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MedNext Journal of Medical and Health Sciences
Review
DOI: 10.54448/mdnt22S611
Submitted: 05-12-2022
Published: 05-12-2022

Major approaches to ozone therapy in endodontic treatments for bone infections and necrosis: a systematic review

UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
Ozone therapy Infected wounds Bone necrosis Endodontic treatment

Abstract

Introduction: The bacterium Staphylococcus aureus is, in most cases, the agent of the disease. Thus, inflammation of the bone marrow can cause compression of the bone tissue walls and decrease or blockage of blood supply in the region's blood vessels, which can induce bone necrosis. Clinical studies have demonstrated the efficiency of ozone therapy in the treatment of peritonitis, infected wounds, and advanced ischemic disease. Objective: It was demonstrate the main scientific findings of the use of antiseptic ozone therapy in endodontic treatment. Methods: The research was carried out from July to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and 57 articles were evaluated and 29 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.8% >50%. Ozone therapy is scientifically proven and demonstrated in this work, it proved to be effective for tissue repair and the prevention and treatment of bone necrosis. It was observed that patients undergoing chemotherapy, radiotherapy, and antiresorptive drugs are more affected by bone necrosis. It was also observed the importance of the patient feeling that the treatment works and is restoring his ability to reinvent himself and adapt to his social environment. Treatments should not only be based on established numbers and protocols, without analyzing the specific sensations and perceptions of each patient with their lived reality.

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References

  1. Nunes IA, Novais TM, Garcia PP, Silva WS, Tavarez RJ, Rizzi CC, Carvalho CN, Filho EM. Antimicrobial action of ozonated water and photodynamic therapy with sonic activation in root canals infected with Enterococcus faecalis. J Clin Exp Dent. 2022 Jun 1;14(6):e486-e491. doi: 10.4317/jced.57909.
  2. Sinha N, Asthana G, Parmar G, Langaliya A, Shah J, Kumbhar A, Singh B. Evaluation of Ozone Therapy in Endodontic Treatment of Teeth with Necrotic Pulp and Apical Periodontitis: A Randomized Clinical Trial. J Endod. 2021 Dec;47(12):1820-1828. doi: 10.1016/j.joen.2021.09.006.
  3. Silva EJNL, Prado MC, Soares DN, Hecksher F, Martins JNR, Fidalgo TKS. The effect of ozone therapy in root canal disinfection: a systematic review. Int Endod J. 2020 Mar;53(3):317-332. doi: 10.1111/iej.13229.
  4. Makeeva MK, Daurova FY, Byakova SF, Turkina AY. Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review. Clin Cosmet Investig Dent. 2020 Oct 28;12:447-464. doi: 10.2147/CCIDE.S267933.
  5. Sen S, Sen S. Ozone therapy a new vista in dentistry: integrated review. Med Gas Res. 2020 Oct-Dec;10(4):189-192. doi: 10.4103/2045-9912.304226.
  6. A SR, Reddy N, Dinapadu S, Reddy M, Pasari S. Role of ozone therapy in minimal intervention dentistry and endodontics - a review. J Int Oral Health. 2013 Jun;5(3):1028. Epub 2013 Jun 23. PMID: 24155611; PMCID: PMC3769872.
  7. Halbauer K, Prskalo K, Janković B, Tarle Z, Pandurić V, Kalenić S. Efficacy of ozone on microorganisms in the tooth root canal. Coll Antropol. 2013 Mar;37(1):101-7.
  8. Vincent JL, Lartigau G. A propos de l'ozone [Ozone]. Rev Fr Odontostomatol. 1971 Aug-Sep;18(7):839-58.
  9. Brignardello-Petersen R. Insufficient evidence regarding the effects of ozone when used as a disinfectant in root canal therapy. J Am Dent Assoc. 2020 May;151(5):e43. doi: 10.1016/j.adaj.2019.12.007.
  10. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n71
  11. H Balshem H, Grade guidelines: 3 ratng the quality of evidence. Journal of Clinical Epidemiology, Maryland Heights, 64 (4) (2011) 401-406.
  12. Higgins, S Green, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.
  13. 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, 1733–9.
  14. Case PD, Bird PS, Kahler WA, George R, Walsh LJ. Treatment of root canal biofilms of Enterococcus faecalis with ozone gas and passive ultrasound activation. Journal of Endodontics, 2012, 38, 523–6.
  15. Rojas-Valencia MN. 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. Badajoz: Formatex, 2011, pp. 263–71.
  16. Junior OO, Lages GC (2012) Ozone therapy for lumbosciatic pain. Revista Dor 13, 261–70.
  17. Hubbezoglu I, Zan R, Tunc T, Sumer Z (2014) Antibacterial efficacy of aqueous ozone in root canals infected by Enterococcus faecalis. Jundishapur Journal of Microbiology 7, e11411.
  18. Cunningham SJ, Garratt AM, Hunt NP. Development of a condition-specific quality of life measure for patients with dentofacial deformity: II. Validity and responsiveness testing. Community Dent Oral Epidemiol. 2002;30(2):81–90.
  19. Montero-Martin J, Bravo-Pérez M, Albaladejo-Martínez A, Hernández-Martin LA, Rosel-Gallardo EM. Validation the Oral Health Impact Profile (OHIP-14sp) for adults in Spain. Med Oral Patol Oral Cir Bucal. 2009;14(1).
  20. Huth KC, Quirling M, Maier S, et al. Effectiveness of ozone against endodontopathogenic microorganisms in a root canal biofilm model. International Endodontic Journal, 2009, 42, 3–13.
  21. Kist S, Kollmuss M, Jung J, Schubert S, Hickel R, Huth KC (2017) Comparison of ozone gas and sodium hypochlorite/chlorhexidine two-visit disinfection protocols in treating apical periodontitis: a randomized controlled clinical trial. Clinical Oral Investigations 21, 995–1005.
  22. Kaya BU, Kececi AD, Guldas HE, 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.
  23. Nagayoshi M, Kitamura C, Fukuizumi T, Nishihara T, Terashita M (2004) Antimicrobial effect of ozonated water on bacteria invading dentinal tubules. Journal of Endodontics 30, 778–81.
  24. Hyslop PA, Hinshaw DB, Halsey WA 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, 1665–75.
  25. Filippi A (2001) The effects of ozonized water on epithelial wound healing (in German). Deutsche Zahna¨rztliche Zeitschrift 56, 104–8.
  26. Noites R, Pina-Vaz C, Rocha R, Carvalho MF, Goncalves A, Pina-Vaz I (2014) Synergistic antimicrobial action of chlorhexidine and ozone in endodontic treatment. BioMed Research International 2014, 592423.
  27. Silva EJNL, Prado MC, Soares DN, Hecksher F, Martins JNR, Fidalgo TKS. The effect of ozone therapy in root canal disinfection: a systematic review. Int Endod J. 2020 Mar;53(3):317-332. doi: 10.1111/iej.13229.
  28. Almadi K, Alkahtany M, Alamam Y, Alaql F, Alaqil A, Almutairi M, Thafrah SMB. Influence of Propolis, Ozone and Photodynamic therapy in root canal disinfection on resin bond strength to radicular dentin. Photodiagnosis Photodyn Ther. 2021 Mar;33:102131. doi: 10.1016/j.pdpdt.2020.102131.
  29. Kaur A, Bhavikatti SK, Das SS, Khanna S, Jain M, Kaur A. Efficacy of Ozonised Water and 0.2% Chlorhexidine Gluconate in the Management of Chronic Periodontitis when Used as an Irrigant in Conjugation with Phase I Therapy. J Contemp Dent Pract. 2019 Mar 1;20(3):318-323.

How to Cite

Azevedo, M. V. da C. A., Nunes, V. R., Sbrogio, G. F., & Rosa, A. P. B. da. (2022). Major approaches to ozone therapy in endodontic treatments for bone infections and necrosis: a systematic review. MedNEXT Journal of Medical and Health Sciences, 3(S6). https://doi.org/10.54448/mdnt22S611