Ozone in Dentistry - A Paradigm Shift

Abstract Today we are suffering from one problem or another repeatedly. Given this situation, how would it sound if someone says that one can cure any health hazard by using some home ingredients after following some small procedures? Wouldn't it be great? This article will elaborate on how to prepare a one stop solution for your problems - ozonated olive oil - at home, its benefits and also its application in dentistry. Introduction Ozone is basically a protective shield of earth which protects us from harmful UV radiations. It also helps to control air pollution. Symbol of Ozone is O3 .It contains three atoms of oxygen molecules. We all have felt many a times, a particular fresh smell after every rainfall - that is because of Ozone only. The first Ozone generator was developed by Werner Von Siemens in Germany in 1857 and in 1870 there is the first report therapeutically of Ozone being used to purify blood by C Lender in Germany. In 1881, certain evidences were found for use of Ozone as a disinfectant which was mentioned by in a book on Diphtheria. The world’s first water treatment plant using Ozone was installed in Ousbaden Holland in 1893. Ozone was used medically to treat wounds and other infections during World War 1. The name ozone was given to a gas (a Greek word that means "smell") by the German chemist Christian Frederick Schonbein of the University of Basel in Switzerland 1840 (Seidler et al.; Veranes et al., 1999).2 Medical grade Ozone is a mixture of pure of three atoms of oxygen versus two atoms in a normal oxygen molecule.1 Due to presence of this extra oxygen atom, Ozone has anti-microbial properties, it act as a stimulator for immune system, act as a analgesic, has anti- hypnotic properties, antibacterial and anti-fungal properties. Due to its properties, it is used for sterilisation and disinfection. It is nowadays used in every field including medical, veterinary and dental field also. Ozone has these amazing properties due to which dentists are ready to transform and become the part of revolutionary ozone therapy by using Ozone in very controlled application. Generation of Ozone There are three different systems of generating Ozone gas.

1. The Ultra violet system which produces low concentrations of Ozone used in aesthetics and air purification.
2. Cold plasma system used to purify air and water.
3. Corona discharge system produces high concentration of Ozone. 1

The bacteria and viruses lack protective layers. So Ozone can easily penetrate and play a role of antibacterial property here. Whereas, healthy normal cell contain their protective layers, so Ozone causes no harm to it. The ozone oxidant potential induces the cellular walls destruction and cytoplasmic membranes of bacteria (Thanomsub et al., 2002). 2 How to make ozonated Olive Oil at home? Yes, it’s possible to prepare Ozonated olive oil at home. For this, high quality extra-virgin oil is required. This extra-virgin olive oil is putting through the process of ozonation. Because Ozone is hard to stabilize, passing it through a tight container with lead helps, after which Ozone gas begins to stabilize in olive oil. An Ozone generator is required ideally to create Ozonated olive oil because Ultraviolet machines are not quite strong and effective to prepare Ozonated olive oil. Place olive oil in the glass jar or in a container that comes along with generator. The jar should be connected to the generator and should be covered before the generator is turned on. Initially tiny bubbles will appear on the top of jar which signifies the process of Ozonation has begun. This process is time consuming and when the color of the olive oil becomes clear and thick, it indicates the complete formation of Ozonated olive oil. This Ozonated olive can be stored easily. Among the various systems of ozone production, coronal discharge system is used for the production of ozone gas in ozone generator. It releases high concentration of oxygen which is required for antimicrobial and healing properties in medical and dental field. The other system of ozone production is cold plasma system, ultraviolet system, electrolyte system which is low concentration ozone generation (below 2 ppm) used for air purification and water purification and not same as coronal discharge. So, Coronal discharge system is comparatively much batter then others. Properties of Ozone

• Immunostimulator
• Antimicrobial
• Disinfectant and used in sterilisation
• Analgesic
• Anti-inflammatory and natural antibiotic
• Ozonated olive oil can be use for cosmetic purpose and has a fast healing effect.

Various forms used in Dentistry

1. Gaseous Ozone: Gaseous form is used to sterilise instruments, disinfection of instruments and surfaces, sterilisation of lesions, cavities & in RCT, for air purification in clinic.
2. Injectable ozone: This form is used for fast healing in surgeries cases, trauma, implant placements, fracture, large lesion, intralesional injections, submucosal injections.1
3. Aqueous: This form is used to purify water, as a carrier medium for grafts, hair follicles.
4. It replaces antibiotics and analgesics
5. Ozonated activation of NaOCL, EDTA, grafts at site in oral cavity, activation of grafts during hair transplants.

Application of Ozone in Dentistry

• Periodontics: It is used for complete oral prophylaxis which includes scaling and root planing. It can be recommended for patients to cure hypersensitivity and as a mouth rinse also. In periodontal diseases, the gingival, sulcus and pocket depth can be irrigated with ozonated water and ozonated gas . For some lesions, ozonated oil is recommended for topical application. Single visited inflamed lesion can be cured.
• Aesthetic dentistry: It is used for topical application on scars of skin for effective healing. It is used as a hemostat, to control bleading during surgical procedure and to disinfect cavities and margins of the lesion.
• Endodontics: Ozonated water can be used to irrigate the canals. To sterilise the canal ,ozonated olive oil works efficiently. Infected canals with complete remission of periapical lesion is also treated with ozonetherapy. With its direct application it prevent caries on tooth,which is applied with the help of silicon cups.1
• Oral surgery: No worries after extraction, because of ozonetherapy! It accelerates the process of healing after surgical procedure without complications. In case of noninvasive surgical procedure, pre and postsurgical cycles of Ozone therapy can be conducted. These cycles consist of eight sessions lasting for about 3 minutes each. Besides this, its antibiotic and anti fungal therapies have been applied for the treatment of bisphosphonate induced osteonecrosis of jaw.1
• Prosthodontics: In case of edentulous patients, to cure the ulcers because of impingement of denture, ozone gives magical effects if topically applied. Ozone is also used to disinfect the denture due to it properties. Also ozonated water is used to disinfect the crown and bridges. To prepare a vital tooth, as a desensitizer, ozone can be use.
• Oral medicine: It provide relief from ulcerated oral mucosal lesions. Intralesional injection and topical application both gives positive results. It is used as a carrier medium to carry a graft for biopsy and further surgical procedures.
• Orthodontics: During orthodontic treatment there are more chances of caries as there is more chance of food accumulation. To prevent caries, patients are given mouth rinses with ozonated water.
• Implants: It is used to disinfect the surgical area and surgical instruments as well. After the surgical procedure, a controlled amount of ozonated oil is used and applied on the surgical area. It promoted the healing without complications. In case of peri-implantitis, ozone therapy is indicated as it have antimicrobial, antibacterial properties. A study of gaseous Ozone showed the selective efficacy to reduce adherent bacteria on Titanium and Zirconia implants without any interferences in their adhesion properties. It also induced proliferation of osteoblastic cells. Ozone eliminates Porphyromonas gingivalis from all surfaces with in 24 sec to below the detection limit (99.94%), while Streptococcus sanguis showed the highest reduction on zirconia substrates (90%) and was more resistant. 3

Conclusion Ozonated oil has some amazing properties and gives excellent results. It is used in every field related to human care and medical science due to its unique properties. All its properties are due to the presence of enriched oxygen. Ozonated olive oil even can be prepared at home. By using ozone therapy in dentistry, treatment time is reduced and side by side it reduces the complications along with fast healing effect on the operating site. This new era of ozone world may change the way we treat patients in the future.