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OZONE THERAPY
Presented By
Dr. M. Shiva Shanker
II Year Post Graduate Student ,
Dept of Periodontics, Mamata Dental Colleg...
contents
• Introduction
• History
• Chemistry
• Ozone generators
• Biological actions
• Goals
• Routes of administration
•...
Introduction
• The word ozone is derived from the
greek “ozein” meaning odorant.
• It is an unstable gas and it quickly
gi...
History
• In 1785, Van Marum noticed that air near his
electrostatic machine acquired a characteristic
odor when electric ...
CHEMISTRY:
• Ozone is a triatomic molecule, Its molecular
weight is 47, 98 g/mol.
• Thermodynamically highly instable
comp...
• The ozone concentration may vary between
1 and 100 μg/ml (0.05-5%).
• Ozone gas has a high oxidation potential
and is 1....
How am I produced???
• Thunderstorms
• UV rays
• Ozone generators
OZONE GENERATORS:
• The first ozone generator was developed by
Werner Von Siemens in Germany in 1857.
• Ultraviolet system...
Appliances producing ozone for
Dental use
• HealOzone by KaVo
• OzonyTron by MYMED Gmb H.
• Product photo (Prozone) by W&H...
How I work???
• “ Transient oxidative burst”.
Am I Allergic to you???
BIOLOGICAL ACTIONS
• Anti –microbial action
• Anti –inflammatory & analgesic action
• Immune-stimulating action
• Anti-hyp...
GOALS
• Elimination of pathogens.
• Restoration of proper oxygen metabolism.
• Induction of a friendly ecologic environmen...
ROUTES OF ADMINISTRATION
• Gaseous ozone
• Ozonated water
• Ozonized oil
Advantages
• Disinfectant.
• Anti-inflammatory.
• Activation of intracellular metabolism of oral
mucosa and dental wounds....
DISADVANTAGES
• Ozone toxicity if the level increases at
0.0007% per application.
• Instability.
• Not readily available
INDICATIONS
• Chronic or recurrent infections in the oral
cavity.
• Sterilization of cavities, root canals,
periodontal po...
CONTRAINDICATIONS:
• Pregnancy – to avoid mutagenic risk.
• Hyperthyroidism
• Severe anemia
• Thrombocytopenia
• Cardiovas...
OZONE THERAPY IN PERIODONTICS
• Ozonated water (4 mg/l) was found effective
for killing gram-positive and gram-negative
or...
• Thanomsub et al. 2002 tested the effects of
ozone treatment on cell growth and ultra-
structural changes in bacteria (Es...
• Ebensberger et al. in 2002 evaluated the
effect of irrigation with ozonated water on
the proliferation of cells in the p...
• Nagayoshi et al. 2004 tested the efficacy of
ozonated water on survival and permeability
of oral micro-organisms.
• Gram...
• Hems and Gulabivala, 2005 evaluated the
potential of ozone as an anti-bacterial agent
using Enterococcus faecalis as a t...
• Ramzy et al. in 2005 irrigated the
periodontal pockets by ozonized water in 22
patients suffering from aggressive
period...
• Huth et al. in 2006, in their study declared
that the aqueous form of ozone, as a
potential antiseptic agent, showed les...
• Muller et al. in 2007 compared the influence of
ozone gas with photodynamic therapy (PDT)
and known antiseptic agents (2...
• Kshitish and Laxman in 2010 conducted a
randomized, double-blind, crossover split-
mouth study on 16 patients suffering ...
• Fillippi. A observed the influence of
ozonized water on the epithelial wound
healing process in the oral cavity. It was
...
• Huth, et al. in 2011 compared the
effectiveness of ozone with that of the
established antiseptic CHX, against
periodonta...
• Dodwad et al. in 2011 compared the effect
of oral irrigation with ozonated water, 0.2%
Chlorhexidine and 10% Povidone io...
• Sadatullah et al in 2012 analysed the effect
of 0.1 ppm ozonated water on 24-hour
supragingival plaque (SP) samples.
• O...
• Hayakumo et al in 2012 evaluated the
clinical and microbiological effects of NBW3
irrigation as an adjunct to subgingiva...
• Yilmaz et al in 2013 evaluated the clinical
and microbiological results of treatment with
the Er:YAG laser and topical g...
• Punit vaibhav et al in 2013 in a case report
A 42-years female patient was selected,
who presented with a mild to modera...
• Shoukheba et al in 2014 evaluated the
effect of subgingival application of ozonated
olive oil gel as an adjunct to scali...
• Habhasneh et al in 2014 aimed to
determine the clinical and biological effects
of the adjunctive use of ozone in
nonsurg...
• Kl Vandana et al in 2015 assessed the
effect of chlorhexidine (CHX), povidone
iodine (PI), and ozone (OZ) on the
microor...
OZONE FOR TREATMENT OF PERIIMPLANTITIS
• El Hadary et al in 2011 evaluated the effect
of ozonated oil under the influence ...
• Hauser gerspach et al in 2012 investigated
the antimicrobial efficacy of gaseous ozone
on bacteria adhered to several su...
• Mc Kenna et al in 2013 assessed the effect
of subgingival ozone and/ or H2O2 on the
development of peri implant Mucositi...
OZONE TOXICITY
• Ozone inhalation can be toxic to the
pulmonary system and other organs.
• Known side-effects are upper re...
OZONE INTOXIFICATION
• Patient must be placed in supine position
• Inhale humid oxygen
• Ascorbic acid
• Vitamin E
• Acety...
CONCLUSION
• Ozone therapy allows a new vision, which
complies with needs and demands of the
public for non-invasive, effe...
References:
• Clinical and microbiological effects of ozone nano-bubble water
irrigation as an adjunct to mechanical subgi...
• Ozone and its use in periodontal treatment, open journal of stomatology,
2013,3, 197-202.
• Ozone in periodontics, natur...
Ozone therapy
Ozone therapy
Ozone therapy
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Ozone therapy

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ozone therapy in periodontics

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Ozone therapy

  1. 1. OZONE THERAPY Presented By Dr. M. Shiva Shanker II Year Post Graduate Student , Dept of Periodontics, Mamata Dental College.
  2. 2. contents • Introduction • History • Chemistry • Ozone generators • Biological actions • Goals • Routes of administration • Ozone therapy in periodontics • Ozone toxicity • conclusion
  3. 3. Introduction • The word ozone is derived from the greek “ozein” meaning odorant. • It is an unstable gas and it quickly gives up nascent oxygen molecule to form oxygen gas. • Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth and is caused either by specific microorganisms or
  4. 4. History • In 1785, Van Marum noticed that air near his electrostatic machine acquired a characteristic odor when electric sparks were passed. • In 1801, Cruickshank observed the same odor at the anode during electrolysis of water. • In 1840, Schonbein named the substance “Ozein”. • it was not until 1932 that ozone was seriously studied by the scientific community, when ozonated water was used as a disinfectant by Dr. E.A. Fisch, a Swiss dentist.Ozone Therapy: A New Paradigm in Periodontics, Rose Kanwaljeet Kaur, 2014
  5. 5. CHEMISTRY: • Ozone is a triatomic molecule, Its molecular weight is 47, 98 g/mol. • Thermodynamically highly instable compound. • Medical Ozone is made when medical grade oxygen is electrically activated (using an Ozone Generator) to form ozone. • Medical grade Ozone is a mixture of pure O2 and pure O3 in the ratio of 0.1% to 5% of O3 and 95%-99.5% of O2Ozone Therapy – A New Approach in Periodontal Management, Benita P, Volume 13, Issue 3 Ver. I. (Mar. 2014),
  6. 6. • The ozone concentration may vary between 1 and 100 μg/ml (0.05-5%). • Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. Ozone Therapy – A New Approach in Periodontal Management, Benita P, Volume 13, Issue 3 Ver. I. (Mar. 2014),
  7. 7. How am I produced??? • Thunderstorms • UV rays • Ozone generators
  8. 8. OZONE GENERATORS: • The first ozone generator was developed by Werner Von Siemens in Germany in 1857. • Ultraviolet system • Corona discharge system • Cold plasma system Garg R.K.,Tandon S. 2009.Ozone: A new face of dentistry. The Internet Journal of Dental Science,7(2). DOI: 10.5580/c75
  9. 9. Appliances producing ozone for Dental use • HealOzone by KaVo • OzonyTron by MYMED Gmb H. • Product photo (Prozone) by W&H. Ozone: A Future in Periodontal Therapy, Dr. Chandni Adalja, Volume : 3, Issue : 3, March 2013
  10. 10. How I work??? • “ Transient oxidative burst”.
  11. 11. Am I Allergic to you???
  12. 12. BIOLOGICAL ACTIONS • Anti –microbial action • Anti –inflammatory & analgesic action • Immune-stimulating action • Anti-hypoxic action • Bioenergetic and biosynthetic action
  13. 13. GOALS • Elimination of pathogens. • Restoration of proper oxygen metabolism. • Induction of a friendly ecologic environment. • Increased circulation. • Immune activation. • Simulation of the humoral anti-oxidant system. Mollica P, Harris R. Integrating oxygen/ ozone therapy into your practice. Available from site: www.absoluteozone.com/Ozone_Article_Dentistry_ref.htm
  14. 14. ROUTES OF ADMINISTRATION • Gaseous ozone • Ozonated water • Ozonized oil
  15. 15. Advantages • Disinfectant. • Anti-inflammatory. • Activation of intracellular metabolism of oral mucosa and dental wounds. • Improvement of regional circulation. • Stimulation of regenerative processes. • Hemostasis in capillary bleedings. • Painless procedures.
  16. 16. DISADVANTAGES • Ozone toxicity if the level increases at 0.0007% per application. • Instability. • Not readily available
  17. 17. INDICATIONS • Chronic or recurrent infections in the oral cavity. • Sterilization of cavities, root canals, periodontal pockets, herpetic lesions. • Desensitization of extremely sensitive tooth necks. • Pre-washing of surgical sites. • Plaque control. • Contamination control.
  18. 18. CONTRAINDICATIONS: • Pregnancy – to avoid mutagenic risk. • Hyperthyroidism • Severe anemia • Thrombocytopenia • Cardiovascular instability • Patients on ACE inhibitors
  19. 19. OZONE THERAPY IN PERIODONTICS • Ozonated water (4 mg/l) was found effective for killing gram-positive and gram-negative oral microorganisms and oral Candida albicans in pure culture as well as bacteria in plaque biofilm.
  20. 20. • Thanomsub et al. 2002 tested the effects of ozone treatment on cell growth and ultra- structural changes in bacteria (Escherichia coli, Salmonella sp., Staphylococcus aureus and Bacillus subtilis). It was discovered that ozone at 0.167 mg/min/l can be used to sterilize water, which is contaminated with up to 105 cfu/ml bacteria within 30 min. Destroying of bacterial cell membrane was observed, subsequently producing intercellular leakage and eventually causing
  21. 21. • Ebensberger et al. in 2002 evaluated the effect of irrigation with ozonated water on the proliferation of cells in the periodontal ligament adhering to the root surfaces of 23 freshly extracted completely erupted third molars. • They concluded that the 2 min irrigation of the avulsed teeth with non-isotonic ozonated water might lead not only to a mechanical cleansing, but also decontaminate the root surface, with no negative effect on
  22. 22. • Nagayoshi et al. 2004 tested the efficacy of ozonated water on survival and permeability of oral micro-organisms. • Gram negative bacteria, such as Porphyromonas endodontalis and Porphyromonas gingivalis were substantially more sensitive to ozonated water than gram positive oral streptococci and c. albicans in pure culture. Furthermore ozonated water had strong bactericidal activity against bacteria in plaque biofilm.
  23. 23. • Hems and Gulabivala, 2005 evaluated the potential of ozone as an anti-bacterial agent using Enterococcus faecalis as a test species. • Ozone was used both gasiform (produced by Purezone device), and aqueous (optimal concentrations 0.68 mg/l). • It was concluded that ozone in solutions was antibacterial against planctonic Enterococcus faecalis after 240 s treatment. However it was not effective against
  24. 24. • Ramzy et al. in 2005 irrigated the periodontal pockets by ozonized water in 22 patients suffering from aggressive periodontitis. Periodontal pockets were irrigated with 150 ml of ozonized water over 5-10 min once weekly for a clinical 4 weeks study using a blunt tipped sterile plastic syringe. High significant improvement regarding pocket depth plaque index gingival index and bacterial count was recorded related to quadrants treated by scaling and
  25. 25. • Huth et al. in 2006, in their study declared that the aqueous form of ozone, as a potential antiseptic agent, showed less cytotoxicity than gaseous ozone or established anti microbials (chlorhexidine digluconate [CHX]: 2%, 0.2%; sodium hypochlorite 5.25%, 2.25%; hydrogen peroxide-H2 O2 3%) under most conditions. • Therefore, aqueous ozone fulfills optimal cell biological characteristics in terms of biocompatibility for oral application.
  26. 26. • Muller et al. in 2007 compared the influence of ozone gas with photodynamic therapy (PDT) and known antiseptic agents (2% chlorhexidine, 0.5 and 5% hypocholrate solutions) on a multispecies oral biofilm in vitro. • Actinomyces naeslundii, Veillonella dispar, Fusobacterium nucleatum, Streptococcus sobrinus, Streptococcus oralis and c. albicans were studied. • Gasiform ozone was produced by vacuum ozone delivery system Kavo Healozone. They concluded that the matrix-embedded microbial
  27. 27. • Kshitish and Laxman in 2010 conducted a randomized, double-blind, crossover split- mouth study on 16 patients suffering from generalized chronic periodontitis. • They concluded that despite the substantivity of chlorhexidine, the single irrigation of ozone is quite effective to inactivate microorganisms.
  28. 28. • Fillippi. A observed the influence of ozonized water on the epithelial wound healing process in the oral cavity. It was found that ozonized water applied on daily basis can accelerate the healing rate in oral mucosa.
  29. 29. • Huth, et al. in 2011 compared the effectiveness of ozone with that of the established antiseptic CHX, against periodontal microorganisms. There were no significant differences in the effectiveness of aqueous ozone (20 μg ml [−1]) or gaseous ozone (≥4 g [−3]) compared with 2% CHX but they were more effective than 0.2% CHX. Therefore, high-concentrated gaseous and aqueous ozone merit further investigation as antiseptics in periodontitis
  30. 30. • Dodwad et al. in 2011 compared the effect of oral irrigation with ozonated water, 0.2% Chlorhexidine and 10% Povidone iodine in patients with chronic periodontitis. The study concluded that local ozone application can serve as potent atraumatic, antimicrobial agent to treat periodontal disease non- surgically both for home care and professional practice. It may also serve as good tool during supportive periodontal therapy.
  31. 31. • Sadatullah et al in 2012 analysed the effect of 0.1 ppm ozonated water on 24-hour supragingival plaque (SP) samples. • Ozonated water at the 0.1 ppm concentration was effective in reducing the load of 24-hour plaque bacteria, but it did not eliminate them completely.
  32. 32. • Hayakumo et al in 2012 evaluated the clinical and microbiological effects of NBW3 irrigation as an adjunct to subgingival debridement for periodontal treatment. • The present study suggests that subgingival irrigation with NBW3 may be a valuable adjunct to periodontal treatment.
  33. 33. • Yilmaz et al in 2013 evaluated the clinical and microbiological results of treatment with the Er:YAG laser and topical gaseous ozone application as adjuncts to initial periodontal therapy in chronic periodontitis (CP) patients. • ozone has an antimicrobial effect equivalent to that of the Er:YAG laser.
  34. 34. • Punit vaibhav et al in 2013 in a case report A 42-years female patient was selected, who presented with a mild to moderately painful, exophytic, fibrous lesion on the upper anterior gingiva. • Topical ozone therapy provides potential benefits for the treatment of exophytic gingival lesions.
  35. 35. • Shoukheba et al in 2014 evaluated the effect of subgingival application of ozonated olive oil gel as an adjunct to scaling and root planing (SRP) in aggressive periodontitis. • The study concluded that (Oxactiv) gel could be a promising adjunct to SRP in the treatment of aggressive periodontitis.
  36. 36. • Habhasneh et al in 2014 aimed to determine the clinical and biological effects of the adjunctive use of ozone in nonsurgical periodontal treatment. • Irrigation with ozonated water as an adjunctive therapy to SRP produces no statistically significant benefit compared with SRP plus distilled water irrigation.
  37. 37. • Kl Vandana et al in 2015 assessed the effect of chlorhexidine (CHX), povidone iodine (PI), and ozone (OZ) on the microorganisms in dental aerosols. • The study concluded that CHX, PI and OZ showed similar effects in reducing aerobic and anaerobic CFU's at the chest mask and at 9 ft. OZ can be used as a preprocedural agent, considering its beneficial effects.
  38. 38. OZONE FOR TREATMENT OF PERIIMPLANTITIS • El Hadary et al in 2011 evaluated the effect of ozonated oil under the influence of cyclosporine A in bone integration of dental implants. • The administration of short term cyclosporine together with the topical application of ozonated oil may influence bone density.
  39. 39. • Hauser gerspach et al in 2012 investigated the antimicrobial efficacy of gaseous ozone on bacteria adhered to several surfaces of titanium and zirconium. • Ozone treatment was carried out with an ozotop unit, 140ppm; 2L/min for 6-24 sec. p. gingivalis was eliminated in 24 seconds with ozone. S Sanguinis was more resistant and showed greater reduction in zirconium substrates.
  40. 40. • Mc Kenna et al in 2013 assessed the effect of subgingival ozone and/ or H2O2 on the development of peri implant Mucositis. • ozone showed great potential for management of peri implant Mucositis.
  41. 41. OZONE TOXICITY • Ozone inhalation can be toxic to the pulmonary system and other organs. • Known side-effects are upper respiratory irritation, rhinitis, cough, headache, occasional nausea, vomiting, shortness of breath, blood vessel swelling, poor circulation, heart problems and epiphora.
  42. 42. OZONE INTOXIFICATION • Patient must be placed in supine position • Inhale humid oxygen • Ascorbic acid • Vitamin E • Acetylcystein
  43. 43. CONCLUSION • Ozone therapy allows a new vision, which complies with needs and demands of the public for non-invasive, effective periodontal care and it is truly a paradigm shift in dental practice. • Treating patients with ozone cuts off treatment time, eliminates bacterial count more precisely and moreover, it is completely painless resulting increased acceptability and compliance of the patient. • Further research in ozone would bring a
  44. 44. References: • Clinical and microbiological effects of ozone nano-bubble water irrigation as an adjunct to mechanical subgingival debridement in periodontitis patients in a randomized controlled trial, Sae Hayakumo, Clinical Oral Investigations March 2013, Volume 17, Issue 2, pp 379-388. • Effect of chlorhexidine, povidone iodine, and ozone on microorganisms in dental aerosols: Randomized double-blind clinical trial, Ravleen Kaur, Year : 2014,Volume : 25,Issue : 2, Page : 160-165. • Ozone Therapy : A New Revolution In Periodontics, Dr. Pradeep Chitnis, IJRD, May, 2013 Vol 2 Issue 5. • The antimicrobial effect of 0.1 ppm ozonated water on 24-hour plaque microorganisms in situ, syed sadatullah, Braz. oral res. vol.26 no.2 São Paulo Mar./Apr. 2012
  45. 45. • Ozone and its use in periodontal treatment, open journal of stomatology, 2013,3, 197-202. • Ozone in periodontics, natural remedy in dentistry, journal of dental herald, 2014. • Current concepts of oxygen ozone therapy for dentistry, john a rotchfield. • Ozone therapy: a new paradigm in periodontis, journal of advanced medical and dental sciences research, 2014. • Ozone in dentistry: microbiological effects of gas action depending on the method and the time of application on using the ozonytron device, experimental study, katarzyna, annals academiae mcdial, 2011. • The effect of subgingival ozone and or H2O2 on the development of periimplant mucositis: a double blind randomized controlled trial, danial f Mc Kenna, the inernational journal of oral and maxillofacial implants.

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