Effectiveness of the adjunctive use of ozone and chlorhexidine in patients with chronic periodontitis

Gandhi, Kaveri Kranti; Cappetta, Emil G; Pavaskar, Rajdeep

doi:10.1038/s41405-019-0025-9

Cited by 22 publications

(10 citation statements)

References 17 publications

(19 reference statements)

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“…Periodontal research and identification of interventions that could reduce the plaque microbial/bacterial load or act as therapeutic adjuncts to gingival inflammation have been the backbone of research in aerosolized microbes in dentistry. PI, OZ, and ClO 2 have been identified by the present network meta-analysis as potentially effective agents against bacterial aerosol contamination, while alternative applications of these agents constitute disinfection practices in the treatment of periodontitis (Yadav et al 2015; Perrella et al 2016; Gandhi et al 2019). Alternative effects and actions of PI, OZ, and ClO 2 related to certain pathogen types due to their oxidation potential in reaction with virus cell structure are provided in the Appendix.…”

Section: Discussionmentioning

confidence: 88%

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

2020

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The aim of this systematic review and network meta-analysis was to identify and rank the effectiveness of different interventions used in dental practice to reduce microbial load in aerosolized compounds. Seven electronic databases were searched to April 6, 2020, for randomized controlled trials (RCTs) or nonrandomized prospective studies in the field. Study selection, data extraction, and risk-of-bias assessment were performed for all included studies, while the outcome of interest pertained to differences in bacterial load quantification through the use of different interventions prior to aerosol-generating procedures in dental practices. Random effects frequentist network meta-analysis was performed, with mean difference (MD) and 95% CI as the effect measure. Confidence in the documented evidence was assessed through the newly fueled CINeMA framework (Confidence in Network Meta-analysis) based on the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation). Twenty-nine clinical trials were deemed eligible, 21 RCTs and 8 nonrandomized studies, while 11 RCTs contributed to the network meta-analysis, comprising 10 competing interventions. Tempered chlorhexidine (CHX) 0.2% as compared with nonactive control mouth rinse, prior to routine ultrasonic scaling, was most effective toward reduced postprocedural bacterial load with an MD of −0.92 (95% CI, −1.54 to −0.29) in log10 bacterial CFUs (colony-forming units). For CHX 0.2%, an MD of −0.74 (95% CI, −1.07 to −0.40) was observed as compared with control. Tempered CHX 0.2% presented the highest probabilities of being ranked the most effective treatment (31.2%). Level of confidence varied from very low to moderate across all formulated comparisons. These findings summarize the current state of research evidence in the field of aerosolized bacteria in dentistry. Instigated by the era of SARS-CoV-2 pandemic, the stipulation of a broader evaluation of the aerosolized microbes, including viruses, potentially coupled with disinfectant-based prevention schemes should be prioritized.

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Section: Discussionmentioning

confidence: 88%

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

2020

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“…Ozone could be efficacious against both Gram-positive and Gram-negative oral microorganisms. [ 31 ] In a study, Nagayoshi et al . confirmed the time-dependant inactivation of cariogenic and periodontopathogenic bacteria by ozone.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ozonated olive oil and chlorhexidine gel as an adjunct to nonsurgical periodontal therapy for the treatment of chronic periodontitis: A randomized controlled clinical trial

et al. 2022

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Objectives: Complete elimination of the pathogenic microorganisms from the gingival sulcus area is the ultimate goal of any periodontal therapy. Certain factors such as anatomical variation of teeth, deep periodontal pocket, and tissue-invading ability of some bacteria decrease the effectiveness of conventional nonsurgical periodontal therapy, i.e., scaling and root planing (SRP). Hence, antimicrobial agents could be used as an adjunct to SRP, in order to increase the efficacy of it. Although Chlorhexidine (CHX) is the gold standard as an antiplaque agent, it has several drawbacks. Recently, ozone therapy is being tried for the treatment of several diseases in the field of dentistry. Therefore, the purpose of this study was to evaluate and compare the efficacy of local application of CHX and ozonated olive oil as adjunctive to SRP for the treatment of chronic periodontitis. Materials and Methods: Thirty individuals who fulfilled the eligibility criteria were selected for this split-mouth randomized controlled trial. The treatment sites from each individual were randomly allocated into two groups. Along with SRP, the local application of CHX and ozonated olive oil was done for the control and test sites, respectively. Pocket probing depth, relative attachment loss, and sulcus bleeding index were measured before and 3 months after the treatment. Intragroup and intergroup differences in the clinical parameters were analyzed by Wilcoxon signed-rank test and Mann–Whitney U test, respectively. Results: Three months' posttreatment, all the parameters showed significant improvement in both the groups. However, the intergroup comparison failed to be significant statistically. Conclusion: Ozonated olive oil could enhance the outcomes of SRP for the treatment of periodontal diseases.

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“…Its primary application in oral surgery is prevention of post-extraction alveolitis, implantology with flap-less wound method, tissue biopsy and flap grafting, and intraoral sutured wound protection, Drug-Related Osteo Necrosis of the Jaw -DRONJ -prevention, fistulas, and management. [17][18][19][20] Some clinicians apply gaseous ozone while others use ozonated oil or ozone gel; [20,21]however, in the current investigation, we used ozonated water that was produced on the day of the surgery using a professional ozone generating device.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of Ozonated water on reducing post extraction sequelae

Norwali¹,

Alsehli²,

Almoghathawi³

et al. 2022

Journal of Pharmaceutical Negative Results

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Background: The goal of the current study was to determine if irrigation with ozonated water following conventional exodontia lowers post-extraction complications in contrast to irrigation with normal saline.Methods: This prospective cohort study included 80 healthy participants, 40 males and 40 females 40 men who had routine closed tooth extraction. Two groups of participants were formed (Group A: irrigated with ozonated water and group B: irrigated with normal saline). The key research postoperative outcome measures that had been assessed postoperatively were the pain level experienced during the first five days after surgery, the degree of soft tissue healing, and the occurrence of alveolar osteitis.Results: Both groups had an equal distribution of males and females. Gender and age characteristics did not significantly differ across groups (P=0.588 and P=0.104 respectively). Both groups saw a significant postoperative reduction in pin, which decreased from 1.9 on the first day to 0.3 on the fifth. Regarding the occurrence of alveolar osteitis or the rate of soft tissue healing, there was no marked difference between the groups.Conclusion: Although ozonated water reduced the occurrence of postoperative sequla after traditional nonsurgical tooth extraction, the findings were not statistically different from the standard saline irrigation strategy.

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Effectiveness of the adjunctive use of ozone and chlorhexidine in patients with chronic periodontitis

Cited by 22 publications

References 17 publications

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

Comparison of ozonated olive oil and chlorhexidine gel as an adjunct to nonsurgical periodontal therapy for the treatment of chronic periodontitis: A randomized controlled clinical trial

The effectiveness of Ozonated water on reducing post extraction sequelae

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