Aqueous versus gaseous ozone, what is the most effective adjunct to periodontal treatment? A systematic review

Abstract

Objective: To assess the effectiveness of using aqueous and gaseous ozone in the gingival tissues of periodontitis patients. Materials and Methods: Two independent reviewers searched electronic databases (Lilacs, PubMed, Scopus, and Web of Science) using keywords specific to the topic. The variables extracted from each selected article included: type of study, sample size, population, periodontal parameters, and age. The eligibility criteria included randomized clinical trials analyzing the effectiveness of ozone (aqueous or gaseous) as an adjunct to periodontal treatment. Results: After applying the inclusion and exclusion criteria, 1,203 articles were initially selected from the databases. From 926 studies selected by the title, 11 articles were considered appropriate for the present study, with the majority being classified with a low risk of bias. It was found that the two forms of ozone (aqueous and gaseous) provided clinical benefits to the treatment of periodontitis, but aqueous ozone is safer regarding toxicity. Conclusion: Given the results obtained, when compared to a negative control group, aqueous ozone was superior, and when compared to chlorhexidine (CHX), aqueous ozone had similar effects as adjunct in the periodontal treatment. Clinical relevance: Using aqueous ozone can help to safely eliminate bacterial pathogens, improving the periodontal treatment, without side effects, compared to CHX.