Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks.
Ozone inhalation can be toxic to the pulmonary system and other organs. Known side-effects are epiphora and upper respiratory irritation, rhinitis, cough, headache, occasional nausea, and vomiting. However, complications caused by ozone therapy are infrequent at 0.0007 per application. In the event of an ozone intoxication the patient must be placed in the supine position, inhale humid oxygen, and take ascorbic acid, vitamin E, and nacetylcysteine. Because of ozone’s highly oxidative power, all materials that come in contact with the gas must be ozone resistant, such as glass, silicon, and Teflon.
Ozone Therapy Contraindications
The following are contraindications for use of ozone therapy:
• Glucose-6-phosphate-dehydrogenase deficiency (favism)
• Severe anemia
• Severe myasthenia
• Active hemorrhage
Methods of Administering Medical Ozone
Because of its high oxidative power and effect on bacteria, viruses, and fungi, ozone therapy is indicated in the treatment of 260 different pathologies. Systemic administration of ozone gas has been carried out using different methods as described below.
This is an extracorporeal blood treatment with ozone gas followed by the intravenous reinfusion of the patient’s treated blood. It is indicated for treatment of arterial circulatory disorders, infections, and for rheumatic arthritis. It is also useful in the promotion of immunoactivation, provides additive therapy for geriatric carcinoma patients.
• Activation of red blood cell metabolism with an increase of 2.3-diphosphoglycerate and Adenosine Triphosphate (ATP) plus improving O2-release to the tissues.
• Activation of immunocompetent cells with release of cytokins, such as interferons and interleukins.
This is an extracorporeal blood treatment and intramuscular injection. It is indicated for allergies, acne, furunculosis, and adjuvant cancer therapy. The mechanism of action deals with a nonspecific activation and general stimulation of the immune-system.
Rectal O3/O2 Insuflation
This method of administration is indicated for arterial circulatory disorders (stage II), general immunoactivation, adjuvant cancer therapy, and hepatitis A, B, and C. The effects are virtually equal to those of major autohemotherapy
The Use of Ozone in Dentistry
Interest in ozone use in dentistry is due to the infectious diseases associated with the oral cavity. Ozone therapy presents great advantages when used as a support for conventional treatments, for example, to dental caries, periodontal procedures, and endodontic treatment.
Ozone Therapy in Surgery
In a clinical survey involving 11 patients Stübinger et al. described the local effectiveness of ozone on infected intraoral wounds following high-dose radiotherapy.
Guerra et al. compared the use of ozonated oil (Oleozon, Cuba) in an experimental group to a control group in which Alvogil and antibiotic therapy was used in the treatment of alveolitis. Patients treated with Oleozon healed more quickly without the need for systemic medication when compared to the control group. This finding suggests ozonated oil might be effective in the treatment of alveolitis.
For the reasons discussed, the future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies.
Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.