Major biological effects of ozone therapy. 

Contexts in source publication

Context 1

... biological actions ( Fig. 1) of medical ozone include the increase in the synthesis of biologically active substances such as interleukins, leukotrienes and prostaglandins that are beneficial in the reduction of inflammation and in cicatrization, the activation of aerobic processes (glycolysis, Krebs cycle, beta-oxidation of fatty acids), secretion of ...

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... total, 120 bovine mandibular incisor teeth were selected randomly and divided into 4 groups. Groups 1 and 3 were cleaned with pumice and washed with water; groups 2 and 4 were washed with ozonated water before adhesion to stainless orthodontic brackets with resin Transbond XT, 3M Unitek, Monrovia, CA, USA (Group 1 and 2;) and a modified resin of glass ionometer cement (Groups 3 and 4; Fuji Ortho LC, Japan). ...

Context 3

... is a gas with the chemical formula O , 3 and is the third most powerful oxidant. Medical ozone is produced by oxygen and its passage through a voltage gradient, using ozone generators that react to dioxygen molecules, forming ozone (O + O → O ) 2 3 (Ripamonti et al ., 2011; Bocci, 2006; Swilling, 2004). Several biological actions (Fig. 1) of medical ozone include the increase in the synthesis of biologically active substances such as interleukins, leukotrienes and prostaglandins that are beneficial in the reduction of inflammation and in cicatrization, the activation of aerobic processes (glycolysis, Krebs cycle, beta-oxidation of fatty acids), secretion of vasodilators (e.g. nitric oxide-NO), activation of the mechanism of protein synthesis and increase in the quantity of ribosome and mitochondria in the cells, thus raising the functional and potential activity of tissue regeneration (Seidler et al. , 2008). The ozone oxidant potential induces the destruction of cellular walls and cytoplasmatic membranes of bacteria (Thanomsub et al ., 2002). The gas was named ozone (a Greek word that means "smell") by the German chemist Christian Frederick Schonbein of the University of Basel in Switzerland 1840 (Seidler et al. ; Veranes et al ., 1999). During the First World War, ozone gas was used for the treatment of post-traumatic gangrene, infected wounds, burns and fistulas and other anaerobic infections, putrefied wounds, suppurations of bone fractures and various inflammations in German soldiers (Azarpazhooh & Limeback, 2008). By the middle of 1932, German dentist Edward A. Fisch, perceived the therapeutic possibilities of using ozone as a medical therapy (Altman, 2007; Bocci, 2005). Currently, there are divergences in the developed studies regarding ozone therapy action. Therefore, the studies available in the literature must be reviewed in order to evaluate the obtained results and estimate the effectiveness of ozone therapy and the methods used. The purpose of this study was to perform a review regarding the effectiveness of ozone therapy in the area of dentistry, with emphasis on the current uses, focusing on the areas of periodontics, orthodontics and dental implants. The authors aimed at answering the following questions: “What is the action of ozone on periodontal pathogens?” “What are the effects of ozone on the adhesion of brackets to dental enamel?” “How does ozone act in the bone integration of dental implants?” These questions are important for future studies in order to understand the properties of ozone and its contribution in clinical uses. Data sources . The literature review included studies available in the databases, PubMed, LILACS and SciELO, utilizing the following descriptors: ozone, dentistry, periodontics, orthodontics and dental implants. Studies published between the years 2002 and 2012 were included. A combination of the key words was used, which helped to identify studies related to ozone therapy in dentistry. Books regarding ozone therapy were also referred to in order to obtain more information on the theme (Altman; Bocci, 2002, 2005). The search was limited to studies written in English and Spanish. Both in vitro and in vivo studies regarding ozone therapy in dentistry were selected (Fig. 2). Study selection . Letters to the editor, abstracts, conferences, comments, books and panels were not included; however all of them were reviewed in order to identify possible important data that could contribute to the development of this review. Data extraction . After reviewing the titles of the researched studies, seven pertinent studies were found related to the study objectives (accessed on September 26, 2012). Several studies stemming from the search were read with the purpose of identifying relevant information on the theme in question. Results are presented in three sections according to the purposes of the study. Action of ozone on periodontal pathogens. Three i n vivo (Kshitish & Laxman, 2010; Martinez Abreu & Abreu Sardinas, 2005; de Ramon et al ., 2004) and one in vitro study (Huth et al., 2011) evaluating the action of ozone on periodontal microbiota were found. In 2004, de Ramon et al. , (Table IA) analyzed the periodontal responses in terms of the clinical, microbiological and immunologic aspects in patients with moderate and severe periodontal pockets, comparing the technique of scaling and root planning (control group) with the application of ozone (experimental group). After 30 days, the average clinical evaluation showed the following data: in the experimental group, initial periodontal index (Russell’s Index) was 5.72 and the final index was 5.59. Initial supragingival plaque index was 31.30 and the final index was 49.99. Initial gingival bleeding index was 62.43 and the final 26.29. In the experimental group the microbiological analysis the reduction of periodontal pathogens ( Aggregatibacter actinomycetencomitans (Aa), Bacteroides forsythus (Bf), and Porphyromonas gingivalis (Pg) was about 50%). In the immunologic analysis, the initial TNF-a was 101.23 and at the end it decreased to 36.01. Initial IL-1b also reported a decrease from an initial period of 96.12 to 34.28 after 30 days of treatment. Martínez Abreu & Abreu Sardiñas (Table IA) developed a randomized controlled clinical study. The study was divided into two groups: the control (treated with 0.2% chlorhexidine) and the experimental group (treated with the ozonated oil Oleozon). A microbiological analysis was performed on the gingiva of the teeth with periodontitis after 21, 90 and 180 days respectively, during a nine-month postoperative period. The microbiological and clinical evaluation was determined to be: Satisfactory: Absence or lack of gram-negative microorganisms. Unsatisfactory: Abundant presence or prevalence of gram-negative microorganisms. After the postoperative period of 180 days, microbiological results were satisfactory in 98% of the patients in the experimental group and 78% in the control group. Regarding the clinical evaluation, satisfactory results after 180 days were present in 98% of the patients in the experimental group and 95% in the control group. In 2010, Kshitish & Laxman (Table IB) developed a double-blind randomized study regarding the use of ozonated water in the treatment of periodontitis. The control group was irrigated with 0.2% chlorhexidine. Clinical parameters such as gingival index and gingival bleeding index were analyzed, in addition to the ozone activity on oral microorganisms: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gengivalis (Pg), Tannerella forsythensis (Tf), Herpes Simplex virus (HSV-1 and HSV-2), Epstein Barr virus (EBV) human cytomegalovirus (HCMV) and Candida Results of the ozone irrigations showed 12% of reduction of the plaque index. The gingival index decreased 29% and bleeding index 26%. After seven days, ozone showed presence of Aa in 25%, Pg 50%, Tf 25%, HSV-1 62.5%, HSV-2 0%, HCMV 25%, EBV 37.5% and Candida albicans 12.5% of the cases. In an in vitro study, Huth et al. (2011) (Table IB) determined the efficacy of the use of gaseous/aqueous ozone in the reduction of several periodontal pathogens (Aa, Pg, Tannerella forsythia (Tf) and Parvimonas micra (Pm) in both planktonic state and biofilm. Aqueous ozone in a concentration of 20 mg ml-1 resulted in the reduction of approximately 99% of the total A. actinomycetencomitans in planktonic state, and 70% in biofilm. Gaseous ozone (concentration of 1, 2, 4, 8, 16 g m-3) was capable of reducing this pathogen ...