Objective: Based on the impact of pathogens, antiinfective regimen is an important component in any treatment of periodontal and periimplant diseases. As an alternative method to chlorhexidine, application of ozone is discussed. Ozone is a powerful antimicrobial agent by destructing cell walls and cytoplasmic membranes of bacteria and fungi. The study was aimed to determine the effect of ozone on microorganisms, which play a role in pathogenesis of periodontitis and peri-implantitis. Methods: Ozone was generated by using Prozone® device for 6 s – 2 × 24 s against 23 mainly anaerobic periodontopathic species. Agar diffusion test was used as a screening method. Then, the killing activity was tested in a serum-free environment and with 25% v/v inactivated serum. Further, the effect of ozone on bactericidal activity of native serum was analyzed against Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Results: Agar diffusion test showed a high efficacy of ozone against microorganisms, especially against the included P. gingivalis strains. This result was confirmed by the killing tests; most of the strains in a concentration of 105 were completely eliminated after two-fold 18 s application of ozone. Only four of the six potentially “superinfecting” species (Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae, Candida albicans) were resistant in part. Addition of inactivated serum reduced the killing rate of ozone by 78% after 6 s and by 47% after two-fold 18 s exposures; no strain was completely erradicated after any application of ozone. Bactericidal killing of native serum was enhanced after application of ozone; no effect was visible on the included A. actinomycetemcomitans strains which was found to be completely resistant to the bactericidal action of serum. Conclusion: Ozone combined with mechanical therapy may have clinical relevance in non surgical and surgical periodontal therapy.
The study was supported by W&H, Bürmoos, Austria.