Management of Periodontal Disease with Adjunctive Therapy with Ozone and Photobiomodulation (PBM): A Randomized Clinical Trial

Abstract

Periodontitis is an inflammatory condition of the soft and hard tooth-supporting tissues, representing the first cause of tooth loss. In addition to standard mechanical debridement (Scaling and Root Planing, SRP), further approaches have been proposed as adjuncts. The aim of the present randomized clinical trial is to compare the efficacy of ozone or photobiomodulation (PBM) therapy in addition to SRP to treat periodontal disease. According to a split-mouth design, 240 pathological sites, corresponding to 30 periodontal patients, were randomly divided according to the professional oral hygiene protocol performed at baseline (T0) and after 1 (T1), 2 (T2), 3 (T3), 4 (T4), 5 (T5), and 6 (T6) months. A total of 120 sites underwent an ozonized water administration (ozone group), whereas the other 120 sites were treated with photobiomodulation (PBM group), both in addition to SRP. At every timepoint, the following clinical indexes were assessed: Probing Pocket Depth (PPD) (measured on six sites per element), Plaque Index (PI), and Bleeding on Probing (BOP). As regards PPD, significant intergroup differences were noticed from T5, with significantly lower values in the PBM group (p < 0.05), where values further decreased at T6 (p < 0.05). Both PI and BoP generally decreased from baseline to T6 in both groups; a significant difference was found between T0 and T1 among the groups (p < 0.05), with a progressively higher reduction in the PBM group among the time frames of the study, despite intergroup comparisons not being significant (p > 0.05). Both ozone and PBM appear to be effective adjuvant treatments to SRP, obtaining a slightly better outcome for the latter in the long term, with significant differences at T5 and T6 for PPD. However, because of the absence of standardized protocols for PBM considering both therapeutic and research purposes, no definitive conclusions can be reached, and further studies are required.

Effects of an Ozonated Water Irrigator on the Plaque Index and Bleeding Index of Pregnant Women

“…Ozonated water and ozone have a disinfectant power, reduce the signs of inflammation, and inhibit the formation of bacteria that cause halitosis, as demonstrated by the various articles published in the literature on the use of ozone therapy in the dental field [ 10 , 11 , 12 , 13 ]. They were demonstrated to be efficacious in the management of chronic periodontitis [ 14 , 15 ] and oral lichen planus [ 16 ], without the toxic effects of dental pulp cells [ 17 ]. Overall, other recent data suggest that ozonated water suppresses C. albicans growth and biofilm formation on polymethyl methacrylate (a dental prosthetic material) without impairing surface properties [ 18 ].…”

On the Association between Implant-Supported Prosthesis and Glycemic Control (HbA1c Values)

“…Additional means may be taken to help for the professional and home management of diabetic patients, as mentioned in long studied by the research group of Scribante et al as the use of ozonated water [ 31 ], postbiotics [ 32 ] and paraprobiotics [ 33 ].…”

Effect of Green Tea on the Level of Salivary Interleukin-1 Beta in Patients with Chronic Periodontitis: A Randomized Clinical Trial

“…A new treatment introduced by the use of lasers in dentistry is photobiomodulation (PBM) therapy as a supplement to SRP. In a split-mouth design clinical trial comparing the effects of ozone and PBM as a complement to SRP in reducing the clinical parameters of periodontal patients, it was shown that both ozone and PBM are effective adjunctive therapies for SRP, and a slightly better result is expected for the latter in the long-term to reduce the depth of the periodontal pocket [ 27 ]. In addition, it has been shown that the use of diode laser with SRP improves clinical parameters by reducing sclerostin (a bone formation inhibitor) levels in the GCF of patients with chronic periodontitis [ 28 ].…”