Major approaches to ozone therapy in endodontic treatments for bone infections and necrosis: a systematic review

Abstract

Introduction: The bacterium Staphylococcus aureus is, in most cases, the agent of the disease. Thus, inflammation of the bone marrow can cause compression of the bone tissue walls and decrease or blockage of blood supply in the region's blood vessels, which can induce bone necrosis. Clinical studies have demonstrated the efficiency of ozone therapy in the treatment of peritonitis, infected wounds, and advanced ischemic disease. Objective: It was demonstrate the main scientific findings of the use of antiseptic ozone therapy in endodontic treatment. Methods: The research was carried out from July to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and 57 articles were evaluated and 29 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.8% >50%. Ozone therapy is scientifically proven and demonstrated in this work, it proved to be effective for tissue repair and the prevention and treatment of bone necrosis. It was observed that patients undergoing chemotherapy, radiotherapy, and antiresorptive drugs are more affected by bone necrosis. It was also observed the importance of the patient feeling that the treatment works and is restoring his ability to reinvent himself and adapt to his social environment. Treatments should not only be based on established numbers and protocols, without analyzing the specific sensations and perceptions of each patient with their lived reality.