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1 AUTHOR:
Sumit Bhateja
Vyas Dental College and Hospital
4 PUBLICATIONS 7 CITATIONS
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Review Article
ABSTRACT
Atmospheric air is made up of nitrogen (71%), oxygen (28%) and other gasses (1%) including ozone, which could be
altered by various processes related to altitude, temperature and air pollution. Recently many researchers have
indicated that ozone can be utilized for therapeutic purposes & it has long been used in complementary and alternative medicine (CAM) & probably one of the most miraculous healing therapies available on our planet at this time.
Its use is based on the known anti-microbial, antihypoxic, analgesic, immunostimulating properties of ozone (O3) on
biological systems. These mechanisms of action supported with a lot of case reports and scientic studies allow using
it in different elds of medicine. Claims have been made that the oxidizing properties of ozone may in fact be
therapeutic for a variety of ailments; including many chronic infections for which few other treatments are available
and efcacious. This review is another attempt to summarize different modalities of ozone applications in dentistry.
Further studies are necessary to standardize indications and treatment protocols of this promising medical agent.
Keywords: Dentistry, Ozone, Ozone application, Ozone therapy
INTRODUCTION
Ozone (O3) is a triatomic molecule, consisting of three
oxygen atoms. Its molecular weight is 4798 g/mol.1 It is
produced in the upper atmosphere when UV light strikes
the oxygen rising from plants, plankton and algae in our
forests and seas. It then falls back through the atmosphere,
as it is heavier than air, combining with pollutants and
water, cleaning the air and forming peroxides that benet
plants.2 Ultraviolet light breaking down pollutants and
nitrous oxides also can produce ozone at the ground level,
which is the eye and lung irritant in smog. Ozone is an
unstable gas and it quickly gives up nascent oxygen molecule to form oxygen gas. The release of nascent oxygen
has benecial effects on every part and organ.1 It has
been used in medical eld since long back due to its
extremely strong oxidant property that oxidizes nearly
all surfaces to the highest oxidation stage. It is used in
Senior Lecturer, Department of Oral Medicine Diagnosis & Radiology, Dr. D.Y. Patil Dental College & Hospital, Pune (Maharashtra), India.
*
A-3, Flat no. 204, Dwarka Lords, Shivar Chowk, Pimple Saudagar, Pune, Maharashtra 27, India. Tel.: 91 9561334497, email: bhateja.sumit@
gmail.com
Received: 21.12.2011; Accepted: 16.4.2012
2012 Indian Journal of Dentistry. All rights reserved.
http://dx.doi.org/10.1016/j.ijd.2012.04.004
HISTORICAL BACKGROUND
Review Article
151
Immunodeciency and
immunodysbalance:
d Chronic forms of
hepatitis B and C
d Supportive therapy
in cancer patients
d Supportive therapy
in rheumatoid arthritis
Inammatory condition
such as:
d Knee arthrosis
d Gonarthrosis
d Traumatic
knee disorders
Mechanisms
Disinfection, wound cleansing
and improved wound healing
Activation of RBC metabolism
with an improvement of
oxygen release.
Activation of ROS
(reactive oxygen species) and
radical scavengers
Activation of immunocompetent
cells with release of cytokines
such as interferons and interleukins.
Modulation of immune system
Increase of antioxidative capacity
by activation of biological
anti-oxidants
Antiinammatory effect
Activation of antioxidative enzymes
as radical scavangers
Activation of immunocompetent
and cartilage cells with
release of TGF-b
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Bhateja
FORMS OF APPLICATION3,8,10
Systemic forms of application
d
d
d
Elimination of pathogens.
Restoration of proper oxygen metabolism.
Induction of a friendly ecologic environment.
Increased circulation.
Immune activation.
Stimulation of the humoral anti-oxidant system.
3,8,10
1. Pregnancy.
2. Glucose-6-phosphate-dehydrogenase deciency
(favism).
3. Hyperthyroidism.
4. Severe anemia.
5. Severe myasthenia.
6. Acute alcohol intoxication.
7. Recent myocardial infarction.
d
d
d
d
d
Review Article
153
structure of the teeth and the future often brings the need for
repeating the restoration as the structure of the tooth/lling
break down. The vitality of the dental pulp may also be
compromised and endodontic therapy is often required,
signicantly adding to the cost. Patients are astonished by
the comfortable nature and the simplicity of the ozone
therapy. No local anesthetic injection, no drills and an
appointment time measured in a few minutes. The implications for this new treatment to a general dental practitioner
are profound.
The principle line of study has evolved using the ozone
to determine its effect on several kinds of caries (pit and
ssure, noncavity, and primary root caries). The oxidative
impact on this microbiota has been recognized in several
studies; however, there is a divergence of opinion regarding
the amount of time that ozone gas should be applied. One
study suggests application of ozone gas for a period of
10e20 s resulted in 99% of the micro-organisms being
destroyed. Another report states 40 s of application was
insufcient to decontaminate the area and failed to act on
underlying infected dentin. Interesting data shows ozone
does not affect the sealing ability of the bonding-system.
Ozone therapy was also used in prevention of dental caries
in pit & ssures in children.
In root canal treated teeth, crown discoloration is a major
aesthetic problem, especially in anterior teeth. After placing
the bleaching agent into the inner of the tooth, the crown is
irradiated with ozone for minimum of 3e4 min. This ozone
treatment bleaches the tooth within minutes and gives the
patient a happy and healthier-looking smile.
Quick and prompt relief from root sensitivity has been
documented after ozone spray for 60 s followed by mineral
wash onto the exposed dentine in a repetitive manner. This
desensitization of dentine lasts for longer period of time.
Smear layer present over the exposed root surface prevents
the penetration of ionic Calcium and Fluorine deep into the
dentinal tubules. Ozone removes this smear layer, opens up
the dentinal tubules, broadens their diameter and then
Calcium and Fluoride ions ow into the tubules easily, deeply
and effectively to plug the dentinal tubules, preventing the
uid exchange through these tubules. Thus, ozone can effectively terminate the root sensitivity problem within seconds
and also lasts longer than those by conventional methods.
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Bhateja
CONCLUSION
Considered an alternative therapy, Ozone has been increasingly used in recent decades and has been found useful in
various diseases. Medical reports on successful application
of ozone in therapy of different diseases and studies on its
effects caused a rapid growing interest in it. Some factors
are responsible for its wide spreading, such as simplicity
of performance, good tolerance by patients, absence of
side-effects or adverse reactions and high medico-social
and economic efciency. Even though ozone therapy is still
being ignored by most of medical establishment because of
facts that gaseous ozone is quite toxic and has strong oxidative properties. Further research is needed to standardise
indications and treatment procedures of ozone therapy.
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