Ozone therapy as an adjuvant for endondontic protocols: microbiological – ex vivo study and citotoxicity analyses

Abstract

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.

Ozone saline solution counteracts bisphosphonates noxious effects in primary human gingival fibroblasts

“…Addition of the ozone saline solution (stock concentration -O 3 saline solution -80 µg/mL; 100 µL/well) to pretreated HGF cells with F and A for 24 h led to an increase of cells viable percentages as compared to the ones stimulated only with F and A (see Figure 8) and it was also noticed an improvement of cells confluence and a cells morphology similar to the control ones (unstimulated cells) (see Figures 9 and 10), what demonstrates that ozone solution in these experimental conditions was able to reverse the toxic effects induced by F and A. Our data are in line with other data from the literature that confirm the protective effects of ozone on gingival fibroblasts [32,34,35].…”

Candida albicans biofilm inactivated by cold plasma treatment in vitro and in vivo

“…It is generally accepted that RONS has the most important effect on sterilizing. Indeed, many biofilm inactivation methods are developed based on hydroxyl radical formation, and gaseous ozone therapy is also considered as an efficient approach for oral biofilm inactivation . Furthermore, biofilm formation can be inhibited by nitric oxide …”

Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease

“…Ozone therapy is useful for decontamination of the root canal in teeth contaminated with Pseudomonas aeruginosa , Enterococcus faecalis , and Staphylococcus aureus , suggesting that ozone might have antimicrobial efficacy. [ 7 ] Hence, diseases characterized by a chronic oxidative stress or chronic inflammation might be benefited from ozone therapy.…”