Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal
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To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).
Materials and methods
Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.
Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp.
Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.
Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.
KeywordsOzone Incomplete caries removal Antibacterial effect Residual caries Biocompatibility
This study was supported by the grant of Ministry of Science and Technology (No. 19/06-020/961-174/12), Republic of Srpska, Bosnia and Herzegovina.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in study were in accordance with the ethical standards of the Institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
- 2.Casagrande L, Seminario AT, Correa MB, Werle SB, Maltz M, Demarco FF, Araujo FB (2017) Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a retrospective study. Clin Oral Investig 21:847–855. https://doi.org/10.1007/s00784-016-1832-1 CrossRefGoogle Scholar
- 5.Hauser-Gerspach I, Pfäffli-Savtchenko V, Dähnhardt JE, Meyer J, Lussi A (2009) Comparison of the immediate effects of gaseous ozone and chlorhexidine gel on bacteria in cavitated carious lesions in children in vivo. Clin Oral Investig 13:287–291. https://doi.org/10.1007/s00784-008-0234-4 CrossRefGoogle Scholar
- 7.Dukić W, Jurić H, Andrašević AT, Kovačević V, Dukić OL, Delija B (2013) The efficacy of gaseous ozone on some cariogenic bacteria. Coll Antropol 37:109–113Google Scholar
- 8.Castillo A, Galindo-Moreno P, Avila G, Valderrama M, Liébana J, Baca P (2008) In vitro reduction of mutans streptococci by means of ozone gas application. Quintessence Int 39:827–831Google Scholar
- 11.Kollmuss M, Kist S, Obermeier K, Pelka AK, Hickel R, Huth KC (2014) Antimicrobial effect of gaseous and aqueous ozone on caries pathogen microorganisms grown in biofilms. Am J Dent 27:134–138Google Scholar
- 12.Cadenaro M, Delise C, Antoniollo F, Navarra OC, Di Lenarda R, Breschi L (2009) Enamel and dentin bond strength following gaseous ozone application. J Adhes Dent 11:287–292Google Scholar
- 15.Akdeniz SS, Beyler E, Korkmaz Y, Yurtcu E, Ates U, Araz K, Sahin FI, Torun OY (2017) The effects of ozone application on genotoxic damage and wound healing in bisphosphonate-applied human gingival fibroblast cells. Clin Oral Investig 22:867–873. https://doi.org/10.1007/s00784-017-2163-6 CrossRefGoogle Scholar
- 19.Yıldırım AO, Eryılmaz M, Kaldırım U, Eyi YE, Tuncer SK, Eroğlu M, Durusu M, Topal T, Kurt B, Dilmen S, Bilgiç S, Serdar M (2014) Effectiveness of hyperbaric oxygen and ozone applications in tissue healing in generated soft tissue trauma model in rats: an experimental study. Ulus Travma Acil Cerrahi Derg 20:167–175. https://doi.org/10.5505/tjtes.2014.09465 CrossRefGoogle Scholar
- 25.Matsuzaka K, Muramatsu T, Katakura A, Ishihara K, Hashimoto S, Yoshinari M, Endo T, Tazaki M, Shintani M, Sato Y, Inoue T (2008) Changes in the homeostatic mechanism of dental pulp with age: expression of the core-binding factor alpha-1, dentin sialoprotein, vascular endothelial growth factor, and heat shock protein 27 messenger RNAs. J Endod 34:818–821. https://doi.org/10.1016/j.joen.2008.03.027 CrossRefGoogle Scholar
- 33.Ishida S, Usui T, Yamashiro K, Kaji Y, Amano S, Ogura Y, Hida T, Oguchi Y, Ambati J, Miller JW, Gragoudas ES, Ng YS, D'Amore PA, Shima DT, Adamis AP (2003) VEGF164-mediated inflammation is required for pathological, but not physiological, ischemia-induced retinal neovascularization. J Exp Med 198:483–489. https://doi.org/10.1084/jem.20022027 CrossRefGoogle Scholar
- 39.Leone A, Patel M, Uzzo ML, Buscemi M, Gerbino A (2002) Expression and modification of NO synthase in human dental pulps during orthodontic treatment. Bull Group Int Rech Sci Stomatol Odontol 44:57–60Google Scholar
- 44.Sivalingam VP, Panneerselvam E, Raja KV, Gopi G (2017) Does topical ozone therapy improve patient comfort after surgical removal of impacted mandibular third molar? A randomized controlled trial. J Oral Maxillofac Surg 75:51.e1–51.e9. https://doi.org/10.1016/j.joms.2016.09.014 CrossRefGoogle Scholar
- 47.Greene AK, Güzel-Seydim ZB, Seydim AC (2012) Chemical and physical properties of ozone. In: O’Donnell C, Tiwari BK, Cullen PJ, Rice RG (eds) Ozone in food processing. Wiley-Blackwell, Oxford, p 26Google Scholar