By Dr.Hiba Hussain Aouda

1. Presented by :
Dr.Hiba Hussain Aouda
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2. 1-Introduction.
2-Route of adminstration.
3-Mechanism of action .
4-Advantage of ozone in dentistry
5-Disadvantage of ozone in dentistry
6-Application of ozone in dentistry .
7-Contraindication for ozone uses .
8-Ozone safety
9-Ozone toxicity .
10-Conclusion .
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3.  Ozone is a blue gas, with strong odour and most
important gas in the stratosphere.
 In nature, ozone is formed by combination of oxygen in
the air under the influence of factors such as UV
radiation (from the sun), electrical discharges(lightening)
, water falls & ocean waves crashing onto rocks.
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5. A. Gaseous form Gaseous ozone could be
administered topically either by an open system or by
a sealing suction system to avoid inhalation and
adverse effects.
 Most frequently used in restorative dentistry and
endodontics.
 It is a noninvasive therapy for treatment of dental
caries and may be used as a disinfectant before the
placement of a direct restoration and also as therapy
for hypomineralized teeth.
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6. B. Ozonized water It has been shown to be efficacious
against Gram-positive and Gram-negative oral microorganisms
as well as bacteria in plaque biofilm.
 In comparison to other chemical cleaners, it appears to be less
expensive.
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7. C. Ozonized oil It is competitive antimicrobial agent due to
wide accessibility of sunflower oil.
 It is found efficacious against Streptococci, Enterococci,
Staphylococci, Pseudomonas, and especially Mycobacteria
and is used for the cure of fungal infections
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8.  Ozone has been shown to be apowerful and reliable
antimicrobial agent against bacteria , fungi, protozoa and
viruses (kim et al,1999;Avita et al,2005).
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9.  Non invasive - minimal intervention
technique.
 Induction of afriendly ecologic
environment .
 Improves metabolism of infected
tissues by mean of its oxidizing effect.
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(Deepa and porja,2012)

10.  The problem of maintaining the ideal
tightness between the cap and the
ozoned tooth .
 The device does not administer ozone
when there is a risk of untightness.
 More time (may be 10 min) needed for
aproper preparation of cap.
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(Deepa and porja,2012)

11. 6-1-caries prevention:
Dental caries is an
irriversable microbial
disease of the calcified tissue
of teeth.
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(leone&oppenheim,2001)

12.  Ozone appears to be an integral part of non-invasive
therapy of dental caries ,it could be used placing as
adisinfectant prior to policy adirect restoration and as
therapy for hypominaralised teeth (loncar et al,2009).
 Recarding incipient caries by oxidizing biomolcules with
in bacteria ,ozone could eliminate the acidogenic bacteria
within seconds leaving avirtually sterile surface and dentin
structure that would remineralize(halting caries and
clinically reverse lesion)(Azarpaz hood&Limeback,2008)
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6-1-1-coronal caries prevention:

13.  In one iraqi study, Habeeb(2008)found that 10sec exposure to
ozonated water (4mg/L)has strong bacteriocidal activity
aganist adherent mutant strep.
 On dentin surfaces of teeth that made is the best antimicrobial
agent among the other tested antimicrobial agents(sodium
hypochloride 5.25% and chlorohexidine 0.2 %)
 Ozone may arrest of caries , resulting in prevention or
delaying the need for tooth restoration(Rick et al,2004).
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14. Abu
Nabaa
2002 Ozone treatment provoked the least anxiety
comparing to traditional dentistry .
Abu
Nabaa
2003 Ozone treatment for 10 s significantly
reminaralized leasion and could beproposed as an
altrernative treatment for new pit and fissure lesion .
Hath 2003 More caries reversal or reduced caries progresion
was found in the ozone treated lesion after 3
months than in the an treated control lesion .
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authors year finding

15.  Ozone is the most effective in cases of shallow lesions since it
shows enhanced ability to penetrate lesions which are about
1mm deep at the maximum.
 The ozone unit must also be used correctly; the ozone cap
must be held directly against the caries lesion allowing the
ozone to penetrate the decay and biofilm.
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16.  Where there is a cavitated 4mm deep root caries lesion
adjacent to the gingival margin, simply using ozone treatment
would probably not suffice.
 To manage this kind of a situation the outer caries must first
be removed, leaving about 1 mm of caries over the cavity
floor. Then the ozone treatment followed by routine
restoration is indicated.
 Ozone should be considered an adjunct to existing treatment
and preventive methods rather than an isolated treatment
modality (Tiwari et al. 2017)
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17.  Ozone could be used as disinfectant prior to adirect
restoration (Dahnhardt et al.,2006).
 Ozone gas has a strong bactericidal effect on microorganism
in dentinal tubule of deep cavities,which could result in
increasing success of restoraion(geliberti et al.,2006)
 1n iraqi Habeeb(2008)recorded that ozonated water 4mg/L
can be used for cavity disinfection without interfering with
adequate bonding to dentin on the contrary it enhance the
dentin bonding strength .
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19.  A high level of biocompatibility of aqueous ozone on
periodontal cells has been found
 2 minute irrigation of the avulsed teeth with no isotonic
ozonized water not only provides mechanical cleansing, but
also decontaminate the root surface, with no negative effect
on periodontal cells remaining on the tooth surface before
replantation.
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20.  Ozone application for 40-60 sec. might alleviate almost
instantly the pain tablet by the patients from hypersensitive
teeth the applying reminiralizing agent and repeat if
necessary,this approach will remove sensitivity for not just
afew days or weeks as in the case for some surface
application but for anumber of years.
 Its work by openning the tubular structure , so it remove
the organics debris, which then allows deep miniral
penetration into the tubules (Holomes and delay,2003).
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21. o The aim of conventional root canal therapy is to provide a
clean, shaped, root canal that facilitates the placement of an
adequate root filling.
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22.  When irrigating with the usual irrigant solution, for example
sodium hypochlorite, ozone can be applied to the hypochlorite
solution in the root canals.
 This technique allows the root canal system to be thoroughly
disinfected and possibly be sterilized.
 Also that ozone will penetrate through the apical foramen,
and enter into the surrounding and supportive bone tissue.
 The effect of ozone on these tissues will be to encourage
healing and regeneration
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23.  Clinical trial regarding the theraputic
application of ozone in periodontal therapy
have recently been approved by the US
food and Drug Administration.
 Ozonated oils are in conjunction with
scaling and prophylaxis but do not
considered as an alternative to routine
professional oral hygiene care
(Filippi,1997).
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25.  Brilliant result were notified with the use of ozonised oils
and gels in treatment of periodontal pocket.
 The gel is loaded into an optident 1.25 ml small syringe and
with afine blue acid-etch tip, the gel is delivered into pocket
with ease.
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 For larger pocket, it recommended to repeat this at 7- days
intervals , on average, it can be achieved complete resolution of
an infected pocket in about 2 days for smaller and 3-4 and 7
days for larger deeper pocket.
 As there is stimulation of reparative cellular mechanism the
appearance of tissue is pink and healthy(Filippi,1997).

27.  It is chronic bad breath that may be caused due to
several issues.
 Bacteria that forms volatile sulfur compounds
(VSCs) such as hydrogen sulfide and
methylmercaptan are the main causes of the oral
malodor .
 Ozone has the capacity to clinicaly alleviate oral
malodor via direct oxidative inactivation of VSCs
and their aminoacid precurcers(Silwood et
al,2001).
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28. 6-8-1-post extraction surgery:
 Ozone was found to accelerate the healing of the wounds.
 After a tooth is extracted or any surgical procedure the area is
irrigated and insufflated which promotes faster healing
without complications
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29.  After thorough assessment :
I. Remove the necrotic plug and debris from the extraction
site.
II. Irrigate with large amount of ozonized water.
III. fill the alveoli with ozonated oil.
IV. Antibiotic coverage is indicated.
V. Instruct patient to apply ozonated oil 3-4 times aday until
total healing.
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30.  Gaseous or aqueous form of ozone may be used in cases of
peri-implantitis.
 The abutment is fully covered by silicone cap.
 The gingival borders around the implant should be properly
sealed.
 Ozone gas infiltrations can also be used in this situation.
 During debridement and curettage, irrigation is done with
ozonated water.
 On the treated areas, 3–4 times daily application of ozonized
oil can also be advised.
(Gupta & Deepa 2016) 3
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32.  Crown & bridge hypersensitivity is common during the
temporization phase in crown , inlay/onlays and veneers
procedures.
 Many factors might contribute to this event,one of which is
the presence of bacteria left inside the opened dentinal
tubules during preparation.
 It is paraamount to remove the smear layer and disinfect the
prepared teeth before temporization and before seating of the
final restoration (Holmes and Daley,2003).
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 Prior to final prosthesis cementation,clean the prepared teeth
with air abrasion ,disinfect with ozone gas and then seat the
prosthesis (Holmes,2002).

34.  A common occurrence found in full
dentures wearers is denture stomatitis,
mainly due to candida albicans.
 Found that ozone reduce candida
albicans from dentures by 90% after just
a half hour , and by over 99% after 60
min. Of treatment.
 To disinfect dentures , full acontainer
large enough to submerge denture with
cold water for 30 min. With the denture in
the water ( Nagayoshi ,et al. , 2004).
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35.  There are various ways to whiten
teeth, whether it is with a home kit or
at a dental office.
 In a test conducted that bleaching
teeth with 38% hydrogen peroxide
and ozone resulted in whiter teeth
than bleaching teeth with only 38%
hydrogen peroxide (Tessier et al.
2010).
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36.  The temporomandibular joint is a hinge
that connects jaw to the temporal bone on
skull.
 In certain cases, patients have TMJ
dysfunction, where there may be pain or
dysfunction of the mastication muscles and
the joints.
 The ozone gas was injected into the
superior joint space.
 Ozone therapy has been shown to be more
effective than medication for treating TMJ-
related pain. (Doğan. 2014).
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37. Ozone is particularly well suited to the
management of viral lesions.
 The pain and disfigurement of perioral
herpetic infections is a good example.
 In short order, the practitioner can render
the areas comfortable and significantly
accelerate the healing process.
 Interestingly, around 25% of lesions
treated with ozone do not appear to recur.
 Both gas and ozonated oils are well
suited to managing viral infections.
(Domb 2014)
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38.  Ozonated water can also be used as a cold disinfection
solution for medical for cabients and dental instruments as
well as for cabients countertop of disinfection (Nagayosh et
al.,2004).
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40.  DUWL (ozone use in city water disinfection and
purification worldwide) is recognized as the best city water
treatment today.
 It becomes only logical to use ozone for the dental office tap
water disinfection and purification(Al horman et al,2001) the
result is a clean , colorless tap water .
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42. 1) Pregnancy
2) Hyperthyroidism
3) Glucose-6-phosphate dehydrogenase deficiency
4) Severe anemia
5) Severe myasthenia
6) Active hemorrhage
7) Acute alcohol intoxication
8) Recently reported myocardial infarction
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43.  According to most authers, a(10sec.) application of ozone
causes the destraction of 99% of bacteria, and a(20sec.)
application even of 99.9%. (Holmes,2004).
 Ozone is not toxic when it is given in the amount of 0.05 ppm
for 8 hours.
 During ozone therapy amaximum concentration of ozone in
oral cavity amounts to 0.01 ppm.
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44. 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
1) upper respiratory irritation
2) bronchoconstriction
3) rhinitis
4) cough
5) headache
6) vomiting.
In ozone poisoning, the patient is brought to supine position and
treated with vitamin E and N-acetyl-cysteine (Nogales,2008).
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45. • Ozone therapy has a wide range of applications in almost
every field of dentistry. Its unique properties include
immunostimulant, analgesic , antimicrobial , bioenergetics
and biosynthetic actions.
• Its a traumatic, painless, non invasive nature and relative
absence of discomfort increase patient’s acceptability and
compliance thus making it an ideal treatment choice specially
for pediatric patients.
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