OZONE THERAPY

UNDER GUIDED BY:

PRESENTED BY :DR.MONIKA PANDEY

M.D.S. 1ST YEAR

A REVOLUTIONARY NON INVASIVE THERAPY IN DENTISTRY

CONTENT:1. Introduction2. History 3. Mechanism of action4. Dental ozone generators5. Ozone administration6. Indication 7. Clinical application of ozone8. Ozone toxicity 9. Cure for ozone toxicity10.Contraindication 11.Conclusion

INTRODUCTION:

•For over 130yrs, millions of people have benefited from the effects of ozone to eliminate disease and encourage natural healing.

• It is a blue gas, with strong odour and most important gas in the stratosphere due to its ability to filter UV rays which is critical for maintenance of biological balance in the biosphere.

•In nature, ozone is formed by combination of oxygen in the air under the influence of factors such as UV radiation (from the sun), electrical discharges(lightening) and intense physical stress on water (such as water falls & ocean waves crashing onto rocks).

• ozone in stratosphere has a critical role in both the thermal structure of the stratosphere as well as the ecological framework for life on the Earth’s surface

•Occupational exposure to ozone occurs through its production by office photocopying equipment, electric arc welding, mercury vapour lamps, laser printers, X-ray generators and high voltage electrical equipment etc.

•Ozone therapy was used extensively to treat infections, battle wounds and in routine treatment of cancer up to 1950’s. But later the advent of chlorine water sterilization which is more economical declined the use of ozone .

•However research is showing that this ‘old’ technology has a very important role to play in medical and dental treatment especially with the development of multiple resistant microorganisms to antimicrobials.

• Medical grade ozone is made from pure medical oxygen because oxygen concentration in the atmospheric air is variable

• O3 is a powerful oxidant capable of interacting as metabolic & immune modulator as well as anti-microbial agent. Multiple microbiological & the biochemical studies justified that there are no doubts about the effectiveness of ozone in bacterial reduction

There are three different systems for generating

ozone gas.1. Ultra violet system: produces low concentrations of

ozone, used in aesthetics & for air purification.

2. Cold plasma system: used in air and water purification.

3. Corona discharge system: produces high concentrations of ozone. It is the most common system used in the medical/dental field.

HISTORY:

• Christian Friedrich Schönbein (1840), a German Chemist, is regarded as the Father of ozone therapy. When he passed an electrical discharge through water, a strange smell was produced, which he called Ozone, derived from the Greek word ‘OZEIN’ which means odor.

• In 1857 Joachim Hänsler, a German physicist and physician, along with German physician,developed the first ozone generator for medical use.

• In 1860,Monaco first used it in water treatment plants .

•Dr. C. Lender in 1870. He purified blood in test tubes by using O3 . Later, O3 application gained as a popularity as a therapeutic procedure throughout Europe and America

• In 1881, it was used as a disinfectant in the treatment of diphtheria.

• In October 1893, Ousbaden, Holland became the first city to utilize a water treatment plant using ozone.

• In World War I and II it was used to treat wounded

soldiers in the trenches .

• In early 20th century Food and Drug Act, revised its use and effect in the field of medicine.

• A German dentist, Dr. E.A. Fisch, in 1950, used ozonated water for dental procedures and pioneered its use in medicine.

MECHANISM OF ACTION:•There are several actions of ozone such as anti-microbial,

anti-inflammatory, analgesic, immune stimulating, anti -hypoxic, detoxicating, bio-energetic and biosynthetic (activation of the metabolism of carbohydrates, proteins & lipids) actions.

Anti–microbial action: The antibacterial effect of ozone occurs as a result of its

oxidant action on cells by damaging its cytoplasmic membrane due to ozonolysis of dual bonds. It does not damage healthy human body cells because they have superoxide ,catalase, hydrolase and antioxidant nutrients like vitamin C &E which inhibit the uncontrolled activity of free radicals and thus all healthy cells are protected. Only unhealthy cells such as cancer cells which have lost this protective mechanism and organisms such as bacteria, viruses, fungi, parasites which are devoid of these antioxidants are destroyed.

Anti –inflammatory & analgesic action: Ozone helps in the synthesis of biologically active

substances such as prostaglandins which is beneficial in reducing inflammation and pain.

Immune-stimulating action: The electromagnetic action of ozone stimulates and

modulates immune system particularly lymphocytes.the application of medical ozone is extremely useful for immune activation of patients especially with a low immune status.

Anti-hypoxic action: Ozone brings about the rise of O2 in tissues and improves

transportation of oxygen in blood Ozone acts as a super-oxygenator, bringing oxygen to tissues, assisting body in its natural healing process.

Bioenergetic and biosynthetic action: Ozone activates mechanisms of protein synthesis,

increases amount of ribosomes and mitochondria in cells, elevating functional activity and regeneration potential of tissues and organs.

DENTAL OZONE GENERATORS; HEAL OZONE:

•The ozone unit for dental use was initially developed by CurOzone Inc. (Canada) and subsequently manufactured under license and distributed by KaVo Dental GmbH and Co. (Germany) under the name “HealOzone”.

HEALOZONE PROCEDURE: The HealOzone procedure consists of a package which

includes:

•The application of ozone gas, the use of remineralizing agents, a patient kit and information on oral hygiene.

•The HealOzone device comprises an air filter, vacuum pump, an ozone generator, a hand piece fitted with a sealing silicone cup and a flexible hose.

• The procedure usually takes between 20 and 120 second per tooth.

•Immediately after ozone application the tooth

surface is treated with a remineralizing solution (reductant) containing fluoride, calcium, zinc, phosphate.

• HealOzone application for the treatment of non cavitated lesions is usually repeated at 3 and 6 months.

The OzoTop :

•The OzoTop is a free flow ozone delivery system using a corona discharge. It is a compact, easy to use tabletop unit. Due to the delivery system of the OzoTop, root canals and periodontal pockets can be penetrated easily. The system may be used in all cases where point of placement disinfection is needed, including periodontology, endodontology, restorative, implantology, apthous ulcers/herpes,dentures and impression materials.

•Ozone is applied at 6, 12, 18, 24 seconds, depending on which treatment is required.

OZONE ADMINISTRATION:There are three basic forms of ozone application.1. ozone gas 2. ozonated water and 3. ozonated oil• These forms of application are used singly or in

combination to treat dental disease. • Ozone gas has a half life of about 5-30 min• Ozonated water has a life span of about 10hrs if the water

is kept cold.• Ozonated oil produces a stable product (ozonides) with a

longevity exceeding 15 yrs.

INDICATIONS:I. Arterial circulatory disorders II. Immunodeficiency and Immune disbalance ‑

Additive therapy in carcinoma patients diseases caused by viruses (e.g.,: Hepatitis)

III. Inflammatory conditions IV. Rheumatic diseases V. External ulcers and skin lesionVI. External ulcers and skin lesions VII. Dentistry.Ozone is also used in the pharmaceutical

industry, foodprocessing industry, fabrics and cosmetics.

CLINICAL APPLICATION OF OZONE IN PEDIATRIC DENTISTRY: With all the evidence of different actions and lack of toxicity

ozone is developed into a new noninvasive tool for the treatment of diseases in medicine and dentistry.

• INFECTONS LESION: Soft tissue lesions like Herpes, Aphthae, Removable

denture ulcers, Cuts, Cheilitis, Candidiasis, Cysts and Traumatic wounds can be treated with either Ozonated water or oils. The disinfectant and healing properties help in the healing of these lesions.

Remineralization of Incipient Caries: In superficial root caries or early pit and fissure carious

lesions, ozone alone may be sufficient to treat these lesions. However, in situations where severe breakdown of tooth structure has occurred, ozone may be used initially to promote remineralization and when this has occurred the cavity may be restored with a suitable restorative material.

Restoration of Large Cavitations Along With Conventional Conservative Measures:

• The larger lesions need special care. It must be stressed that larger lesions are not those to be treated with ozone alone; most will require a combined approach of traditional therapy, as well as ozone. Where the lesion extends deep into the dentine, the action of ozone will take a longer time period of treatment, or may require several treatment periods over time.

• The basic protocol is the same; the soft debris is removed along with any unsupported enamel. If possible, denatured dentine is removed to the leathery layer. Ozone is applied from 40 seconds or longer. Some practitioners are using 2 to 3 minutes for large deep lesions that extend on x-ray almost to the pulp chamber. Then, the remineralizing wash is applied.

Bleaching :• In root canal treated teeth , crown discoloration is a major

aesthetic problem, especially in anterior teeth. Conventional walking bleach requires much more time and results are not often satisfactory. Also, capping the tooth with ceramic crown in young permanent incisors is not indicated. An alternative option is placing the bleaching agent then the crown is irradiated with ozone for minimum of 3-4 minutes. This ozone treatment bleaches the tooth within minutes and gives the patient a happy and healthier-looking smile

Endodontic Treatment :• The aim of conventional root canal therapy is to provide a

clean, shaped, root canal that facilitates the placement of an adequate root filling.

• There may be multiple canals in a single root in this situation, current procedures can be modified, to greatly improve the quality of treatment for patients.

• When irrigating with the usual irrigant solution, for example sodium hypochlorite, ozone can be applied to the hypochlorite solution in the root canals. This technique allows the root canal system to be thoroughly disinfected and possibly be sterilized.

• Also that ozone will penetrate through the apical foramen, and enter into the surrounding and supportive bone tissue. The effect of ozone on these tissues will be to encourage healing and regeneration.

Ozonated water in decontamination of avulsed

teeth before replantation:

•A high level of biocompatibility of aqueous ozone on periodontal cells has been found .Two-minute irrigation of the avulsed teeth with no isotonic ozonated water not only provides mechanical cleansing, but also decontaminate the root surface, with no negative effect on periodontal cells remaining on the tooth surface before replantation

Extraction: •Ozone was found to accelerate the healing of the wounds.

After a tooth is extracted or any surgical procedure the area is irrigated and insufflated which promotes faster healing without complications

Disinfectant:

•Ozonated water effective for killing gram-positive and gram-negative oral microorganisms and oral Candida albicans.

• Gaseous ozone can be clinically useful for disinfection of dentures

OZONE TOXICITY: •Ozone inhalation can be toxic to the pulmonary system and

other organs. Complications caused by ozone therapy are infrequent at 0.0007 per application. Known side effects are upper respiratory irritation, rhinitis, cough, headache, occasional nausea, vomiting, shortness of breath, blood vessel swelling, poor circulation, heart problems.

•European cooperation of medical ozone societies prohibited the intravenous injections of ozone gas due to risk of air embolism.

CURE FOR OZONE TOXICITY:

•The patient must be placed in the supine position.

• The patient should inhale the humid oxygen and treated with Vitamin E, & ascorbic acid

CONTRAINDICATION:•Pregnancy •Glucose 6 phosphate dehydrogenase deficiency‑ ‑ ‑• Hyperthyroidism• Severe anemia• Severe myasthenia • Acute alcohol intoxication • Recent myocardial infarction •Hemorrhage from any organ •Ozone allergy.

CONCLUSION:•Ozone therapy allows a new vision, which complies with

needs and demands of the public for noninvasive, effective dental care and it is truly a paradigm shift in dental practice.

•Ozone therapy has opened new ways in treatment for dental patients of all ages and applicable to a wide range of conditions of intra oral hard and soft tissues.

• It is especially suitable to the younger patients who are often scared of “drilling” and find conventional treatment unacceptable.

•The ozone therapy has been more beneficial than present

conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment.

• Treating patients with ozone therapy reduces the treatment time with a great deal of difference, and it eliminates the bacterial count more precisely.

• The treatment is completely painless and increases the patients’ acceptability and compliance with minimal adverse effect