Aim The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry. Background 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. Conclusion 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. Citation Nogales CG, Ferrari PA, Kantorovich EO, Lage-Marques JL. Ozone Therapy in Medicine and Dentistry. J Contemp Dent Pract 2008 May; (9)4:075-084.

Objectives This study evaluated the antimicrobial efficacy of ozone therapy in teeth contaminated with Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus using a mono-species biofilm model. Parallel to this, the study aimed to evaluate the cytotoxicity of ozone for human gingival fibroblasts. Material and Methods: One hundred and eighty single-root teeth were contaminated with a mono-species biofilm of Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus. Groups were formed: Group I – control; Group II – standard protocol; Group III – standard protocol + ozone gas at 40 µg/mL; and Group IV – standard protocol + aqueous ozone at 8 µg/mL. In parallel, human gingival fibroblasts were submitted to the MTT test. Cells were plated, then ozone was applied as follows: Group I (control) – broth medium; Group II – aqueous ozone at 2 µg/mL; Group III – aqueous ozone at 5 µg/mL; and Group IV – aqueous ozone at 8 µg/mL. Data were submitted to the Kruskal Wallis test and Bonferroni post hoc analyses to assess microbiology and cytotoxicity, respectively (p<0.05%).Results The results revealed antimicrobial efficacy by Group IV with no CFU count. The cytotoxicity assay showed Groups III and IV to be the most aggressive, providing a decrease in cell viability at hour 0 from 100% to 77.3% and 68.6%, respectively. Such a decrease in cell viability was reverted, and after 72 hours Groups III and IV provided the greatest increase in cell viability, being statistically different from Groups I and II.Conclusion According to the applied methodology and the limitations of this study, it was possible to conclude that ozone therapy improved the decontamination of the root canal ex vivo. Ozone was toxic to the cells on first contact, but cell viability was recovered. Thus, these findings suggest that ozone might be useful to improve root canal results.

ObjectiveNew drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy.Material and MethodsHuman gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofloxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn’s tests at a significance level of 5%. Cell viability was assessed for the different concentrations and times.RESULTSAll drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mg/L produced viable fibroblasts at all experimental times in all groups.ConclusionsCell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofloxacin hydrochloride.

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Dedico este trabalho às pessoas que me serviram de base, que me sustentaram nos momentos de fraqueza e comemoram juntos os momentos de alegria e vitória: À minha esposa Marina Beloti Ferreira, em TODOS os momentosjuntos, parceiros. Escalamos mais uma montanha e agora podemos compartilhar mais essa vitória. Graças a você, minha escalada ficou muito mais fácil. TE AMO DEMAIS e MUITO OBRIGADO!!! Aos meus pais Carlos Nogales Ortiz, Nancy Goes Nogales e minha querida irmã Erica Goes Nogalesvocês são meu porto seguro. Eternamente grato pelo apoio, suporte e pela lição de caráter que me orienta no caminho certo. Ao meu grande AMIGO Dr. Fernando Cerbara, obrigado pela compreensão, apoio e suporte. Sem sua participação e torcida, a realização deste sonho não seria possível. Aos meus AMIGOS de pós-graduação Brígida Kleine, Rafael Paiva, Luciana Blanck, Guilherme Martins, Nilton Azambuja e Thiago Brum, dividimos privações, gaguejadas, estresse, noites em claro, mas estamos chegando ao cume da montanha com a sensação de dever cumprido. Valeu a pena toda essa caminhada para semearmos o nosso futuro, a partir de agora estamos prontos para colher os frutos. À Ana Maria, Soninha e ao Sr. Aldo ficam os meus mais sinceros agradecimentos pela amizade, por toda a ajuda prestada; pessoas especiais que ficarão na lembrança pelo resto da vida. Ao GRANDE Dr Edson Cesar Philippi (in memoriam)ser humano iluminado cuja paixão pela ozonioterapia plantou diversas sementes. Tenho a honra em ser um dos frutos do qual seu conhecimento contagiou e impulsionou na descoberta e aprimoramento da terapia. À minha irmã ozonioterapeuta Letícia Philippi que tanto apoiou a realização deste trabalho. Seu entusiasmo, alegria e paixão pelo ozônio transmitem força e empolgação para trilhar caminhos desconhecidos no conhecimento do ozônio. À Associação Brasileira de Ozonioterapia, fruto de um sonho, um ideal de vários profissionais que lutam pela aplicação médica e odontológica do ozônio no Brasil. AGRADECIMENTOS À maior fonte de Luz, que tanto me apoia, me inspira e me conduz pela busca da serenidade, da paz interior e da evolução-DEUS. Obrigado por colocar as pessoas certas, nas horas certas em meu caminho. Prof Dr João Humberto Antoniazzirecebeu de braços abertos a proposta deste trabalho e na figura de um Professor, na essência da palavra, colaborou de forma fundamental para esta conclusão. Prof Dr José Luiz Lage-Marquessua ajuda inestimável me deu forças para levantar a cabeça e ver que os momentos de dúvida e fraqueza são, na realidade, oportunidades de crescimento. Prof Dr Antonio Carlos Bombana (in memoriam)pessoa iluminada que deixou seu brilho e entusiasmo pelo tema. Ensinou não apenas a Odontologia, mas a arte da humildade e da serenidade. Saudades! "O professor que caminha pelo tempo, entre seus discípulos, não dá a sua sabedoria, mas antes a sua fé e amor. Se for sábio, não vos convida a entrar na casa de sua sabedoria, mas antes vos conduz ao limiar do vosso próprio espírito." Khalil Gibran Ao meu professor na microbiologia e AMIGO Antonio Ferna...

Nogales CG. Effect of ultrasonic irrigation and calcium hydroxide intracanal medication on the levels and metabolism of bacteria that persisted after root canal preparation of teeth with apical periodontitis [thesis]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2019. Versão Original. Molecular studies highlight the limitations of the traditional endodontic protocol in eliminating bacteria from the root canal. Although chemo-mechanical procedures (CMP) provide a drastic bacterial reduction, many canals remain infected after this treatment step. Thus, studies point out to the need for technical complementation to enhance root canal disinfection after CMP. Thus, the aim of this clinical study was to evaluate, by molecular methods based on DNA and RNA, the effect of supplementary preparation methods on root canal disinfection. Microbiological samples from the root canals of 20 single rooted teeth with apical periodontitis were performed at different steps of endodontic treatment: prior to preparation (S1); after chemo-mechanical procedures with Reciproc system associated with 2.5% NaOCl (S2) irrigation; after passive ultrasonic irrigation, or PUI (S3); and after calcium hydroxide intracanal medication (S4). The samples were submitted to DNA and RNA extraction. The RNA was submitted to reverse transcription reaction (RT-PCR) to make the complementary DNA double strand (cDNA). DNA and cDNA were submitted to qPCR reactions with universal primers for the 16S rRNA region of the Bacteria domain. The metabolic activity of bacteria was verified by the relation of rRNA and rDNA levels as determined by qPCR assays. Data were analyzed by Wilcoxon test for paired samples (p <0.05). S1 samples from the 20 cases had high levels of bacterial rDNA (median

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