Ozone safety

1. Baysan A, Lynch E.
Safety of an Ozone delivery system during caries treatment in-vivo. J Dent Res, 80: 1159; 2001. 2001 40 80 10 & 20 Seconds Root Caries Both application times produced O3 aroungd the application cup below the FDA & EU permissible O3 levels in air

2. Ebensberger U, Pohl Y, Filippi A.
PCNA-expression of cementoblasts & fibroblasts on the root surface after extraoral rinsing for decontamination. Dent Traumatol,18:262-266;2002. 2002 O3 in water Extracted teeth, cementobalsts & fibroblasts Marked by Proliferating Cell Nuclear Antigen (PCNA): Irrigation with ozonized water showed higher labelling indices in comparison with saline, but this could not be statistically substantiated (P = 0. 24). Ozonized water, not being isotonic, had no negative effect on periodontal cells remaining on the tooth surface after irrigation for 2 min.

3. Nagayoshi M, Kitamura C, Fukuizumi T, Nishihara T, Terashita M.
Antimicrobial effect of ozonated water on bacteria invading dentinal tubules. Journal of Endodontics, 778-781;2004. Part 1 2004 O3 in water L-929 mouse fibroblasts The metabolic activity of fibroblasts was high when the cells were treated with ozonated water, whereas that of fibroblasts significantly decreased when the cells were treated with 2. 5% NaOCl

1H NMR Studies on Caries Biomolecules

4. Smith C, Lynch E, Baysan A, Silwood CJ, Mills B, Grootveld M.
Oxidative consumption of root caries biomolecules by a novel anti bacterial Ozone delivery system, J Dent Res, 80:1178;2001. 2001 Analysis of root caries by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3. O3 caused oxidative decarboxylation of pyruvate & oxidative attack of carbohydrates to generate formate. O3 also oxidised PRCL lactate, urate, glycosaminoglycans & methionine to yield acetate & CO2, allantoin, low-molecular-mass saccharide fragments & methionine sulphoxide, respectively.

5. Lynch E, Silwood CJL, Smith C, Grootveld M.
Oxidising actions of an Anti-Bacterial Ozone-Generating Device towards Root Caries Biomolecules. J Dent Res, 81:A-138;2002. 2002 20 20 5 Seconds Analysis of 12 soft root caries by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3. Results obtained revealed that in addition to giving rise to the oxidative decarboxylation of pyruvate (generating acetate and CO2 as products), and the attack of carbohydrates to produce formate, O3 also oxidised PRCL lactate, urate, glycosaminoglycans and methionine to yield acetate and CO2 (via pyruvate), allantoin, low-molecular-mass saccharide fragments and methionine sulphoxide, respectively.

6. Lynch E, Silwood C, Smith C, Grootveld M.
Oxidising actions of Ozone towards Root Caries Biomolecules. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no 197; 2002. 2002 18 10 seconds Analysis of Soft root caries by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3. Bacterial- or yeast-derived organic acid anions (formate, acetate, propionate, n-butyrate, lactate, and pyruvate), amino acids (predominantly alanine and glycine) and carbohydrates such as glucose were present. O3 gave rise to the oxidative decarboxylation of pyruvate (generating acetate and CO2), carbohydrates to produce formate, also oxidised lactate, urate and glycosaminoglycans to yield acetate and CO2, allantoin and low-molecular-mass saccharide fragments respectively. VSC precursor methionine was oxidised to sulphoxide. O3-mediated oxidation of 3-D-hydroxybutyrate

7. Lynch E, Silwood CJ, Abu-Naba'A L, Al Shorman H, Baysan A, Holmes J, Grootveld M.
Oxidative Consumption of Root Caries Biomolecules using Ozone. Journal Caries Res, 38:364;2004. 2004 30 30 30 Seconds Analysis of root caries by high field 1H -NMR spectroscopy to detect oxidation of PRCL biomolecules by O3. O3 caused oxidative decarboxylation of pyruvate & oxidative attack of carbohydrates to generate formate. O3 also oxidised PRCL lactate, urate, glycosaminoglycans & methionine to yield acetate & CO2, allantoin, low-molecular-mass saccharide fragments & methionine sulphoxide, respectively.

1H NMR Studies on Saliva Biomolecules

8. Lynch E, A Baysan A, Silwood C, Grootveld M.
Therapeutic oxidising activity of a novel anti-bacterial Ozone-generating device on saliva. J Dent Res, 77: 1187; 1998. 1998 20 30 seconds Analysis of saliva by high field 1H -NMR spectroscopy to detect oxidation of biomolecules by O3 O3 produced oxidative de- carboxylation of pyruvate, & oxidation e sulphur compound methionine to its corresponding sulphoxide, oxidative consumption of polyunsaturated fatty acids O3. Moreover, -mediated oxidation of 3-D-hydroxybutyrate was also obtained.

9. Lynch E, Smith E, Baysan A, Silwood CJL, Mills B, Grootveld M.
Salivary Oxidising Activity of a Novel Anti-bacterial Ozone-generating Device. J Dent Res, 80:13;2001. 2001 20 10 seconds Analysis of saliva by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3 Oxidation e sulphur compound methionine to its corresponding sulphoxide, oxidative consumption of polyunsaturated fatty acids O3.

10. Claxson AWD, Smith C, Turner MD, Silwood CJL, Lynch E, Grootveld M.
Oxidative Modification of Salivary Biomolecules with Therapeutic Levels of Ozone. J Dent Res, 81:A-502; 2002. 2002 20 20 10 seconds Analysis of saliva by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3. In addition to the complete oxidative consumption of salivary pyruvate (mean ? s.e. salivary level prior to treatment 1.75 ? 0.62 mM) and partial oxidation of methionine, results acquired revealed (1) marked elevations in the concentration of formate (a product derived from the oxidation of carbohydrates), (2) substantial reductions in lactate level (up to 92%) via its oxidation to pyruvate, which in turn is oxidised to acetate and CO2, (3) the oxidation of 3-D-hydroxybutyrate to acetoacetate, which liberates acetone on decomposition, (4) the generation of allantoin from salivary urate (up to levels of 40??M), (5) the production of low-molecular-mass saccharide fragments from hyaluronate, and (6) oxidation of malodorous trimethylamine (initial salivary concentration 78 ? 23 ?M) to its corresponding, non-malodorous N-oxide.

11. Turner M, Silwood CJL, Grootveld M, Lynch E.
Oxidative Consumption of Biomolecules using Ozone. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 594; 2002. 2002 10 seconds 5.00 ml of aqueous solutions: sodium pyruvate, D-glucose, L-cysteine and L-methionine (5.00 mM) were prepared in 40.0 mM phosphate buffer (pH 7.00)(rigorously deoxygenated with argon gas) As expected, treatment of aqueous solutions of L-methionine with ozone confirmed oxidation to its corresponding sulphoxide. H NMR analysis demonstrated that exposure of aqueous solutions of L-cysteine to ozone generated its corresponding disulphide, cystine, as a major product. H NMR analysis also showed that ozonolysis of D-glucose generated formate as a major reaction product, i.e., a concentration of 1.29 mM was produced from the 5.00 mM glucose substrate, an observation consistent with previous studies conducted on the interactions of ROS (e.g., radiolytically-generated .OH radical) with carbohydrates in general. Treatment of pyruvate with this oxidant produced acetate and CO2 via an oxidative decarboxylation process immediate.

12. Turner M, Grootveld M, Silwood C, Lynch E.
Oxidative Consumption of Biomolecules by Therapeutic Levels of Ozone J Dent Res, 81:A-272;2002. 2002 10 seconds Aqueous solutions containing sodium pyruvate, ?-D-glucose, L-cysteine and L-methionine (5.00 mM) were prepared in 40.0 mM phosphate buffer (pH 7.00) which was rigorously deoxygenated with argon gas prior to use. Attack of O3 on ?-D-glucose gave rise to formate as a major product, i.e. 1.21 ? 0.11 mM (mean ? s.e.) generated, and treatment of pyruvate with this oxidant produced acetate and CO2 via an oxidative decarboxylation process (93 ? 4 % yield under our experimental conditions). Moreover, the amino acid volatile sulphur compound (VSC) precursors cysteine and methionine were converted to their corresponding primary oxidation products cystine (100% yield) and methionine sulphoxide (98 ? 2 % yield) respectively.

13. Silwood C, Smith C, Turner M, Grootveld M, Lynch E.
Oxidative Modification of Salivary Biomolecules with Ozone. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 593; 2002. 2002 16 0.60 ml saliva 20 seconds Analysis of saliva by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3. After complete oxidative consumption of salivary pyruvate and partial oxidation of methionine, results acquired revealed (1) marked elevations in the concentration of formate (a product derived from the oxidation of carbohydrates), (2) substantial reductions in lactate level via its oxidation to pyruvate, which in turn is oxidised to acetate and CO2, (3) the oxidation of 3-D-hydroxybutyrate to acetoacetate, which liberates acetone on decomposition, (4) the generation of allantoin from salivary urate, (5) the production of low-molecular-mass saccharide fragments from hyaluronate, and (6) oxidation of malodorous trimethylamine to its corresponding, non-malodorous N-oxide.

Ozone effect on dental plaque

14. Shargawi JM, Theaker ED, Drucker DB, MacFarlane T, Duxbury AJ.
Sensitivity of Candida albicans to negative air ion streams. J Appl Microbiol, 87:889-897;1999. 1999 O3 in Negative air ions (NAIs) at different emitter distances, exposure times, relative humidities & under aerobic & oxygen-free conditions O3 levels increased with increasing exposure times (P < 0. 01) but were significantly reduced as emitter distance increased (P < 0. 01). When utilized in a nonventilated room, levels of O3 produced did not exceed recognized safety limits.

15. Grootveld M, Lynch E. Mills B, Smith C, Baysan A, Silwood C.
Therapeutic Oxidation Of Human Plaque Biomolecules by an Anti-Bacterial Ozone-Generating Device. BSDR Abstract no. 292; 2001. 2001 12 10 seconds Analysis of plaque by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3 O3 treatment gave rise to the oxidative decarboxylation of the electron donor pyruvate (generating acetate and CO2 as products), and the oxidation of the volatile sulphur compound precursor methionine to its corresponding sulphoxide. Moreover, evidence for the O3-mediated oxidation of 3-D-hydroxybutyrate was also obtained.

16. Grootveld M., Baysan A, Silwood C, Lynch E.
Oxidation Of Human Plaque Biomolecules by an Anti-Bacterial Ozone-Generating Device. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 595; 2002 2002 12 10 seconds Analysis of plaque by high field 1H –NMR spectroscopy to detect oxidation of biomolecules by O3 O3 treatment gave rise to the oxidative decarboxylation of the electron donor pyruvate (generating acetate and CO2 as products), and the oxidation of the volatile sulphur compound precursor methionine to its corresponding sulphoxide. Moreover, evidence for the O3-mediated oxidation of 3-D-hydroxybutyrate was also obtained

17. Nagayoshi M, Fukuizumi T, Kitamura C, Yano J, Terashita M, Nishihara T.
Efficacy of Ozone on survival & permeability of oral microorganisms. Oral Microbiol Immunol, 19:240-246; 2004. 2004 ozonated water (4 mg/l) for 10 s Streptococcus mutans, And dental plaque from human subjects 1. breakage S. mutans seen by electron microscopy . 2. Ozonated water inhibited the accumulation of experimental dental plaque in vitro 3. Human dental plaque exposed to ozonated water in vitro had no viable bacterial cells detected.

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

18. Al Shorman H, Abu-Naba'a L, Lynch E. Patient's Attitude to Treatment of Pit & Fissure Caries with Ozone. Caries Res, 36:187; 2002. 2002 49 n/a n/a Pit & Fissure Caries 98% happy with treatment, 94% happy with time, 94% would choose O3 even if higher fee, 94% would recommend it for a friend or relative. 100% would choose O3 treatment again, & 100% not anxious after O3 treatment same visit

19. Domingo H, Smith C, Freeman R, Lynch E.
Patients attitudes to managing caries with Ozone. J Dent Res, 81: A-183; 2002 2002 99 n/a n/a Patients had drilling & fillings previously & now O3 treatment by the same dentist happy or satisfied with 1. O3 treatment 99% 2. time 97% 3. if cost was more than conventional treatment 95% 4. Recommend to a friend/ Relative 97% 5.Receive treatment once more 100% 6. Patients reported a reduction in anxiety associated with the O3 treatment (p <0. 05).

20. Megighian GD, De Pieri A, Lynch E.
Patients attitudes to managing caries with ozone in private practice The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 167; 2002 2002 50 n/a Ozone vs previous conventional drill and fill 100% were happy or satisfied with the Ozone treatment, amount of time the Ozone treatment required and not anxious after the Ozone treatment and reported less anxiety after, compared with before, the Ozone treatment and would recommend it to a friend or close relative and receive it once more . 96% were satisfied to choose this treatment even if the Ozone treatment cost more than regular treatment, 80% of patients reported a reduction in anxiety (p <0.05).

21. Domingo H, Abu-Naba’a L, Al Shorman H, Smith C, Freeman R, Lynch E.
Patients attitudes to managing caries with Ozone. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no 435; 2002 & J Dent Res, 82: C-535; 2003 2003 99 n/a n/a Patients had drilling & fillings previously & now O3 treatment by the same dentist happy or satisfied with 1. O3 treatment 99% 2. time 97% 3. if cost was more than conventional treatment 95% 4. Recommend to a friend/ Relative 97% Receive treatment once more 100% 5. Patients reported a reduction in anxiety associated with the O3 treatment (p <0. 05).

Comparison of Caries Detection Techniques

22. Abu-Naba'a L, Al Shorman H, Lynch E.
The Effect of Ozone Application on Fissure Caries QLF Readings. J Dent Res, 81: A-386; 2002 2002 0 242 10 & 20 Seconds Primary Pit & Fissure Carious Lesion on freshly extracted teeth DIAGNOdent readings correlated with histological exam, Airpolishing system improved the performance of visual & DIAGNOdent scores, 10s O3 reduced DIAGNOdent readings immediately & more reduction was by 20s

23. Abu-Naba'a L, Al Shorman H, Lynch E.
In-vivo treatment of occlusal caries with Ozone: Immediate effect & correlation of diagnostic tools. Caries Res, 36:189; 2002. 2002 58 236 10 seconds Primary Occlusal Pit & Fissure Caries ECM readings are inverslay related to caries severity. Clinical severity scores, ECM & DIAGNOdent readings correlate significantly at baseline. 56% of lesions had immediate DIAGNOdent readings reduction after O3. ECM readings have not immediately changed after O3 treatment

24. Megighian GD, Bertolini L.
In vivo Treatment of Occlusal Caries with Ozone: One & Two Months' Effect with Light-induced Fluorescence (QLF) as Diagnostic Methods. J Dent Res, 82:B-354; 2003. 2003 80 300 20,30 & 40 seconds Primary Occlusal Fissure Carious Lesions A significant overall reduction of QLF readings was produced after Ozone treatment at one month. The percentage of teeth which produced this reduction was over 80%. After two months QLF readings showing reduction was over 90% (p<0.05). Ozone treated lesions significantly clinically reversed (P<0.05) whilst control lesions did not change.

25. Marashdeh MM, Abu-Salem OT, Lynch E.
Ozone Treatment of Occlusal Caries in Primary Teeth: Immediate Effects and Correlation of Diagnostic Methods AADR Abstract no. 683; 2003. 2003 17 50 10 seconds Occlusal Carious Lesions Using a paired samples T-test; ECM readings were not altered immediately by the Ozone treatment (p>0.05). However, the DIAGNOdent readings were significantly reduced after Ozone treatment (t = 2.408, p< 0.05). Moreover, ECM and DIAGNOdent readings were significantly correlated with the clinical classification (p< 0.05, p< 0.01 respectively).

26. Marashdeh MM, Abu-Salem OT, Lynch E.
Ozone Treatment of Occlusal Caries in Primary Teeth: Immediate Effects & Correlation of Diagnostic Methods. IADR Abstract 2003. 2003 17 50 10 Seconds Occlusal Caries Primary Teeth Reduced DIAGNOdent Readings after O3 treatment

27. Abu-Naba'a L, Al Shorman H, Lynch E.
Immediate Effect of Ozone Application In-vivo on DIAGNOdent Readings. IADR Abstract no. 3469; 2004. 2004 90 394 10 Seconds Primary Occlusal Pit & Fissure Caries O3 reduced Diagnodent vales (p<0. 05), ECM DIAGNOdent, visual score correlated with each other at baseline+K31

28. Dahnhart JE, Jaeggi T, Scheidegger N, Kellerhoff N, Francescut P, Lussi A.
Treating Caries in Anxious Children with Ozone: Parents' Attitudes after the First Session. J Dent Res, 82: B-265; 2003 2003 20 n/a n/a O3 + ART 75% afraid of dental care before O3 treatment, 75% would recommend to relative/friend. 80% willing to pay more vs. drill & fill

29. Johnson N, Johnson J, Domingo H, Lynch E.
Comparison of Conventional Treatment vs. Ozone for Occlusal Caries with Ozone Therapy . J Dent Res, 82;B-2755, 354 2003. 2003 40 n/a n/a Ozone and conventional drill and fill The conventionally treated (i.e. ‘drill and fill') patients averaged 35 minutes per patient with a SD of 10 minutes whilst the group treated by therapeutic ozone averaged 8 minutes with a SD of 2 (P<0.05). The actual time taken in the application of ozone was less than one minute per tooth.

30. 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. J. Dent. Res, 82: A-679;2003 2003 100 n/a n/a O3 treatment vs drill & fill 83% were anxious about teeth being drilled and 80% were nervous about local analgesia. Having received a verbal explanation of the ozone process, only 33% remained slightly nervous prior to the procedure; the reminder having no anxiety. Immediately following ozone treatment, 100% were feeling no anxiety and were very satisfied with the treatment. 100% were very satisfied with the time taken for ozone treatment. 95% would recommend this treatment to family/ friends, whilst 80% would be happy to pay more for ozone treatment than conventional ‘drill and fill'.

31. Megighian GD, Dal Vera MV.
Patients' Attitudes toward and Satisfaction with Managing Caries with Ozone as a Routine Treatment in Dental Private Practice J Dent Res, 82;B-269; 2003. 2003 250 n/a n/a O3 treatment vs drill & fill 100% were happy or satisfied with the Ozone treatment, amount of time, would recommend this treatment to a friend or close relative and receive it once more. 85% considered the check up appointments to monitor the progression of clinical reversal of lesions a minor draw back. 55% were satisfied pay more than regular treatment, 80% of patients reported a reduction in anxiety (p <0.05). In patients who received conventional but did not need ozone treatment, 100% were happy or satisfied with the treatment received, but 65% reported anxiety before and after the treatment.

32. 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. AADR abstract no. 677; 2003. 2003 377 n/a 20 Seconds All Lesions 99% happy with O3 treatment, 97% happy with the time taken, 100% would like O3 treatment agaian, 99% were not anxious after O3 treatment 3 months

33. 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 no. 3473;2004. 2004 20 n/a n/a n/a 83% - 99% Caries Reversal

34. Domingo H. Steier L. Steier G. , Freeman R. & Lynch E.
Patients Attitudes To Managing Caries With Ozone. IADR Abstract 2005. 2005 98 N/a N/a Caries & had a previous experience with conventional filling 100% satisfied with the O3 treatment 100% satisfied with the amount of time the O3 treatment required. 66% were satisfied to choose this treatment even if it cost more than regular conventional 100% would recommend it to a friend, receive this treatment again, not anxious. 86% of patients reported a reduction in anxiety (p <0. 05).

Treatment of Primary Root Carious lesions

35. Baysan A.
Management of Primary Root Caries using Ozone Therapies. PhD Thesis, University of London, 2002.

36. Baysan A, Whiley R, Lynch E.
Ozone effect on microflora from primary root caries ex-vivo. J Dent Res, 77:1213;1998. 1998 20 10 seconds in water Root caries O3 reduced CFU from (log10 5. 91± 0. 15) (p<0. 001) to (log10 3. 57± 0. 37)

37. Baysan A, Whiley R, Lynch E.
The effect of a novel anti-bacterial Ozone-generating device on microflora from primary root caries ex-vivo. Caries Res, 32:300; 1998. 1998 20 20 20 seconds ozonized water Root caries ozonised water group (log10 3. 77±0. 42) compared with the control group (log10 6. 18±0. 21) (p<0. 001).

38. Baysan A, Whiley R, Lynch E
The effect of Ozone on Streptoccoccus mutans in-vitro. Caries Res, 33:291; 1998. 1998 10 seconds S. mutans (NCTC 10449) (p<0. 0001) difference (Mean ± SE) between the control samples (log10 3. 93 ± 0. 07) & O3 treated samples (log10 1. 01 ± 0. 27).

39. Baysan A, Whiley R, Lynch E.
The effect of Ozone on Streptoccoccus sobrinus in-vitro. J Dent Res, 78:1047; 1999. 1999 10 seconds S. sobrinus (TH 21) control samples (log10 4. 61 ± 0. 13) & O3 treated samples (log10 1. 09 ± 0. 36).

40. Baysan A, Whiley R, Lynch E.
Anti-microbial effects of a novel Ozone generating device on micro-organisms associated with primary root carious lesions in-vitro. Caries Res, 34:498-501;2000. 2000 40 10 or 20 Soft root caries 10 seconds O3 Reduced CFU from (log(10) 5. 91+/-0. 15 to (log(10) 3. 57+/-0. 37) or 20-second from (log(10) 6. 18+/-0. 21 to log(10) 3. 77+/-0. 42) O3 Invitro - S. mutans (log(10) 1. 01+/-0. 27) & S. sobrinus (log(10) 1. 09+/-0. 36) compared with the control samples (log(10) 3. 93+/-0. 07 & log(10) 4. 61+/-0. 13, respectively).

41. Baysan A & Lynch E.
Treatment of Primary Root Caious Lesions using Ozone for either 10 or 20 Seconds In Vivo IADR Abstract 2001. 2001 26 70 10 or 20 Seconds Root Caries 10 seconds reduced CFU's from 7. 0 to 4. 35 Log10. 20 seconds reduced 6. 0 to 0. 46 Log10

42. Baysan A, Lynch E.
Management of root caries using Ozone in-vivo. J Dent Res, 80:37;2001. 2001 48 48 10 or 20 Root caries Reduction (mean ± SE) 10 s O3 (log10 3. 36 ± 0. 48) or 20 s (log10 1. 17 ± 0. 62) compared with the control samples (log10 6. 73 ± 0. 27) & (log10 6. 30 ± 0. 28)

43. Baysan A, Lynch E.
Clinical reversal of root caries using Ozone. J Dent Res, 81: A-343; 2002. 2002 80 214 10 Seconds Root Caries 30.9% of PRCL reversed from severity index 2 to 0 (i.e., hard) in the ozone group, whilst none of the lesions reversed in the control group (p < 0.001) and 34% of lesions reversed from severity index 2 to 1 in the ozone group compared to only 7.5% in the control group (p < 0.001). Modified USPHS criteria revealed 61.5% of intact sealants in the ozone and sealant group, whilst 38.5% of intact sealants in the sealant only group (p < 0.05). The ECM and DIAGNOdent readings showed improvements in the ozone group compared to the control group (p < 0.001). The ozone and sealant group also had greater improvements in the ECM and DIAGNOdent values compared to the sealant only group (p < 0.05).

44. Baysan A, Lynch E.
Management of Primary Root Caries using Ozone The First Pan European Festival of Oral Sciences, Abstract no. 195; Cardiff, UK. 2002 2002 79 220 10 seconds Root caries 45% PRCLs reversed from severity index 2 to 0 (i. e. , hard) in the O3 only group, 0% in the control group (p < 0. 001) 51% of lesions reversed from severity index 2 to 1 in the O3 group, 8% in the control group (p < 0. 001). 6 & 9 months, the ECM & DIAGNOdent readings improved in the O3 only group when compared to the control group (p < 0. 001)

45. Baysan A, Lynch E.
12-month Assessment of Ozone on Root Caries J Dent Res, 82:B-311; 2003. 2003 79 220 10 seconds Root caries 47% of PRCLs reversed from severity index 1 to 0 (i.e., hard) in the ozone only group, whilst none of the lesions became hard in the control group (p < 0.001) and 52% of lesions reversed from severity index 2 to 1 in the ozone group compared to only 11.6% in the control group (p < 0.001) After 1, 3, 6, 9 and 12 months, the ECM and DIAGNOdent readings showed improvements in the ozone only group when compared to the control group (p < 0.001).

46. Holmes J.
Clinical reversal of root caries using Ozone, double-blind, randomised, controlled 18-month trial. Gerodontology 2003: 20 (2): 106-14 2003 89 178 40 seconds Root caries At 18 months, 87 (100%) of O3-treated PRCL's had arrested, whilst in the control group, 32 lesions (37%) of the PRCL's had worsened from leathery to soft (p<0. 01), 54 (62%) PRCL's remained leathery & only one of the control PRCL's had reversed (p<0. 01).

47. Holmes J.
Ozone Treatment of Root Caries after 18-Months IADR Abstract no. 2881;2004. 2004 89 178 40 seconds Root caries After 18 months, 81 patients completed the study. There were no observed adverse events. At 18 months, 100% of ozone treated PRCL's had reversed, whilst only 8% of the control lesions reversed (p < 0.001). At 18 months, in the control group,12% of the PRCL's had progressed from severity index 2 to 3 (p < 0.001); i.e. they had become more severe.

48. Holmes J.
Ozone Treatment of Root Caries after 21-Months. IADR Abstract no. 117; 2004.
2004 89 178 40 Seconds and Root Caries also treated by Remineralising pastes, mouthrinses and sprays were also dispensed After 21 months, 81 patients completed the study. There were no observed adverse events. At 21 months, 100% of ozone treated PRCL's had reversed, whilst only 8% of the control lesions reversed (p < 0.001). At 21 months, in the control group,12% of the PRCL's had progressed from severity index 2 to 3 (p < 0.001); i.e. they had become more severe.

49. Baysan A, Lynch E.
Clinical Assessment of Ozone on Root Caries. IADR Abstract no. 80; 2004. 2004 80 226 20 Seconds Root Caries 47% of PRCLs reversed from severity index 1 to 0 (i.e., hard) in the ozone only group, whilst none of the lesions became hard in the control group (p < 0.001) and 52% of lesions reversed from severity index 2 to 1 in the ozone group compared to only 11.6% in the control group (p < 0.001). Modified USPHS criteria revealed that there were 61% of intact sealants in the ozone and sealant group and 26.1% of intact sealants in the sealant only group (p < 0.05). After 1, 3, 6, 9 and 12 months, the ECM and DIAGNOdent readings showed improvements in the ozone only group when compared to the control group (p < 0.001). The ozone and sealant group also had greater improvements in the ECM and DIAGNOdent values when compared to the sealant only group (p < 0.05).

Treatment of Pit & Fissure Carious Lesions

50. Abu-Naba, A
Management of Primary Occlusal Pit and Fissure Caries Using Ozone. PhD Thesis, Queens University Belfast, 2004.

51. Reaney D.
Management of Occlusal Caries Using Ozone. M Clin Dent , London University, 2003.

52. Abu-Naba'a L, Al Shorman H, Lynch E.
Ozone Efficacy in the Treatment of Pit & Fissure Caries. AADR abstract no. 2002. 2002 47 210 10 Seconds Primary Pit & Fissure Carious Lesion Lesions were divided by severity, 10s O3 significantly remineralised lesions with DIAGNOdent readings below 40 at baseline

53. Megighiam GD, Bertolini L, De Pieri A., Lynch E.
In-Vivo Treatment of Occlusal Caries with Ozone. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 434; 2002 And J Dent Res, 82: C-535; 2003 2002 60 200 10 seconds Primary Occlusal Fissure Carious Lesions DIAGNOdent readings correlated significantly with the clinical classification. A significant overall reduction of DIAGNOdent readings was produced immediately after Ozone treatment. The percentage of teeth which produced this reduction was over 50%. After one month DIAGNOdent readings showing reduction was over 90%.

54. Holmes J.
Clinical Reversal of Occlusal Pit & Fissure Caries Using Ozone The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 431; 2002 and J Dent Res, 82: C-535; 2003 2003 193 579 10, 20, 30 or 40 seconds Primary Pit & Fissure Carious Lesion 99% of the O3 treated primary occlusal fissure carious lesions had clinically reversed based on the DIAGNOdent readings (P<0.001). The control primary occlusal fissure carious lesions, which had not received any ozone treatment, did not significantly change

55. Abu-Naba'a L, Al Shorman H, Stevenson M, Lynch E.
Ozone Treatment of Pit & Fissure Caries: 6-month Results. AADR Abstract no. 765; 2003. 2003 78 240 10 Seconds Primary Pit & Fissure Carious Lesion mean ECM change was 1. 5 times better than baseline for the treatment group while for the control it was -1. 1 times deterioration of lesions. These improvements were regardless of tooth number, position, lesion’s type or severity.

56. Abu-Naba'a L, Al Shorman H, Lynch E.
Ozone Treatment of Primary Occlusal Pit & Fissure Caries (POPFC): 12-Months Clinical Severity Changes. J Caries Res, 37:272; 2003. 2003 90 258 10 Seconds Primary Pit & Fissure Carious Lesion 10% more lesions had their clinical scores reduced after O3 treatment than control lesions, 5% more of teeth had clinical severity scores increase in the control group. A detailed clinical criteria should be used for monitoring O3 treated lesions

57. Holmes J, Lynch E.
Arresting Occlusal Fissure Caries Using Ozone. AADR Abstract no. 678; 2003. 2003 278 1275 10, 20, 30 or 40 Seconds Primary Pit & Fissure Carious Lesion 93% of the ozone treated primary occlusal fissure carious lesions had clinically reversed based on the reversal of the clinical severity index to lesions which were deemed to be reversing or to have reversed, whilst the control lesions were deemed not to have clinically changed (P<0.01). In addition, this clinical reversal was supported by DIAGNOdent readings, which showed a significant reduction in the test lesions compared to the control lesions (P<0.001).

58. Abu-Naba'a L, Al Shorman H, Lynch E.
Ozone Treatment of Primary Occlusal Pit & Fissure Caries: 12-month ECM results & Cinical implications. Caries Res, 37:272; 2003. 2003 90 258 10 seconds Primary Pit & Fissure Carious Lesion treatment group's ECM change ranged from 0. 02 to 0. 62 (average 0. 30 ±0. 009) & Control ranged from 0. 07 to -0. 27 (-0. 13±0. 009). Difference between groups ranged from 0. 22 to 0. 56 (p<0. 05 at 4 recalls). ECM showed significa+K56ntly a better change for the treatment group from the first recall at one month

59. Reaney D, Lynch E.
Clinical Reversal of Pit & Fissure Caries After Using Ozone. AADR Abstract no. 674; 2003. 2003 22 78 30 Seconds Primary Pit & Fissure Carious Lesion 74. 4% O3 treated teeth clinically reversed 100% stable or reversed. 82% control lesions got worse

60. Daly T, Lynch E.
Reversal of Occlusal Pit & Fissure Caries by Ozone. AADR Abstract n. 682; 2003. 2003 58 58 30 Seconds Primary Pit & Fissure Carious Lesion 18 of the ozone treated primary pit and fissure carious lesions had clinically reversed based on the clinical measurement of lesion severity whilst 7 other lesions remained stable and 4 became worse (P<0.05). The control lesions did not significantly change clinically.

61. Stinson P, Abu-Naba'a L, Al Shorman H, Lynch E.
Clinical Reversal of Occlusal Pit & Fissure Caries after Using Ozone AADR abstract no. 681; 2003 & J Dent Res 82: B-355 2003 2003 98 279 30 Seconds Primary Pit & Fissure Carious Lesion To date, 32 test subjects with 69 test lesions have attended the recall visit. There were no observed adverse events. 58 of the ozone treated primary pit and fissure carious lesions had clinically reversed based on the clinical measurement of lesion severity whilst the other 11 test lesions remained stable or progressed (P<0.05). The control lesions did not significantly change clinically.

62. Holmes J.
Clinical Reversal of Occlusal Pit & Fissure Caries Using Ozone. J Dent Res, 82:B- 354; 2003 2003 376 2364 10,20,30, or 40 seconds Primary Occlusal Fissure Carious Lesions 315 patients had been recalled for re-evaluation. There were no observed adverse events. 99% of the ozone treated primary occlusal fissure carious lesions (1918 lesions) had clinically reversed and this correlated with the improvement in the DIAGNOdent readings (P<0.01). The control carious lesions, which had not received any ozone treatment, did not significantly change in the study period.

63. Jackson P, Lynch E.
Healing of Pit & Fissure Caries after Using Ozone. AADR Abstract no. 1174; 2003. 2003 78 139 30 Seconds Primary Occlusal Fissure Carious Lesions After 3 months, 36 test subjects with 88 lesions, and 16 control subjects with 33 lesions reattended for re-evaluation. There were no observed adverse events. 70 of the ozone treated lesions had reversed based on the DIAGNOdent, which has been shown to correlate with clinical severity of primary fissure caries. 9 of the Ozone treated lesions maintained a stable DIAGNOdent reading and a further 9 had an increased DIAGNOdent reading (P<0.05). The DIAGNOdent readings for the control lesions did not significantly change.

64. Cronshaw MA
Treatment of Primary Occlusal Pit and Fissure Caries with Ozone: Six-month Results IADR Abstract no. 2750;2003. 2003 18 49 30 Seconds Primary Occlusal Fissure Carious Lesions Of the 31 teeth treated, 25 showed improvements in DIAGNOdent measurements whilst 6 remained the same (P<0.05). 25 out of the 31 Ozone treated lesions had clinically reversed (P<0.05). In this test group there was an average reduction in Diagnodent readings of 49% (P<0.05). The control pit and fissure lesions, which had not received any ozone treatment, did not significantly change clinically and had deterioration in their DIAGNOdent readings.

65. Johnson N, Johnson J, Johnson K, Lynch E.
Effective Treatment of Occlusal Fissure Caries Using Ozone AADR Abstract no. 676; 2003. 2003 35 90 20 Seconds Primary Occlusal Fissure Carious Lesions After 1 month, 35 patients (90 lesions) were recalled for re-evaluation. There were no observed adverse events. Based on the clinical measurement of lesion severity, 59% of the ozone treated lesions showed visible signs of reversal, whilst 41% had remained stable (P<0.05). 100% of lesions had been stabilised with no progression. When measured using the DIAGNOdent, 79% of the ozone treated had reversed and 18% remained stable. The control primary occlusal fissure carious lesions, which had not received any ozone treatment, did not significantly change clinically

66. Johnson N, Johnson J, Johnson K, Lynch E.
Effective Treatment of Occlusal Fissure Caries Using Ozone. J Dent Res, 82: B-354; 2003. 2003 105 300 20 Seconds Occlusal Fissure Caries Based on the clinical measurement of lesion severity, the ozone treated lesions showed significant signs of reversal (P<0.05). When measured using the DIAGNOdent, 81% of the ozone treated primary occlusal fissure carious lesions had reversed and 17% remained stable. The control primary occlusal fissure carious lesions, which had not received any ozone treatment, did not significantly change clinically.

67. Abu-Naba'a L, Al Shorman H, Lynch E.
Clinical Indices Changes afterTreatment of Pit & Fissure Caries (PFC). AADR Abstract no. 1173; 2003. 2003 8 34 40 seconds Primary Occlusal Fissure Carious Lesions since one month, lesions treated with O3 lose frostiness are judged as lesions that require more conservative treatment needs. Stains on the surface or undermining enamel of fissures didn't reduce in length

68. Abu-Naba'a L, Al Shorman H, Lynch E.
6-month Clinical Indices Changes after Ozone Treatment of Pit & Fissure Caries (PFC). J Dent Res, 82: B-135; 2003. 2003 8 34 40 seconds Primary Occlusal Fissure Carious Lesions At six months, lesions treated with O3 lose frostiness, became smooth judged as more arrested lesions that require more conservative treatment needs. There was a trend for lesions to become darker & the stains on the surface or undermining enamel of fissures didn't reduce in length

69. Morrison R, Lynch E.
Efficacy of Ozone to Reverse Occlusal Caries J Dent Res: 82, B-354; 2003 2003 145 240 40 seconds Primary Occlusal Fissure Carious Lesions 123 of the ozone treated primary pit and fissure carious lesions had clinically reversed based on the clinical measurement of lesion severity whilst the other 18 lesions remained stable and none became worse (P<0.05). The control lesions did not significantly change clinically

70. Morrison R, Lynch E.
Remineralization of Occlusal Pit & Fissure Caries After Using Ozone. AADR Abstract no. 680; 2003. 2003 108 186 40 Seconds Primary Occlusal Fissure Carious Lesions 80. 5% lesion reversal, 100% stability, no progression in O3 treated group

71. Huth KC, Paschos E, &. Hickel R.
The Effect of Ozone on Fissure Caries in Permanent Molars IADR Abstract no. 2466; 2004 2004 41 114 40 Seconds Primary Occlusal Fissure Carious Lesions Immediately after the treatment the test teeth showed a significant improvement of DD- and ECM-values compared to the control (Wilcoxon-Test, p=0.001 for DD and 0.008 for ECM). When selecting patients with deterioration of the DD-values of their control teeth over the 3-months-period, the positive effect of ozone on the DD-values compared to the controls became also significant after 1, 2 and 3 months (Wilcoxon-Test, p<0.05). It appears that these selected patients showed significant more caries experience in the past (dmfs-index), a significant higher caries prediction value (Dentoprog-value) and a significant worse oral hygiene than the non-selected patients.

72. Hamid A.
Clinical Reversal of Occlusal Pit & Fissure Caries Using Ozone. IADR Abstract no. 3470 2004. 2004 184 184 40 Seconds Primary Occlusal Fissure Carious Lesions There were no observed adverse events. 86.6% of the ozone treated primary pit and fissure carious lesions had clinically reversed based on the clinical measurement of lesion severity whilst the control lesions did not significantly change clinically .(P<0.05). The DIAGNOdent® values correlated with the clinical findings.

Treatment of Primary/Deciduous Teeth

73. Abu-Salem OT.
Management of Occlusal Caries in Primary Teeth Using Ozone. Mphil thesis, Queens University Belfast, 2004.

74. Abu-Salem OT, Marashdeh MM, Lynch E.
Immediate Effect of Ozone on Occlusal Caries of Primary Teeth. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 432; 2002 and J Dent Res, 82: C-535; 2003 2002 12 invitro 10 seconds Occlusal Carious Lesions DIAGNOdent and standard scale ECM readings correlated significantly with the clinical classification (rs=0.675, p = 0.016 and rs= -0.697, p=0.012 respectively). Ozone application reduced the DIAGNOdent readings after 10s application (t = 2.891, p =0.015), and after 20s (t = 5.313, p < 0.001).

75. Abu-Salem OT, Marashdeh MM, Lynch E.
Ozone Efficacy in Treatment of Occlusal Caries in Primary Teeth. J Dent Res, 82: B-136; 2003 2003 16 42 10 Seconds Occlusal Carious Lesions At six months ECM readings were improved significantly (p<0.05) and DIAGNOdent readings also improved significantly (p<0.05) compared to the baseline readings. The carious lesions in the treatment group showed significant improvement in the texture and perceived treatment needs indices with no significant changes on Ekstrand clinical index, frosted enamel index and stained enamel length.

76. Abu-Salem OT, Marashdeh MM, Lynch E.
Ozone Efficacy in Treatment of Occlusal Caries in Primary Teeth. AADR Abstract no. 685; 2003. 2003 17 50 10 Seconds Occlusal Caries + Air Abrasion ECM readings were increased significantly (p<0.05) and DIAGNOdent readings were reduced significantly (p<0.01) in the test lesions compared to the control lesions.

Combining Ozone Treatment with Other Preparation Systems

77. Clifford C.
Successful Use of Airbrasion in Conjunction with Ozone Treatment. J Dent Res, 82: B-2747; 2003. 2003 37 48 40 Seconds Approximal lesion requiring drilling and filling airabrasion and Ozone with GI filling All lesions were successfully exposed and a seal established for the delivery of ozone. Clinically acceptable seals have been achieved around all restorations. The airabrasion and Ozone technique was significantly faster than conventional drilling and filling (P<0.05).

78. Clifford C.
Reversal of Caries Using Airbrasion & Ozone- Nine Month Results. IADR Abstract no. 2467; 2004. 2004 34 68 40 Seconds requiring drilling and filling airabrasion and Ozone with GI filling All Ozone treated restorations were symptom less throughout the 9 months. All 34 Fuji 7 restorations, removed after 3 months recall, showed hard ‘caries' to exploration suggesting remineralisation was successful. All lesions were successfully exposed and a seal established for the delivery of ozone at baseline. The airbrasion and Ozone technique was significantly faster (lesions were exposed, ozonated and sealed in under 7 minutes) than conventional drilling and filling (P<0.05).

79. Holmes J & Lynch E.
Reversal of Occlusal Caries using Air Abrasion, Ozone, & Sealing. IADR Abstract no. 3468; 2004. 2004 38 76 40 Seconds Occlusal Caries Group 1; air abrasion + O3 40 seconds+ a mineral wash, then glass ionomer.After 3 months, a posterior composite; Group 2; drill and fill by posterior composite.3 5 patients attended all recall visits. 6 Subjects receiving the posterior composite restoration at baseline complained of some post-operative sensitivity whilst no sensitivity was reported associated with any of the Ozone treated teeth (P<0.05). At 3 months all Ozone-treated dentine caries was hard and required no additional removal

80. Holmes J.
Restoration of ART & Ozone treated primary root carious lesions. J Dent Res, IADR Abstract 2004. 2004 60 120 20 Seconds Primary Root Caries ART & O3 lead to no puplp exposures, retained full vitality & strength of tooth. Drill&Fill lead to pulp exposures & further RCT was required before review period.

81. Domingo H, Holmes J.
Reduction in treatment time with combined air abrasion & Ozone compared to traditional ‘Drill & Fill’. J Dent Res, IADR abstract 2004. 2004 64 128 40 Seconds Primary Root Caries AA & O3 was faster than Drill&Fill. AA was more profitable than D&F

Cost Benefits of Ozone Treatment

82. Johnson N, Johnson J, Lynch E.
Cost Benefit Assessment of a Novel Ozone Delivery System vs. Conventional Treatment. AADR Abstract no. 684; 2003. 2003 48 n/a n/a Occlusal & Root Carious Lesions Conventional treatments (local analgesia, drilling and filling) necessitated a minimum of 20 minutes of chair time. Ozone therapy involved a minimum of 3 minutes. Typical UK costs for providing treatment were considered and compared with the costs of using ozone therapy. The time and cost of conventional treatment far outweighed the ozone therapy (P<0.05).

83. Domingo H, Holmes J.
Reduction in treatment time with combined air abrasion & Ozone compared to traditional ‘Drill & Fill’ & cost comparison. IADR abstract 2004. 2004 64 128 40 Seconds Primary Root Caries AA & Ozone was faster than Drill & Fill. AA was more profitable than D&F

Ozone Treatment of Endodontic Pathologies

84. Schwan L, Bamfaste M.
[Experiences with the use of chlorine gas and ozone in the treatment of root gangrene and dental granuloma]. Dtsch Zahnarztl Z, 6:301-308; 1951. 1951

85. Brunel A, Vannier R, Archinet F.
[Sterilization of minute endodontic material by the combination of ethylene oxide and ozone. Experimental evaluation of its effectiveness]. Acta Stomatol Belg 62:355-359;1965. 1965

86. Sandhaus S.
[Ozone therapy in odontostomatology, especially in treatments of infected root canals]. Rev Belge Med Dent, 20:633-646;1965. 1965

87. Haimovici A, Lacatusu S, Irjicianu A, Joan E.
[Ozone in endodontic therapy]. Stomatologia (Bucur ),; 17:303-307; 1970. 1970

88. Chang H, Fulton C, Lynch E.
Antimicrobial Efficacy of Ozone on Enterococcus faecalis. J Dent Res, 82: B-220; 2003. 2003 n/a n/a 60, 30, 20, 10, 0 seconds 108 solution E Faecalis 60= 0 cfu's, 30= 0 cfu's, 20= 0 cfu's, 10= 0 cfu's at 106 & 105 concentrations. Higher concentrations were markedly reduced

89. Nagayoshi M, Kitamura C, Fukuizumi T, Nishihara T, Terashita M.
Antimicrobial effect of ozonated water on bacteria invading dentinal tubules. J Endodontics, 778-781; 2004. Part 2 2004 Enterococcus faecalis & Streptcoccus mutans infections in vitro in bovine dentin. When the specimen was irrigated with sonication, ozonated water had nearly the same antimicrobial activity as 2.5% sodium hypochlorite (NaOCl). After irrigation with ozonated water, the viability of E. faecalis and S. mutans invading dentinal tubules significantly decreased.

Use of ozone in treatment associated with Dental and maxillofacial surgery

90. Minguez F, Gomez-Lus ML, Andre J, Cabronero MJ, Prieto J.
[Antimicrobial activity of ozonized water in determined experimental conditions]. Rev Sanid Hig Publica (Madr ), 64:415-423; 1990. 1990 Disinfection of Buccal flora and hand flors Antimicrobial activity in ozonized water on bacterial suspensions and contaminated materials was meaningful and depended fundamentally on concentration and time of exposure. On buccal flora, one rinse alone had no effect, but various successive rinses led to substantial reductions in the number of colonies of bacteria. Ozone had a similar effect, although more pronounced, on the flora of the hands. Ozonized water placed in an open dish kept up antimicrobial activity for the first 20 minutes, but after 30 minutes this activity decreased substantially

91. Kiniapina ID, Durnovo EA.
[The efficacy of using ozone in the combined treatment of disseminated odontogenic phlegmons of the maxillofacial area]. Stomatologiia (Mosk), Spec No:60-6; 1996. 1996

92. Lazutikov OV, Lunev BV.
[The use of ozonized solutions in the combined treatment of odontogenic putrefactive-necrotic phlegmons of the maxillofacial area and neck]. Stomatologiia (Mosk), Spec No:64-65;1996. 1996

93. Malanchuk VA, Gorshevikova EV, Kopchak AV.
[Antimicrobial action of ozone in the treatment of mandibular fracture]. Klin Khir, 3:43-46;2000. 2000

94. Korotkikh NG, Lazutikov OV, Dmitriev VV.
[The effect of ozone on the microbiological characteristics of the oral fluid in patients with mandibular fractures]. Stomatologiia (Mosk), 79:20-21;2000. 2000

95. Korzhachkina NB, Radzievskii SA, Olesova VN.
[Preventive use of ozone, short waves, and laser therapy alone and in combination in early postoperative period after dental implantation]. Vopr Kurortol Fizioter Lech Fiz Kult,6:17-19; 2002. 2002

Ozone treatment for Gingivitis and Periodontitis

96. Brauner A.
[Clinical studies of therapeutic results from ozonized water for gingivitis and periodontitis]. Zahnarztl Prax , 42:48-50;1991. 1991

OHManagement Software for Patient Management

97. Scholz V.
OHManagement Software for quality management in an Ozone treatment practice. IADR Absrtact no. 715; 2004. 2004 n/a n/a n/a 10 clinics operating with new OHManagement Software, compared to no OHM Patient recall attendence (53% v 44%) & compliance (84% v 75%) were better with the new OHM

Ozone Treatment of Dentinal sensitivities

98. Ciriello G.
[Ozone and dentinal sensitivity.]. Riv Ital Stomatol, 10:159-164;1955. 1955

Ozone treatment of Pulpal pathologies

99. Dechaume M.
[The use of ozone in the local treatment of caries, pulpitis and periapical osteitis.]. Suom Hammaslaak Toim, 48:61-66; 1952. 1952

1H NMR Studies on Tooth Whitening

100. Holmes J, Grootveld M, Smith C, Claxson AWD, Lynch E.
Bleaching of Components Responsible for Extrinsic Tooth Discoloration by Ozone. AADR Abstract no. 615; 2003. 2003 n/a n/a 5,10,15, 20 seconds tooth stain removal (Melanoidins) Stains were generated via the reaction of L-lysine (1.25-250.0 x 10-3 mol. dm-3) with an equivalent concentration of alpha-D-glucose in phosphate buffer (pH 7.00) at 80oC for a period of 240 hr. Substantial bleaching of melanoidins following treatment with O3 [e.g., at an O3 delivery level of 4.48 mmol, the decrease in absorbance at 366 nm was 90 ± 4% (mean ± s.e.) for the 1.25 x 10-3 mol.dm-3 reaction mixture, and 28 ± 3% for that initially containing 250.0 x 10-3 mol.dm-3 reactants]. The extent of the bleaching process observed increased with increasing levels of O3 treatment The mechanism of this process may involve the ozonation of (>C=C<) bond systems which contribute to the chromophoric properties of such “browning products”.

Effects of Ozone on Dental Materials

101. Murakami H, Sakuma S, Nakamura K, Ito Y, Hattori M, Asai A, Noguchi T, Maeda H, Kameyama Y, Kimura Y, Nagao T, Kawai T, Hasegawa J.
Disinfection of removable dentures using Ozone. Dent Mater J, 15:220-225; 1996. 1996 O3 in water 10 ppm Removable partial dentures C. albicans decreased to about 1/10 after 30 min & to 1/10(3) after 60 min.

102. Oizumi M, Suzuki T, Uchida M, Furuya J, Okamoto Y.
In vitro testing of a denture cleaning method using Ozone. J Med Dent Sci, 45:135-139; 1998. 1998 700 mg/h gas for 1 & 3 minutes ozonated water at 1 ppm & 3 ppm Streptococcus mutans (IID 973), Staphylococcus aureus (209-P), & Candida albicans (LAM 14322). direct exposure to gaseous O3 seems to be a more effective microbicide compared with ozonated water, & that gaseous O3 can be clinically useful for disinfection of dentures.

103. Krozer A, Hall J, Ericsson I.
Chemical treatment of machined titanium surfaces. An in vitro study. Clin Oral Implants Res, 10:204-11; 1999. 1999 O3 made by commercial mercury lamp in ambient air Implant material rinsed with a disinfectant solution with amino-alcohol 1. Amino alcohols forms a stable & dense film in vitro. Which most likely prevents re-integration to occur at the implant-tissue interface in vivo 2 Rrinsing in water, saline solution, & 5% H2O2 did not remove the amino-alcohol from the surface. O3 complete removal of the adsorbed amino-alcohol adherent film

104. Suzuki T, Oizumi M, Furuya J, Okamoto Y, Rosenstiel SF.
Influence of Ozone on oxidation of dental alloys. Int J Prosthodont, 12:179-83; 1999. 1999 O3 gas 20 mg/h dental alloys (Co-Cr, Au-Ag-Pt, & Au-Cu-Ag-Pd). reflectance, surface roughness, & weight were measured O3 caused a slight change in the Au-Cu-Ag-Pd alloy in terms of measured reflectance, but the changes were significantly less than those caused by acid-electrolyzed water & one of the commercial denture cleaners.

105. Zhao H, Zheng D, Hong L.
The disinfection efficiency comparison of different treatments on dental impression & gypsum casts. Hua Xi Kou Qiang Yi Xue Za Zhi, 18:332-335;2000. 2000 Gypsum casts O3 treatment is an effective method in disinfecting the gypsum casts

106. Hussey D, Armstrong C,Lynch E.
Bond strengths of composite to enamel /dentine treated with ozone. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 697; 2002. 2002 n/a 40 teeth enamel and dentine samples 10 Seconds 2.7min diameter tubes of composite resin (Esthet-X, Dentsply, &bonding agent (Prime and Bond NT, Dentsply) The mean loads (Newtons) to debond the specimens were as follows: enamel without ozone 116.4 (sd 50. 1), enamel with ozone 128.6 (sd 49.4), dentine without ozone 54.7 (sd 23.6), dentine with ozone 51.6 (sd 15.6). Wilcoxon signed rank test revealed no statistically significant difference between the groups with and without the ozone treatment (Enamel z= -1.05, p=0.29, Dentine z-- -0.15, p=0.88).

107. Baysan A, Lynch E.
Management of Primary Root Caries using Ozone The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no 195; 2002. 2002 79 220 10 seconds Fissure sealant applied over Root caries 61% of intact sealants in the O3 & sealant group & 42% of intact sealants in the sealant only group (p < 0. 05). After 3 6 & 9 months, O3 & sealant group also had greater improvements in the ECM & DIAGNOdent values when compared to the sealant only group (p < 0. 05).

108. Matsumura K, Ikumi K, Nakajima N, Peng C, Hyon SH, & Tsutsumi S,
A Trial of Regeneration of Periodontal Ligament around Dental Implants J Dent Res, 81: A-101; 2002. 2002 titanium implant PDL cell taken from dog’s a. titanium implant was oxidized by 30%H2O2 b. poly(ethylene-co-vinyl alcohol)(EVA) was coated onto the implant & O3 c. Third, the collagen sponge was immobilized around the implant by freeze-drying method. d. PDL cells were seeded onto the implant and then implanted into dog's alveolar bone. After 3 months of implantation, the implants and their surrounding tissues were removed. The specimens were stained with Masson Trichrome stain. From the results, the tissue around implant was observed to be similar to the one around natural tooth.

109. Murakami H, Mizuguchi M, Hattori M, Ito Y, Kawai T, Hasegawa J.
Effect of denture cleaner using ozone against methicillin-resistant Staphylococcus aureus and E. coli T1 phage. Dent Mater J, 21:53-60; 2002. 2002 10 ppm Methicillin-resistant Staphylococcus aureus (MRSA) and T1 phag virus bacteria was 3.1 x 10(3) CFU/mL at the beginning of the experiment, fell to 1.0 x 10(0) CFU/mL 10 min later, and was 1.0 x 10(0) CFU/mL or less afterwards. In contrast, when the ozone supply was cut off (air bubble only), the number of bacteria was 3.4 x 10(3) CFU/mL at the beginning of the experiment, and had fallen to 3.0 x 10(3) CFU/mL 60 min later (no statistically significant difference). In the virucidal activity test, the number of phages was 1.2 x 10(6) PFU/mL before ozone treatment, fell to about 1/10 of that number 10 min later, and was 6.1 x 10(0) PFU/mL 40 min later.

110. Campbell D, Hussey D, Cunningham L, Lynch E.
Effect of Ozone on Surface Hardness of Restorative Materials. J Dent Res,82:B-262; 2003. 2003 n/a 18 x 3 10 Seconds Restorative Materials Statistical analysis using a 2-way ANOVA did not reveal any difference in surface hardness following the treatment with O3 (p >0.15)

111. Baysan A, Lynch E.
12-month Assessment of Ozone on Root Caries J Dent Res, 82; B-311; 2003. 2003 79 220 10 seconds Fissure sealant applied over Root caries Modified USPHS criteria revealed that there were 61% of intact sealants in the ozone and sealant group and 26.1% of intact sealants in the sealant only group (p < 0.05). After 1, 3, 6, 9 and 12 months, the ozone and sealant group also had greater improvements in the ECM and DIAGNOdent values when compared to the sealant only group (p < 0.05). Conclusions: Leathery root caries can be treated non-operatively with ozone

112. Hiller Ka, Federlin M, Mackow A, Redlich M, And Schmalz G.
Influence of ozone treatment on marginal adaptation of fissure sealing Continental NOF Divisions of the IADR Abstract no. 62; 2004. 2004 120 extracted human molars Art + Group I: O3 40s, seal Tetric Flow, Helioseal Clear or Fuji VII Group II: restorations were placed immediately after preparation. Before TC, the frequency of silver-staining was 26-50% (group I) and 23-50% (group II), TF revealing the lowest (26%) and FU the highest frequency (50%) (group I). After TC, the frequency of silver-staining was 8-46% (group I) and 10-50% (group II), TF revealing the lowest (8%/10%) and FU the highest frequency (46%/50%) in groups I and II. Before and after TC, microleakage was limited to enamel with TF and FU, whereas with HC silver-staining included enamel and dentin. The Error Rates Method revealed a significant influence of the sealing material upon the frequency of silver-staining but no difference was determined with respect to ozone treatment. thermocycling 60s/cycle), stored in saline at 37°C for one week.

113. Czarnecka B, Deegowska-Nosowicz P, Prylinski M, Limanowska-Shaw H.
Bond strength of glass-ionomer's to dentine after Heal Ozone treatment Continental NOF Divisions of the IADR Abstract no. 63; 2004. 2004 60 extracted bovine teeth n/a group Ozone then conditioned with conditioner group B were treated with Ozone and Reductant then conditioned. Group C (controls) were conditioned. samples of glass ionomer Fuji Fast (GC International-X) and 20 similar samples of Ketac Molar Aplicap (3M-ESPE, Seefeld, Germany-Y) were bonded to the prepared surfaces; Group A gave the lowest values of SBS in both cases though this was statistically significant (p<0.05) only for cement Y. There was no statistical difference between group B and the control group. Heal Ozone treatment alone thus has a tendency to weaken the SBS of glass-ionomers bonded to bovine enamel, but this is eliminated by the use of Ozone Reductant.

114. Abu-Naba'a L, Al Shorman H, Lynch E.
6-months Fissure Sealant Retention Over Ozone- treated Occlusal Caries. IADR Abstract no. 3472; 2004. 2004 53 132 10 Seconds Fissure sealant applied over non-cavitated Occlusal Carious Lesions At baseline, severity of lesions in both groups was similar(p>0.05). At 6 months, there were no significant differences between the groups in terms of FS retention, marginal discolouration, FS colour and secondary caries at any of the recall visits (p>0.05).

115. Steier L. , Lynch E.
15-months Sealant Retention Over Ozone- treated Occlusal Caries. J Dent Res, IADR Abstract 2005. 2005 73 146 40 seconds Primary Occlusal Fissure Carious Lesions & flowable fissure sealant O3 treatment had not affected retention of flowable composite resin sealants occlusally in-vivo, nor marginal discoloration, FS color & secondary caries at any of the recall visits.

116. Steier L , Steier G.
Ozone & Sealant Treatment of Root Caries after 12-Months. J Dent Res, IADR Abstract 2005. 2005 62 124 40 seconds flowable root sealant Primary Occlusal Fissure Carious Lesions and 60/61 arrested in treatment group, 24/61in control at one month. retention of sealants on these arrested lesions is very promising 2/55 Tt; 8/32 in control lost retention completely or partially 1 & 12 month.

117. Abu-Naba'a L, Al Shorman H, Lynch E.
Fissure sealant retention over Ozone-treated occlusal pit & fissure caries: 12-months results. J Dent Res, IADR Abstract 2005. 2005 53 132 10 seconds Primary Occlusal Fissure Carious Lesions & fissure sealant O3 treatment followed by immediate sealant placement was not detrimental to retention rate compaired to the control group. 0% secondery caries, 0% complete loss of fissure sealant retention after one year

118. Abu-Naba'a L, Al Shorman H, Hayajneh R, Lynch E.
Ozone effects on denture acrylic surface. J Dent Res, IADR Abstract 2005. 2005 40 samples 1 & 2 hours Heat cured acrylic with a polished & glazed surface O3 didn’t produce any change in the roughness of the surface of treated samples

Treatment of Dental Unit Water Lines (DUWL)

119. Filippi A, Tilkes F, Beck EG, Kirschner H.
[Water disinfection of dental treatment units using ozone]. Dtsch Zahnarztl Z, 46:485-487; 1991. 1991 Dental unit Under the precondition that the dental chair had been thoroughly sanitized, the system showed a good disinfecting effect. Finally, for reasons of practical medical treatment, the ozone concentration in air and, for reasons of hygiene in drinking water, the ozone concentrations in water were determined under various conditions. In addition, the influence of continuous-flow water heaters is discussed. The problem of continuous-flow water heaters regarding their effects on the colonisation of water by microbes proves not to be significant. The exposure of patients to disinfectants is discussed

120. Al Shorman, Coulter W, Lynch E Claxson AWD, Silwood CJL,Grootveld M.
Use of Ozone to Treat Dental Unit Water Lines. BSDR Abstract no. 219; 2001. 2001 n/a n/a 10 seconds DUWL samples the biomolecules in the DUW were acetate, proprionate, formate, the amino acid glycine, aromatic compounds & occasionally ethanol. O3 treatment of the DUW gave rise to oxidation of ethanol & an increase in formate levels presumably due to oxidation of carbohydrate

121. Walker JT, Bradshaw DJ, Fulford MR, Martin MV, Marsh PD.
Control of planktonic and biofilm contamination in a laboratory dental unit water system J Dent Res, 81:A-445; 2002. 2002 200mg/hour Combizyme (1.25%) Tegodor (1%), Spor-Klenz (Neat), Dialox (Neat), Tegodor (1%), Bleach (0.5%), Ozone (200mg/hour), Chlorhexidine (0.2%), Ultrakleen (powder) and Betadene (10%) were tested overnight (16h). Flushing did not reduce the viability or the extent of the biofilm on DUWS tubing. Only Combizyme did not completely reduce the total viable counts of planktonic or biofilms cells. However, the efficiency of biofilm removal was: Dialox > Bleach > Ultrakleen > Betadine > Spor-Klenz > Bio2000.

122. Cardon B, Eleazer P, Miller R, Staat R.
Low concentration Ozone treatment insufficient to control DUWL biofilm. AADR Abstract no. 714; 2002. 2002 n/a n/a O3 conc 0. 05ppm DUWL samples The O3 concentrations at the handpiece during recirculation was 0.01 to 0.06 ppm;. Microbiological data indicated that water samples taken 30 or more minutes after the O3 treatment cycles all exceeded 10,000 CFU. After 10 weeks of O3treatment, microscopic analysis showed biofilm formation on the interior of all tubing sections.

123. Al Shorman, Abu-Naba'a, Coulter W, Lynch E.
Ozone efficacy in the treatment of Dental Unit Water Lines. J Dent Res, 81: B 299. 2002. 2002 2 dental units n/a 1 & 3 minutes / unit/ days 1,2,3,4,& 7 DUWL samples after flushing for 2 minutes Reduction of bacteria 1000 fold on day 7 for the 1 min application. Sterile water on day 2 for the 3 min application, sterile water followed up till 5 weeks

124. Al Shorman, Coulter W, Abu-Naba'a, Mohan G, Boyle C, Lynch E.
Effect of Ozone on biofilms in Dental Unit Water Lines. AADR Abstract 2002. 2002 4 dental units n/a 1,2,3 minutes & 15 min 1,2,3 minutes application 2 min flushing, 15 min application & 15 min flushing 10 fold increase for 1 min, 10,000 fold decrease of bacterial counts for 2 & 3 min application times. Biofilm layer seen to be reduced at 15 min application time & 10 min flushing, but completely removed at 15 minutes application & flushing time 7 days for units 1,2 & 3

125. Al Shorman, Abu-Naba'a, Coulter W, Lynch E.
Ozone, An Effective Treatment For Dental Unit Water Lines. J Dent Res 81:A-112; 2002. 2002 1 dental units n/a 3 minutes, at 2100ppm O3, 615 ml/min DUWL flushed for 2 minutes O3 treatment showed reduction from 5. 2*103 CFU/ml to 300 CFU/ml after first application, then 0 CFU/ml at the second & subsequent (1000 fold reduction)

126. Al Shorman, Abu-Naba'a, Coulter W, Lynch E.
Ozone, An Effective Treatment For Dental Unit Water Lines. J Dent Res 81:A-112, 2002. 2002 1 dental units n/a 3 minutes, at 2100ppm O3, 615 ml/min DUWL flushed for 2 minutes O3 treatment showed reduction from 5. 2*103 CFU/ml to 300 CFU/ml after first application, then 0 CFU/ml at the second & subsequent (1000 fold reduction)

127. Smith C, Al Shorman H, Grootveld M, Silwood C, Lynch E, Mills B, Silwood C.
Rapid Detection of Microbial-Derived Components in Dental Unit Water Lines by NMR Analysis. J Dent Res, 81:A-112, 2002. 12 dental units Multicomponent 1H NMR investigations of DUWLs Results acquired revealed that many biomolecules were detectable in the samples examined, including a wide range of microbial fermentation products (MFPs). For example, the organic acid anions acetate, formate, lactate, propionate and succinate, and occasionally ethanol were present in the samples examined. Further components detectable included the amino acids alanine and glycine, and also a series of aromatic compounds. Treatment of DUWLs with the powerful microbicidal agent ozone gave rise to a substantial reduction in many of the MFPs detectable in samples collected 18 hr. after treatment (p < 0.01).

128. Walker JT, Bradshaw DJ, Fulford MR, Marsh PD.
Microbiological evaluation of a range of disinfectant products to control mixed-species biofilm contamination in a laboratory model of a dental unit water system. Appl Environ Microbiol, 69:3327- 32; 2003. A model in-vitro O3 was applied for 10 min In-vitro model Low concentration of O3 did not completely reduce the biofilm total bacterial count at this concentration nor reduce the percentage biofilm coverage

129. Smith C, Al Shorman H, Abu-Naba'a L, Grootveld M, Silwood C and Lynch E
Detection of Microbial-Derived Components in Dental Unit Water Lines using NMR. The First Pan European Festival of Oral Sciences, Cardiff, UK. Abstract no. 477; 2002 & J Dent Res, 82: C-542; 2003. 16 dental units 10 seconds Multicomponent 1H NMR investigations of DUWLs signals presented in control samples by microbial-derived organic acid anionsused for chemotaxonomic ‘markers’ of, notably acetate, formate , lactate, propionate and succinate. Others are the amino acid glycine, a number of aromatic compounds and occasionally ethanol. O3 caused reduction in many of the microbial fermentation products detectable in samples collected 18 hr. after treatment (p < 0.01).

130. Al Shorman, Abu-Naba'a, Coulter W, Lynch E.
Primary Colonization of DUWL by P. aeruginosa & its Eradication by Ozone. J Dent Res, 82: B-284; 2003. 5 minutes ozone then 10 minutes flushing Dental Unit Water Lines treated either with continuous H2O2 (Oxygenal, KaVo, Germany) or ozone Oxygenal treatment continuously produced water with TVC of less than 100 CFU/mL. TVC of water from the control unit was 2.3 x 104 and 3.4 x 104 CFU/mL after 1 and 2 weeks of installation. The primary coloniser was identified (API 20 NE kit) as pure P.A. After the first O3 treatment the TVC was reduced to 60 CFU/mL and rose to 3.9 x 104 CFU/mL after a week with few Pseudomonas colonies. After two weeks, TVC was 2.8 x 103CFU/mL CFU/mL with no detected P.A. and became 0 CFU/mL after the treatment. Repeated sampling of the unit for 9 weeks showed no re-growth of P.A.

Studies on Ozonated Oils

131. Lynch E, Grootveld M, Holmes J, Silwood CJ, Claxson AWD, Prinz J, Toms H.
Analysis of Ozone-treated Grapeseed, Olive, & Sunflower Seed Oils. AADR Abstract no. 182; 2003. Ozonated Oils Comparison Treatment of each vegetable oil with O3 gave rise to the consumption of polyunsaturated fatty acids present (i.e. significant reductions in their mono- and bis-allylic-CH2 group resonances located at 2.06 and 2.76 ppm respectively, and also that of their vinylic protons at 5.38 ppm), consistent with their ozonation. Indeed, signals present in the 5.10-5.25 ppm regions of the ozonated GO and SO spectra are assignable to the ring protons of ozonides. Further O3-induced modifications to the oils included the production of aldehydes, i.e. -CH2CHO aldehydic group triplet resonances at 9.65 (ozonated GO and SO) and 9.74 ppm (all ozonated oils), terminal products arising from the decomposition of ozonides.

Other References

132. Baysan A, Lynch E, Grootveld M.
The use of Ozone for the management of primary root carious lesions. Tissue Preservation & Caries Treatment. . Quintessence Book 2001, Chapter 3, 49-67. 2001 50 100 10 Seconds Primary Root Caries