Ozone Treatment for the Management of Caries in Primary Dentition: A Systematic Review of Clinical Studies

Abstract

Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the effectiveness of ozone applications for the treatment of caries in primary dentition. According to PRISMA guidelines, a systematic literature search was performed up to 6 January 2024. Clinical studies using ozone to treat caries of deciduous teeth were considered for inclusion. Out of the 215 records retrieved, seven studies were eventually included in the review, all of which used gaseous ozone. Four studies were judged at high risk of bias, two at low risk, and one of some concerns. The great heterogeneity of designs, outcomes, and protocols made it impossible to conduct a meta-analysis. Despite some limitations, the evidence yielded by the included studies suggests that ozone application, regardless of the protocol applied, is comparable to other interventions in terms of clinical outcomes and anti-bacterial activity, with no reported adverse effects and good patient acceptance. Therefore, ozone application may be a non-invasive approach to treat caries in primary dentition, especially in very young and poorly cooperative patients. Further standardized and rigorous studies are, however, needed to identify the best clinical protocols for this specific field.

Ozone therapy in dentistry: An overview of the biological mechanisms involved (Review)

“…This would allow comparisons between established traditional treatments for specific oral health conditions, both in terms of clinical efficacy and patient acceptance. For example, the use of ozone for oral ulcerative lesions of various etiologies, as well as for the treatment of dental caries in young children, has shown promising results ( 31 , 32 ). This has provided an alternative treatment option that is less invasive compared with traditional approaches, free of side effects and with good patient compliance.…”

“…In addition, a beneficial remineralizing effect on hard dental tissues has been reported and used to treat dental demineralization and decay ( 38-41 ). In particular, ozone application has been suggested as a possible alternative or complementary strategy to manage dental caries in a less invasive and more comfortable procedure than traditional approaches, especially in young or poorly cooperative children ( 31 , 41 , 42 ). Since dental caries is considered a global public health challenge, especially in children and the socioeconomically disadvantaged population, the implementation of effective, safe and economic interventions to prevent and treat caries should be a priority in oral health care policies ( 43-45 ).…”

Antibacterial Effect of Ozone on Cariogenic Bacteria and Its Potential Prejudicial Effect on Dentin Bond Strength—An In Vitro Study

“…It causes the oxidation of phospholipids and lipoproteins in the bacterial cell envelope, destroying the cell wall and rupturing the cytoplasmic membrane, allowing the ozone itself to infiltrate the microorganisms. Consequently, it oxidizes glycoproteins and glycolipids, thus blocking enzyme function, which leads to a loss of organelle function [7][8][9][10]. For this reason, ozone could be promising in conservative dentistry since it could potentially play a role in the prevention of dental caries and as a cavity disinfectant [7,[9][10][11][12].…”

“…Consequently, it oxidizes glycoproteins and glycolipids, thus blocking enzyme function, which leads to a loss of organelle function [7][8][9][10]. For this reason, ozone could be promising in conservative dentistry since it could potentially play a role in the prevention of dental caries and as a cavity disinfectant [7,[9][10][11][12].…”