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Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials

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Abstract

Objective

This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment.

Materials and methods

Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment.

Results

Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone.

Conclusions

The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive.

Clinical relevance

The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.

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Funding

Brazilian agencies Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro - FAPERJ (Grant number 202619/17) supported this research.

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Authors and Affiliations

  1. Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rua Ibituruna, 108, Maracanã, Rio de Janeiro, Brazil

    Vittorio Moraschini & Suelen Cristina Sartoretto

  2. Department of Oral Surgery, Dentistry School, Fluminense Federal University, Rua Mario dos Santos Braga, 30, Centro, Niterói, Rio de Janeiro, 24020-140, Brazil

    Ingrid Chaves Cavalcante Kischinhevsky & Monica Diuana Calasans-Maia

  3. Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil

    Jamil Awad Shibli

  4. Department of Periodontology, Faculty of Dentistry and Oral Health, Griffith University, Brisbane, Queensland, Australia

    Carlos Marcelo Figueredo

  5. Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil

    José Mauro Granjeiro

  6. National Institute of Metrology, Quality and Technology (INMETRO), Rio de Janeiro, Brazil

    José Mauro Granjeiro

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  1. Vittorio Moraschini
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Correspondence to Vittorio Moraschini.

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Moraschini, V., Kischinhevsky, I.C.C., Calasans-Maia, M.D. et al. Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. Clin Oral Invest 24, 1877–1888 (2020). https://doi.org/10.1007/s00784-020-03289-2

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