Antibiofilm effect of ozonized physiological saline solution on peri‐implant–related biofilm

Abstract

Background Removal of dental plaque and local application of local chemical adjuncts, such as chlorhexidine (CHX), have been used to control and treat peri‐implant disease. However, these methods can damage the surface properties of the implants or promote bacterial resistance. The application of ozone as an adjunctive treatment represents a new approach in the management of peri‐implantitis. Thus, the purpose of this study was to evaluate the antimicrobial effect of ozonized physiological saline solution in different concentrations against oral biofilms developed on titanium surface. Methods Single and multi‐species biofilms of Porphyromonas gingivalis, Fusobacterium nucleatum, and Streptococcus oralis were formed on titanium specimens for 5 days in anaerobic conditions. Biofilms were treated with ozonized saline solution at different concentrations (25, 50, and 80 μg/NmL), for 30 seconds and 1 minute. CHX (0.12%) and saline solution (0.89% NaCl) were used as positive and negative controls, respectively. Bacterial viability was quantified by colony forming units (CFU mL−1), and biofilm images were acquired by confocal laser scanning microscopy (CLSM). Data were analyzed by parametric test (ANOVA) with Tukey post‐hoc test (P < 0.05). Results Ozonized saline solution showed antibiofilm activity at a concentration of 80 μg/NmL for 30 seconds and 1 minute, reducing, mainly, Porphyromonas gingivalis viability, with 2.78 and 1.7 log10 CFU mL−1 of reduction in both single and multi‐species biofilms, respectively, when compared to the control (saline), whereas CHX reduced 1.4 and 1.2 log10 CFU mL−1. Conclusion Ozonized saline solution has antibiofilm activity, with better effect when applied for 1 minute at 80 μg/NmL, being a promising candidate therapy for the treatment of peri‐implant diseases.

The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review

“…The role of adjunctive treatments in such situations needs further investigation. Furthermore, there are several reported adjuncts to NSMD for peri-implant disease including ozone therapy [ 53 , 54 ], desiccant application [ 55 ], electrolytic cleaning procedures [ 56 ] and herbal medications [ 57 ] for which no evidence was synthesized in the systematic reviews of peri-implant mucositis included in the present study. Therefore, conclusions regarding the efficacy of these measures cannot be drawn from the present study.…”

Ozone Gel in Chronic Periodontal Disease: A Randomized Clinical Trial on the Anti-Inflammatory Effects of Ozone Application

“…In the last few years, a renewed interest in the therapeutic potential of ozone has emerged. In particular, the focus is on the ability to promote wound healing, to attenuate the adverse effects of inflammation by reducing the oxidative activities of inflammatory cells, to express antimicrobial activities against various bacterial species and mycetes pathogenic for humans, and also against biofilm-producing and antibiotic-resistant bacteria, thus offering chances of overcoming antibiotic-resistance issues [30][31][32][33][34][35][36][37][38][39] (Figure 2).…”

“…In addition to SRP, the use of the ozonized gel GeliO3 can be regarded as a valid substitute to chlorhexidine, especially considering the major shortcomings associated with the latter. Interestingly, some studies show that ozone treatments could be useful in combating implant-associated infections, exhibiting antibacterial activity and promoting osseointegra-tion [32,33]. Furthermore, ozone-functionalized dental and orthopedic implant materials seem to favorably influence the behavior of bone marrow cells and macrophages [34].…”

Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer

“…Elshinawy et al (2018) tested the efficacy of ozonated olive oil on the removal of biofilm biomass of mixed-species biofilms and demonstrated a 79% reduction of biomass [ 46 ]. Tonnon et al (2020) showed that the anti-biofilm effect of ozonized saline solution was similar to the effect of chlorhexidine in multi-species biofilms [ 47 ]. However, studies have shown that resistance to ozone may occur in bacteria due to N-acetyl glucosamine that is present in the peptidoglycan cell wall [ 48 , 49 ].…”