Ozone therapy, due to its various effects on periodontal tissues, is used in periodontology as well as in many branches of dentistry [1]. The first person to consider using ozone gas or ozonated water in dentistry practice is the Swiss dentist, EA Fisch [2] used ozonated water in the early 1930s for surgical disinfection and wound healing.
Biological effects of ozoneOzone has antimicrobial effects on the human body, stimulating the immune system, increasing blood circulation, biosynthetic, analgesic and detoxification effects [3].
Antimicrobial effectOzone shows a cytotoxic effect on bacteria, fungi and viruses. The antimicrobial effect of ozone is selective against microbial cells and does not harm human cells. Ozone is also very effective in antibiotic resistant species. The effect of ozone on viral infections; it is based on the sensitivity of the infected cells to changes in peroxide and reverse-cryptase activity [1,3].The immune system stimulating effect: Ozone has a strong effect on the cellular and humoral immune system. It contributes to the proliferation of defense cells, immunoglobulin synthesis, as well as the phagocytosis function of macrophages. Ozone causes the expression of anti-inflammatory and wound healing cytokines such as interleukin, leukotriene and prostaglandin [3]. While low concentration of ozone causes immunostimulatory effect, high concentration of ozone creates immunodepressive effect [1,4].Antihypoxic effect: Ozone causes partial oxygen pressure in the tissues and oxygen transport in the blood to cause changes in cell metabolism. Superoxide dismutase, catalase, dehydrogenase, glutathione peroxidase enzymes are activated with low-dose ozone. These enzymes protect the organism from free oxygen radicals [3]. Increases the contact surface of erythrocytes for oxygen transport. It is important in circulatory disorders, in stimulating circulation and in revitalizing organ functions [5,6]. Biosynthetic effect: Activates the mechanism of protein synthesis. Increase the amount of ribosome and mitochondria in cells. These changes at the cell level; stimulates the potential of regeneration in tissues and organs by raising functional activities [3]. Analgesic and detoxification effect: It causes the release of vasodilators such as nitric oxide (NO) and causes dilatation of arterioles and venules [6].Ozone toxicity: Inhalation of ozone may be toxic to the pulmonary system and other organs. Therefore, long-term exposure to ozone may indicate some side effects such as epiphora, upper respiratory irritation, bronchoconstriction, rhinitis, cough, headache and vomiting. In ozone poisoning, the patient is brought to supine position and treated with vitamin E and N-acetyl-cysteine [7-9] (Table 1 & Table 2).
