozdemir H, Toker H, Balcı H, Ozer H. Effect of ozone therapy on autogenous bone graft healing in calvarial defects: a histologic and histometric study in rats. J Periodontal Res. 2013;48(6):722–726.
    1. Teresa B, Wolanska E, Cieszko-Buk M, Orlowski M, Chalas R. Practical use of ozone in dentistry - comments. Ann Univ Mariae Curie Sklodowska. 2008;63:28–28.
    1. Agrali ÖB, Kuru BE, Yarat A, Kuru L. Evaluation of gingival crevicular fluid transforming growth factor-β1 level after treatment of intrabony periodontal defects with enamel matrix derivatives and autogenous bone graft: a randomized controlled clinical trial. Niger J Clin Pract. 2016;19(4):535–543.

Source: PubMed

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