The molecule ozone (O3), which exists as a gas at room temperature, is a very reactive, powerful oxidizing agent. Caries treatment using ozone makes therapeutic use of its bactericidal (bacteria-killing) properties, which result from oxidation processes on the cell membranes of microorganisms.
Ozone treatment is user-friendly due to its uncomplicated procedure and low time expenditure, and at the same time very patient-friendly because it is painless, vibration-free and noiseless. A major drawback lies in its efficacy, which is highly controversial. While its bactericidal properties are beyond doubt; the problems arise from its purely superficial action and rapid bacterial recolonization (recolonization) of the treated surfaces.
Indications (areas of application)
Ozone therapy is recommended as useful for the treatment of, for example:
- Superficial, incipient fissure caries or fissures in the observation phase.
- Sterilization of fissures (dimples in the occlusal relief of the posterior teeth) before fissure sealing.
- Root caries
- Carious initial lesions (holes in the making).
- Open carious lesions
- Cavities (holes) after excavation (caries removal) for disinfection.
Contraindications
The contraindications necessarily arise from the surface effect of ozone:
- Deep carious lesions (holes) without prior excavation (caries removal).
- Hard-to-reach areas that make it impossible to fit the suction cup and thus build up a vacuum
- Inaccessible caries under restorations (fillings, crowns).
The procedure
The course of treatment is inexpensive, not very time-consuming and is as follows:
- Pre-cleaning of the surface to be treated, e.g., by means of rotating brushes and cleaning paste.
- In the case of deeper cavities, first excavation (caries removal) e.g. with rotating instruments (drills); due to the bactericidal ozone effect limited to the surfaces, treatment without drilling can therefore only take place in the case of initial caries (small defects)
- Drying of the surface to be treated
- Fitting a silicone suction cup, available in different sizes. This prevents the leakage of the gas and allows the creation of a vacuum around the surface to be treated; in case of leakage, the ozone supply is automatically stopped. This prevents ozone inhalation (inhalation of ozone) by the patient and the practitioner.
- Ozone application (application) with an ozone therapy device in high dosage for 30 to 40 seconds under constant volume exchange. Already after 10 seconds, 95% of all germs are killed.
- Automatic suction of the residual gas at the end of the application.
- Application of remineralization solution to the hard substances demineralized by the bacterial acid attack.
Sensibly, caries treatment using ozone must be integrated into an overall preventive (precautionary) concept to permanently prevent bacterial recolonization of the surfaces at risk. Preventive measures include:
- Home remineralization by the patient.
- Fluoridation in the dental practice.
- Antimicrobial therapy, e.g., with chlorhexidine digluconate.
- Nutritional control
- Optimization of tooth brushing technique for permanent plaque reduction.
- Regular dental checkups
- Professional dental cleaning (PZR), if necessary.
