Ozone Therapy as an Adjuvant in the Treatment of Periodontitis

Abstract

The current study aimed to assess the efficacy of ozone therapy in the treatment of stage II and stage III periodontitis. This prospective split-mouth study selected patients who were diagnosed with either stage II or stage III periodontitis. All patients were treated with scaling and root-planing (SRP) on the control side and SRP with ozone therapy on the test side. Probing depth (PD), clinical attachment loss (CAL), O’Leary plaque index (PI), and bleeding on probing (BOP) scores were recorded at baseline and six weeks after the SRP treatment. A total of 46 patients were selected for this study, including 31 males and 15 females. All periodontal variables (PD, CAL, PI, and BOP) showed significant changes (p < 0.0001) from baseline to six weeks. Moreover, significant changes (PD = 0.0001, CAL = 0.0001, PI = 0.042 and BOP = 0.0001) were also observed between the control and test sides. Gender showed no significance on periodontal variables (p > 0.05) except PD on the test side (p = 0.030). In addition, periodontal stages and grades showed no significant changes (p > 0.05) in any periodontal variables on both sides. Ozone therapy significantly improves the periodontal condition compared to SRP treatment alone. However, the stages and grades of periodontitis do not influence the outcome of ozone therapy.

Keywords: ozone therapy, periodontitis, stages and grades of periodontitis

1. Introduction

Periodontitis is one of the most prevalent inflammatory diseases, affecting between 20 to 50% of people globally. Severe periodontitis affects 11.2% of people around the world [1,2,3]. Gingival bleeding and tooth mobility are the most common characteristics of periodontitis; if untreated this phenomenon could lead to loss of the tooth. There are multiple factors that cause the pathogenesis of periodontal disease; bacteria play an important role [4]. Anaerobic Gram-negative bacteria are the most hostile in the progression of periodontitis [5] and are commonly found in the subgingival plaque. Due to the rapid progression of microorganisms, professional assistance is required to remove bacterial plaque [6].

Many surgical or nonsurgical therapeutic modalities are performed to eliminate biofilm or bacterial plaque [7]. Generally, scaling and root-planing (SRP) is the most conventional treatment procedure for removing sub-gingival and supra-gingival plaque and calculus [8,9]. Nevertheless, SRP cannot completely remove the pathogenic bacteria, and residual pockets, specifically in the furcation area, interproximal area, root concavities, and areas with deeper pockets, as the instrument cannot access these areas properly [10,11,12]. Previous research has indicated that the mechanical removal of bacterial plaque in patients having a pocket depth of 5 mm and more is challenging; therefore, an additional therapeutic technique is required to increase the effects of the treatment [13,14,15]. Systemic or local antibiotics and topical antiseptics have been used as adjunct therapies along with SRP for a better outcome [16,17].