Abstract
Introduction: In dental treatment and oral health, ozone in low concentrations has been used successfully due to its oxidizing and antimicrobial properties. It also has anti-inflammatory and immunological action. Objective: A systematic review was developed to demonstrate the positive clinical effect of ozone therapy in dentistry through randomized clinical studies and meta-analysis. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from November 2024 to January 2025 in the 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: 111 articles were found, 38 articles were evaluated in full and 13 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with a high risk of bias and 30 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=75.8%>50%. It was concluded that ozone therapy is an alternative to accelerate healing and reduce pain in traumatic and autoimmune ulcers. Ozone offers a painless alternative to conventional treatment for dental caries and has been shown to arrest primary root caries, primary pit, and fissure caries, and clinically reverse the lesion. Its antimicrobial action on endodontic microbiota is quite promising. Ozone gel is suggested as an adjunctive therapy in diabetic patients to improve periodontal health. Oxygen-ozone therapy has been shown to enhance post-extraction healing in patients at risk for MRONJ. As for reducing the microbial load for patients undergoing root canal treatment, ozone therapy has inferior results when compared to conventional chemomechanical techniques using NaOCl.