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REPORT
Ozone
in
Periodontitis Treatment

by
Prof. Dr. med. dent. Hans-Georg Schneider
Berlin Nov. 2003

Ozone in Periodontitis Treatment

Within the context of a clinically controlled study, patients with the diagnosis of
periodontitis, provided that the probing depth of the gingival pockets was more than 5
mm / 0.2 in, where treated with the ozone generator OzonyTron of the company
mymed.
Testing criterions were the papilla bleeding index (PBI) and the measurement of the
sulcus fluid flow rate SFFR. Two variables were used in the methodology:
1.
Variable application time in different series of experiments
10 20 30 40 sec ozone application per pocket and visit with the intensity
remaining constant at level 4 (cf. chart in illustration 1)
2.
Variable current intensity and with that variable ozone concentration by
choosing different levels from level 3 to level 5 with the application time
remaining constant at 40 sec per pocket and visit
Ozone application was carried out in two visits in 3 - 4 day intervals; follow-up
appointment was set 3 - 4 days after the last ozone application.
With every patient, the procedures mentioned under 1. or 2. where followed for the
treatment of the right-hand side, the teeth / periodontitis in the left-hand side of the
jaws served as reference. Each initial diagnosis corresponded to the state after
debridement, 2 3 weeks before ozone application.
During the clinical test, no other treatments were carried out.
The Pa probe, an exchangeable top part of the hand-piece, which looks like a blunt
probe, was used for the therapy. This probe-shaped top part was inserted for about
3 mm / 0.12 in in the gingival pocket (not to the fundus of the pocket) while the device
was activated and was moved to and fro with pendular movement. Constant pendular
movement is essential, since it ensures that air can get into the pocket and thus a
part of the atmospheric oxygen can permanently be transformed into ozone (cf.
illustration 2).

Illustration 2: Interdental pockets seen from above (schematically).

With pendular movement of the Pa probe (green circle), the gingival pocket is
constantly ventilated. The incoming oxygen is used for ozone formation. It would be
wrong to leave the probe in one position.
Illustrations 3 + 4 clearly depict the findings of the study.
The left-hand side of both illustrations shows the variable time in 4 pairs of columns,
the 2 pairs of columns on the right-hand side show the variable current intensity =
ozone concentration.
From a comparison of both illustrations it is visible that under testing conditions both
testing criteria react nearly in the same way.
This is not surprising, because every practicing dentist daily observes the connection
between inflammation intensity and gingival secretion and therefore knows it from his
own experience.
The constant decrease of the PBI and the SFFR show:
1.
Ozone application needs 20 seconds to have perceptible effects.
There is a conspicuous reduction between the 20 th and the 30th second. Both
testing criteria continue decreasing to the 40 second, but as much as before.
2.
The effectiveness of ozone depends on its concentration. Level 5 is
incontestably more effective than level 3.
The clinical state of the teeth / periodontitis that served as reference had not
improved.
In some individual tests, smears were taken from pockets with probing depths of
8 9 mm / 0.31 0.35 in with sterile paper points. Then the samples were washed in
physiological sodium chloride solution.

3
The shaken mixture or suspension was spread on Columbia Agar (Blood Agar) and
incubated at 35 C / 95 F.
The number of the numerous growing germ-colonies was limited by means of a grid
and then counted. The result is depicted in illustration 5.
Considering the fact that ozone is highly effective against bacteria (according to
literature also against fungi and viruses) on the one hand, and reverts back to
molecular oxygen (neglecting bonds to organic structures) on the other hand, ozone
is a perfect therapeutic agent. Neither resistance formation of the microflora nor
allergic reactions have been observed. Thanks to its gaseous state, the therapeutic
agent is able to penetrate even narrow, hardly accessible and branched cavities (biand trifurcations, fistulae, serpiginous pockets and the like) much better than liquid,
gel or paste substances.
Prof. Dr. H.-G. Schneider, Berlin

Legends
Illustration 3:
Illustration 4:
Illustration 5:

Evolution of the papilla bleeding index (PBI) because of ozone

treatment of periodontitis
Influence of the ozone application on the sulcus fluid flow rate
(SFFR) as a testing criterion of the pocket secretion
Germ reduction in the gingival pockets with probing depths of
8 9 mm / 0.31 0.35 in after single ozone treatments with
different duration of application

papilla bleeding index

before

after

ozone treatment

all data in arithmetic average with n=25

per application at level 4

sulcus fluid flow rate

before

40 sec at the level indicated above

after

ozone treatment

all data in mm in arithmetic average with n=25

normal
SFFR
per application at level 4

intensity
for 40 sec

average number of bacterial colonies with more than 1mm / 0.039 in in diameter
in each Petri dish

ozone application before taking the smear, in sec