Abstract
The aim of this study was to investigate the effects of systemic and topical ozone applications on alveolar bone healing following tooth extraction. One hundred and twelve male Wistar rats were divided into eight groups of 14 rats each; seven groups were experimental (A–G) and one formed the control group (K). The experimental groups were further divided into two sub-groups, with seven rats in each – sacrificed on days 14 and 28 (subgroups 1 and 2). The maxillary right central incisors were extracted under general anaesthesia following the administration of local anaesthesia. After sacrifice, semi-serial histological sections were prepared, and mineralized and trabecular bone and osteoid and osteoblast surfaces were measured. Measurements of the trabecular bone showed statistically higher values in the groups treated with systemic ozone (D 2 : 50.01 ± 2.12; E 2 : 49.03 ± 3.03; F 2 : 48.76 ± 2.61; G 2 : 50.24 ± 3.37) than in the groups that underwent topical ozone administration (A 2 : 46.01 ± 3.07; B 2 : 46.79 ± 3.09; C 2 : 47.07 ± 2.12; P = 0.030 (G 2 –A 2 , G 2 –B 2 , G 2 –C 2 )). Within the limitations of the current study, it may be concluded that postoperative long-term systemic ozone application can accelerate alveolar bone healing following extraction. However, additional studies are required to clarify the effects of the different ozone applications on new bone formation.
The basic mechanisms of action of ozone (O 3 ) in medicine have, to some extent, been clarified in the last decade. The possible benefits of ozone in medicine are generally attributed to its antimicrobial, disinfectant, and healing properties. In addition, Bocci et al. have stated that a small dose of ozone can trigger several useful biochemical mechanisms and reactivate the antioxidant system.
Ozone therapy can be applied via a range of methods, usually involving the mixing of ozone with various gases and liquids and injecting this into the body, including the vagina, rectum, and intramuscularly or subcutaneously. Ozone can also be introduced via autohemotherapy, in which blood is drawn from the patient, is exposed to ozone, and is then re-injected into the patient. Due to safety concerns, only dissolved ozone in water and ozonated oils have been and are still commonly used in different dental applications intraorally. However, the disinfection properties of ozone over other antiseptics have made the use of ozone in dentistry a very good alternative and an additional disinfectant to standard antiseptics. Ozone has also gained popularity due to its application in various clinical procedures such as the management of early carious lesions, ulcerations, and herpetic lesions of the oral mucosa, the sterilization of cavities, root canals, and periodontal pockets, and the cleaning of dentures.
As well as systemic application options for different medical purposes, the topical application of ozone is becoming more common in daily dental practice. In oral surgery, it has been speculated that the use of ozone is indicated during the surgical intervention as well as post-surgery as a topical disinfectant and healing agent. Filippi has proclaimed that since ozonated water is germ-free, it can be used in oral surgery as a coolant for burrs and for rinsing wounds.
Despite the increasing number of studies focusing on the effects of ozone in dentistry, the number of scientific papers in oral surgery is limited, and to the best of our knowledge, the effects of ozone therapy on the healing of extraction sockets have not yet been evaluated scientifically.
The aim of this study was to assess the effects of systemic and topical ozone application before and after tooth extraction on alveolar bone healing at the cellular level.
Materials and methods
Experimental design
One hundred and twelve male Wistar rats ( Rattus norvegicus albinus ; initial body weight 250–300 g) were divided into eight groups of 14 rats each; seven groups were experimental (groups A–G) and one constituted the control group (group K). The experimental groups were each divided into two sub-groups of seven rats, sacrificed on days 14 and 28, respectively. A detailed description of the experimental design is given in Table 1 .
| Group | Systemic ozone | Topical ozone | Day of sacrifice | Number |
|---|---|---|---|---|
| A 1 | – | Day 0 and day 2 postoperatively | 14 | 7 |
| A 2 | 28 | 7 | ||
| B 1 | Three times, starting 1 week before extraction, 2-day intervals | – | 14 | 7 |
| B 2 | 28 | 7 | ||
| C 1 | Three times, starting 1 week before extraction, 2-day intervals | Day 0 and day 2 postoperatively | 14 | 7 |
| C 2 | 28 | 7 | ||
| D 1 | Three times, starting 1 week before extraction, 2-day intervals and on days 0, 2, 4, 6, 8, 10, 12, and 14 following extraction | Day 0 and day 2 postoperatively | 14 | 7 |
| D 2 | 28 | 7 | ||
| E 1 | On days 0, 2, 4, 6, 8, 10, 12, and 14 following extraction | Day 0 and day 2 postoperatively | 14 | 7 |
| E 2 | 28 | 7 | ||
| F 1 | On days 0, 2, 4, 6, 8, 10, 12, and 14 following extraction | – | 14 | 7 |
| F 2 | 28 | 7 | ||
| G 1 | Three times, starting 1 week before extraction, 2-day intervals and on days 0, 2, 4, 6, 8, 10, 12, and 14 following extraction | – | 14 | 7 |
| G 2 | 28 | 7 | ||
| K 1 | – | – | 14 | 7 |
| K 2 | 28 | 7 | ||
| Total | 112 |
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