Ozone Information For Clinicians - Dental

Evidenced Based Research - References.

© Dr Julian Holmes
2015


Ozone Information

  • Evidenced Based Research into Ozone Treatment in Dentistry – An Overview.
  • 1H NMR Studies on Caries Biomolecules
  • Comparison of Diagnostic Techniques
  • Assessment of Anxiety & Fear
  • Treatment of Primary Root Carious lesions
  • Treatment of Pit and Fissure Carious Lesions
  • Treatment of Primary/Deciduous Teeth
  • Treatment of Occlusal Caries with Ozone
  • Combining Ozone Treatment with Other Preparation Systems
  • Ozone in Endodontics
  • Cost Benefits of Ozone Treatment
  • Treatment of Dental Unit Water Lines (DUWL)
  • Effects of Ozone on Dental Materials
  • OHManagement Software for Patient Management
  • Other References
  • 1H NMR Studies on Ozonated Oils
  • 1H NMR Studies on Tooth Whitening

  • Evidenced Based Research - References.

    Referenced Published Research

    1H NMR Studies on Caries Biomolecules

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    1 Lynch E, Smith E, Baysan A, Silwood C J, Mills B, Grootveld M. Salivary Oxidising Activity of a Novel Anti-bacterial Ozone-generating Device. Journal of Dental Research 2001; 80:132001n/an/an/an/an/an/an/a
    2 C.J.L. Silwood and M. Grootveld. Surface Analysis of Novel Hydroxyapatite Bioceramics Containing Titanium (IV) and Fluoride. IADR Abstract 20022002n/an/an/an/an/an/an/a
    3 Lynch E, Silwood CJL, Smith C, Grootveld M. Oxidising actions of an Anti-Bacterial Ozone-Generating Device towards Root Caries Biomolecules. IADR Abstract 20022002n/an/a5 SecondsPrimary Root Caries Biomoleculespyruvate oxidised to acetate and CO2n/an/a
    4 Claxson AWD, Smith C, Turner MD, Silwood CJL, Lynch E, Grootveld M. Oxidative Modification of Salivary Biomolecules with Therapeutic Levels of Ozone. IADR Abstract 2002n/an/an/a10 SecondsMultiComponent Analysis shows chemical pathways of ozoneshows oxidation of VSC's, & Pyruvaten/an/a
    5 Lynch E, Silwood CJ, Abu-Naba'A L, Al Shorman H, Baysan A, Holmes J and Grootveld M. Oxidative Consumption of Root Caries Biomolecules using Ozone. IADR Abstract 2003.2003303030 SecondsMulticomponent analysis of root caries by high field 1H -NMR spectroscopy provides useful information regarding the oxidation of PRCL biomolecules by O3.shows oxidation of VSC's, & Pyruvaten/an/a

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    Comparison of Diagnostic Techniques

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    6 Abu-Naba'a L, Al Shorman H, Lynch E. The Effect of Ozone Application on Fissure Caries QLF Readings. IADR Abstract 2002.20020242 QLF readings20 SecondsOcclusal Fissure Caries on extracted teethQLF readings correlated with histological examn/aNone
    7 Megighian GD, Bertolini L. In vivo Treatment of Occlusal Caries with Ozone: One and Two Months' Effect with Light-induced Fluorescence (QLF) as Diagnostic Methods. IADR Abstract 2003.20038030020,30 & 40 secondsPrimary Occlusal Fissure Carious Lesions80% reduction of QLF at 1 month, and 90% reduction at 2 months2 monthsNone
    8 Marashdeh MM, Abu-Salem OT, Lynch E. Ozone Treatment of Occlusal Caries in Primary Teeth: Immediate Effects and Correlation of Diagnostic Methods. IADR Abstract 2003.2003175010 SecondsOcclusal Caries Primary TeethReduced DIAGNOdent Readings after ozone treatmentn/aNone
    9 Abu-Naba'a L, Al Shorman H, Lynch E. Immediate Effect of Ozone Application In-vivo on DIAGNOdent Readings. IADR Abstract 2004.20049039410 SecondsPrimary Occlusal Pit & Fissure CariesOzone immediately reduced Diagnodent vales (p<0.05)n/aNone

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    Assessment of Anxiety & Fear with Ozone Treatment v Traditional Dental Amputation Therapy

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions
    10 Dahnhardt JE, Jaeggi T, Scheidegger N, Kellerhoff N, Francescut P, Lussi A. Treating Caries in Anxious Children with Ozone: Parents' Attitudes after the First Session. IADR Abstract 2003.200320n/an/an/aozone + ART. 75% afraid of dental care before ozone treatment, 75% would recommend to relative/friend. 80% willing to pay more v. drill&filln/aNone
    11 Johnson N, Johnson J, Johnson K, Abu-Naba'a L, Al Shorman H, Freeman R, Lynch E. Patients’ Attitudes to Dental Treatment Using Ozone vs. Conventional Treatment. IADR Abstract 2003.2003100n/aozone treatment v drill&fillAll Lesionsozone reduces anxiety and fear of dental treatmentn/aNone
    12 Domingo H, Abu-Naba'a L, Al Shorman H, Holmes J, Marshdeh MM, Abu-Salem AT, Smith C, Freeman R, Lynch E. Reducing Barriers to Care in Patients Managed with Ozone. IADR 2003.2003377n/a20 secondsall lesions99% happy with ozone treatment, 97% happy with the time taken, 100% would like ozone treatment again, 99% were not anxious after ozone treatment3 monthsNone
    13 Megighian GD, Dal Vera M. Reducing Barriers to Care in Patients Managed with Ozone in a General Dental practice in Italy. IADR Abstract 2003.2003250n/an/aall lesion types100% happy with ozone treatment, 100% would recommend, 80% reduced anxiety6 monthsNone
    14 Domingo H, Abu-Naba'a L, Al Shorman H, Holmes J, Marshdeh MM, Abu-Salem AT, Freeman R, Lynch E. Reducing Barriers to Care in Patients Managed with Ozone. IADR Abstract 2004.200420 studiesn/an/an/a83% - 99% Caries Reversaln/aNone
    15 Abu-Naba'a L, Al Shorman H, Lynch E. Patient's Attitude to Treatment of Pit and Fissure Caries with Ozone. IADR Abstract 2004.200449n/an/aPit and Fissure Caries98% happy with treatment, 94% happy with time, 94% would choose ozone even if higher fee. 100% would choose ozone treatment again, and 100% not anxious after ozone treatment6 monthsNone

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    Treatment of Primary Root Carious lesions

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions
    16 Baysan A & Lynch E. Treatment of Primary Root Carious Lesions using Ozone for either 10 or 20 Seconds In Vivo. IADR Abstract 2001.2001267010 or 20 SecondsRoot caries10 seconds reduced CFU's from 7.0 to 4.35 Log10. 20 seconds reduced 6.0 to 0.46 Log10n/aNone
    17 Baysan A & Lynch E. Treatment of Primary Root Carious Lesions using Ozone for either 10 or 20 Seconds In Vivo. IADR Abstract 2001.2001267010 or 20 SecondsRoot caries10 or 20 seconds treatment time showed significant changesn/aNone
    18 Baysan A, Lynch E. Management of root caries using ozone in-vivo. Journal of Dental Research 2001; 80:3720018021410 secondsRoot caries30.9% S2 to S0, 34% S2 to S13 monthsNone
    19a Holmes J. Clinical reversal of root caries using ozone, double-blind, randomised, controlled 18-month trial. Gerodontol 2003: 20 (2): 106-14 200220028917840 secondsRoot caries100% reversal of treated Lesions 18 months18 monthsNone
    19b Holmes J. Ozone Treatment of Root Caries after 21-Months. IADR Abstract 2004.20048917840 secondsRoot caries100% reversal of treated Lesions 21 months21 monthsNone
    20 Baysan A & Lynch E. Clinical Assessment of Ozone on Root Caries. IADR Abstract 2004.20048022620 secondsRoot Caries47% S1 to S0, 52% S2 to S112 monthsNone
    21 Baysan A. Management of Primary Root Caries using Ozone Therapies. PhD Thesis, University of London, 2002.2002n/an/an/an/an/an/an/a
    22 Baysan A, Lynch E. Safety of an ozone delivery system during caries treatment in-vivo. Journal of Dental Research 2001; 80: 1159-1159. 20012001n/an/an/an/an/an/an/a

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    Treatment of Pit and Fissure Carious Lesions

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions
    23 Abu-Naba'a L, Al Shorman H, Lynch E. Ozone Efficacy in the Treatment of Pit and Fissure Caries. J. Dent Res. 2002; abstract.2002n/an/an/an/an/an/aNone
    24 Abu-Naba'a L, Al Shorman H, Stevenson M, Lynch E. Ozone Treatment of Pit and Fissure Caries: 6-month Results. IADR Abstract 2003.20037824010 secondsPit & Fissure Caries100% successful remineralisation6 monthsNone
    25 Abu-Naba'a L, Al Shorman H, Lynch E. Ozone Treatment of Primary Occlusal Pit and Fissure Caries (POPFC): 12-Months Clinical Severity Changes. IADR Abstract 2003.200312925810 secondsPrimary Occlusal Pit and Fissure CariesTreated lesions got better 0.018±0.05, 0.216±0.06* and 0.283±0.06*, while control lesions got worse 0.079±0.04*, 0.294±0.07 and 0.443±0.0712 monthsNone
    26 Holmes J, Lynch E. Arresting Occlusal Fissure Caries Using Ozone. IADR Abstract 2003.2003278127510, 20, 30 or 40 SecondsPrimary Occlusal Pit & Fissure Caries93% clinical reversal of treated lesion, control lesions did not change or got worse12 monthsNone
    27 Abu-Naba'a L, Al Shorman H, Lynch E. Ozone Treatment of Primary Occlusal Pit and Fissure Caries: 12-month ECM results and Clinical implications. IADR Abstract 2003.203 12925810 secondsTrt ECM change ranged from 0.02 to 0.62 (average 0.30 ±0.009) and Ctrl ranged from 0.07 to -0.27 (-0.13±.009).Difference between groups ranged from 0.22 to 0.56 (p<0.05 at 4 recalls).12 monthsNone

    28 Reaney D, Lynch E. Clinical Reversal of Pit and Fissure Caries After Using Ozone. IADR Abstract 2003.

    2003227830 secondsPrimary Pit & Fissure Carious Lesion74.4% ozone treated teeth clinically reversed 100% stable or reversed. 82% control lesions got worse1 monthsNone

    29 Daly T, Lynch E. Reversal of Occlusal Pit and Fissure Caries by Ozone. IADR Abstract 2003.

    2003585830 secondsPrimary Occlusal Fissure Carious Lesions62% lesion reversal (p=<0.05)10 weeksNone

    30 Stinson P. Clinical Reversal of Occlusal Pit and Fissure Caries after Using Ozone IADR Abstract 2003.

    2039827930 secondsPrimary Occlusal Fissure Carious Lesions84% lesion reversal with ozone (p<0.05)3 monthsNone
    31 Holmes J. Clinical Reversal of Occlusal Pit and Fissure Caries Using Ozone. IADR Abstract 2003.2003376236410,20,30, or 40 secondsPrimary Occlusal Fissure Carious Lesions99% reversal12 monthsNone

    32 Jackson P, Lynch E. Healing of Pit and Fissure Caries after Using Ozone. IADR Abstract 2003.

    2037813030 secondsPrimary Occlusal Fissure Carious Lesions68% reversal / stable3 monthsNone

    33 Johnson N, Johnson J, Johnson K, Lynch E. Healing of Pit and Fissure Caries after Using Ozone. IADR Abstract 2003.

    2003359020 secondsPrimary Occlusal Fissure Carious Lesions59% reversal, 41% stable, none got worse1 monthNone

    34 Johnson N, Johnson J, Johnson K, Lynch E. Effective Treatment of Occlusal Fissure Caries Using Ozone. IADR Abstract 2003.

    200310530020 secondsOcclusal Fissure Caries81% lesion reversal p<0.05). 17% remained stable1 monthNone

    35 Abu-Naba'a L, Al Shorman H, Lynch E. 6-month Clinical Indices Changes after Ozone Treatment of Pit and Fissure Caries (PFC). IADR Abstract 2003.

    200383440 secondsPrimary Occlusal Fissure Carious Lesionslesions reversed using clinical criteria indices (p<0.05)6 monthsNone

    36 Morrison R & Lynch E. Remineralisation of Occlusal Pit and Fissure Caries After Using Ozone. IADR Abstract 2003.

    200310818640 secondsPrimary Occlusal Fissure Carious Lesions80.5% lesion reversal, 100% stability, no progression in ozone treated group 13 weeksNone

    37 Hamid A. Clinical Reversal of Occlusal Pit and Fissure Caries Using Ozone. IADR Abstract 2004.

    2004929240 secondsPrimary Occlusal Fissure Carious Lesions86.6% reversal6 monthsNone

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    Treatment of Primary/Deciduous Teeth

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions

    38 Abu-Salem OT, Marashdeh MM, Lynch E. Ozone Efficacy in Treatment of Occlusal Caries in Primary Teeth. IADR Abstract 2003.

    2003164210 secondsOcclusal Carious LesionsECM improved (p<0.05) and Diagnodent improved (p<0.05)6 monthsNone

    39 Abu-Salem OT, Marashdeh MM, Lynch E. Ozone Efficacy in Treatment of Occlusal Caries in Primary Teeth. IADR Abstract 2003.

    2003175010 secondsOcclusal Caries + Air AbrasionECM readings increased in test v control (p=<0.05)3 monthsNone

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    Treatment of Occlusal Caries with Ozone

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions
    40 Morrison R, Lynch E. Efficacy of Ozone to Reverse Occlusal Caries. IADR Abstract 2003.200314524040 secondsPrimary Pit & Fissure Caries96% treated lesions reversed, none got worse13 weeksNone
    41 Cronshaw MA. Treatment of Primary Occlusal Pit and Fissure Caries with Ozone: Six-month Results. IADR Abstract 20042004184930 secondsPrimary Occlusal Fissure Carious Lesions89% clinical reversal of ozone treated lesions6 monthsNone

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    Combining Ozone Treatment with Other Preparation Systems

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type;% Success;Follow-up Period;Adverse Reactions
    42 Clifford C. Successful Use of Airbrasion in Conjunction with Ozone Treatment. IADR Abstract 2003.2003374840 secondsInterproximal Carious lesionsTreatment faster than drill&fill (p<0.05) and allows other cavity types to be treated3 monthsNone

    43 Clifford C. Reversal of Caries Using Airbrasion and Ozone- Nine Month Results. IADR Abstract 2004

    2004346840 secondsApproximal lesion100% reversal with hardened tissue9 monthsNone
    44 Holmes J & Lynch E. Reversal of Occlusal Caries using Air Abrasion, Ozone, and Sealing. IADR Abstract 20042004387640 secondsOcclusal Caries100% reversal3 monthsNone

    45 Holmes J. Restoration of ART and Ozone treated primary root carious lesions. IADR Abstract 2004.

    20046012020 secondsPrimary Root CariesART & Ozone lead to no pulp exposures, retained full vitality and strength of tooth. Drill&Fill lead to pulp exposures and further RCT was required before review period.6 monthsNone

    46 Domingo H, Holmes J. Reduction in treatment time with combined air abrasion and ozone compared to traditional ‘Drill & Fill’. IADR abstract 2004.

    20046412840 secondsPrimary Root CariesAA & Ozone was faster than Drill&Fill. AA was more profitable than D&F6 monthsNone

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    Ozone in Endodontics

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions

    47 Chang H, Fulton C, Lynch E. Antimicrobial Efficacy of Ozone on Enterococcus faecalis. IADR Abstract 2003.

    2003n/an/a60, 30, 20, 10, 0 seconds108 solution E Faecalis 60= 0 cfu's, 30= 0 cfu's, 20= 0 cfu's, 10= 0 cfu's at 106 and 105 concentrations. Higher concentrations were markedly reducedn/aNone

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    Cost Benefits of Ozone Treatment

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions

    48 Johnson N, Johnson J, Lynch E. Cost Benefit Assessment of a Novel Ozone Delivery System vs. Conventional Treatment. IADR Abstract 2003.

    2003 48n/an/aOcclusal and Root Carious LesionsOzone tooth 3 minutes max, conventional drill&fill 20 minutes minimum. Ozone treatment takes less time and cost (p<0.05)n/aNone

    49 Domingo H, Holmes J. Reduction in treatment time with combined air abrasion and ozone compared to traditional ‘Drill & Fill’ and cost comparison. IADR abstract 2004.

    200464 12840 SecondsPrimary Root CariesAA & Ozone was faster than Drill&Fill. AA was more profitable than D&F6 monthsNone

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    Treatment of Dental Unit Water Lines (DUWL)

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    50 Cardon B, Eleazer P, Miller R, Staat R. Low concentration ozone treatment insufficient to control DUWL biofilm. IADR Abstract 2002.2002n/an/aOzone conc. 0.05ppm DUML samplesNo Effects Seen10 weeksNone
    51 Al Shorman, Abu-Naba'a, Coulter W, Lynch E. Ozone, An Effective Treatment For Dental Unit Water Lines. IADR Abstract 2002.2002n/an/a3 minutes, at 2100ppm ozone 615 ml/min DUWL flushed for 2 minutesOzone treatment showed reduction from 5.2*103 CFU/ml to 300 CFU/ml after first application, then 0 CFU/ml at seconds and subsequent application.8 daysNone
    52 Al Shorman, Abu-Naba'a, Coulter W, Lynch E. Primary Colonization of DUWL by P. aeruginosa and its Eradication by Ozone. IADR Abstract 2003.2003n/a n/a5 minutesDental Unit Water LinesReduced DUWL count <100 CFU's/ml at 2 weeksreduced to 0 CFU's/ml v2 weeksNone

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    Effects of Ozone on Dental Materials

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    53 Campbell D, Hussey D, Cunningham L, Lynch E. Effect of Ozone on Surface Hardness of Restorative Materials. IADR Abstract 2003.200318310 SecondsRestorative MaterialsOzone has no effect on material hardness n/aNone
    54 Abu-Naba'a L, Al Shorman H, Lynch E. 6-months Fissure Sealant Retention Over Ozone- treated Occlusal Caries. IADR Abstract 2003.200353 6610 SecondsPrimary Occlusal Fissure Carious LesionsOzone treatment followed by immediate sealant placement was not detrimental to retention rate.6 monthsNone

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    OHManagement Software for Patient Management

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    55 Scholz V. OHManagement Software for quality management in an ozone treatment practice. IADR Abstract 20042004n/a n/a10 clinics operating with new OHManagement Software, compared to no OHMn/aPatient recall attendance (53% v 44%) and compliance (84% v 75%) were better with the new OHMn/an/a

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    Other References

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period;Adverse Reactions
    56 Bocci V. Ozone as a bioregulator. Pharmacology and toxicology of ozone therapy today. J Biol Regul Homeost Agents 1996; 10: 31-53.1996n/an/an/an/an/an/an/a
    57 Baysan A, Lynch E, Grootveld M. The use of ozone for the management of primary root carious lesions. Tissue Preservation and Caries Treatment. Quintessence Book 2001, Chapter 3, 49-67.2001n/an/an/an/an/an/an/a

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    1H NMR Studies on Ozonated Oils

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period; Adverse Reactions

    58 Lynch E, Grootveld M, Holmes J, Silwood CJ, Claxson AWD, Prinz J, Toms HB. 1H NMR Analysis of Ozone-treated Grapeseed, Olive, and Sunflower Seed Oils. IADR Abstract 2003

    2003n/an/a10 MinutesOzonated Oils Comparisonozonides are likely to account for anti-microbial qualities of ozonated vegetable oilsn/aNone

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    1H NMR Studies on Tooth Whitening

    Study Title;Study Date;Subjects Number;Teeth Number;Ozone Time(Seconds);Caries Type; % Success;Follow-up Period; Adverse Reactions
    59 Holmes J, Grootveld M, Smith C, Claxson AWD, Lynch E. Bleaching of Components Responsible for Extrinsic Tooth Discoloration by Ozone. IADR Abstract 2003.2003n/an/a10,20 seconds, 10 & 20 minutestooth stain removal (Melanoidins) bleaching effect with ozonetreatment time None

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    January 2015
    The-O-Zone © Dr Julian Holmes