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| Ozone Therapy: A Drill-Free, Anaesthesia-Free Breakthrough in Caries Treatment |
| Ozone therapy emerges as a cutting-edge alternative for caries treatment, eliminating the need for anaesthesia injections and drilling, and promising a more refined patient experience. |
| The table below encapsulates the uses of ozone therapy highlighted in various studies. (A) discusses its applications, while (B) addresses its effects in dentistry.1 |
| (A) Author |
Study outcomes |
| AlMogbel A A et al. |
Ozone, when applied just for few minutes, effectively eliminates caries-causing bacteria. It penetrates fissures and dentinal tubules, soothing nerve endings and enhancing blood flow, making it an excellent pain reliever. |
| Reddy N tet al. |
Exposure to ozone destroys 99.9% of the bacteria that cause caries. In the weeks following treatment, the tooth undergoes remineralization, becoming hard and resistant once again. |
| Dähnhardt et al. |
The use of ozone therapy for treating dental caries in children with dental phobia effectively reduces their fear. |
| Huth et al and Zaura et al. |
The complete disappearance of carious spots under the influence of ozone is a remarkable outcome attributed to ozone's unique properties in dental treatment |
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| (B) The effects of ozone and ozone therapy in dentistry1 |
| Anti-inflammatory effect |
Ozone's anti-inflammatory effect stems from its ability to oxidize compounds like arachidonic acid and its prostaglandin derivatives, which are key players in inflammation at high levels. |
| Analgesic effect |
Ozone's analgesic effect is attributed to its modulation of prostaglandins, which regulate cellular reactions and inflammation. Additionally, ozone enhances tissue oxygenation, aiding in the metabolism and elimination of pain-triggering substances. Moreover, by increasing oxygen release in tissues, ozone improves the cell membrane's cation/anion balance, acting as a pain antagonist. |
| Disinfecting effect |
Before the intervention, the oral cavity is disinfected by rinsing with ozonated water. After opening the abscess cavity, it's washed intensively with the same solution. This process is repeated every 2-3 days until the wound cavity heals. |
| Anti-inflammatory and immunomodulatory effects |
After surgical intervention for open mandibular fractures, the oral cavity is rinsed daily for five days with ozonated distilled water containing 1,500 µg/L of ozone. This increases antioxidant activity in oral fluid, inhibiting lipid peroxidation and preventing inflammation. |
| Prosthetics and Conservative dentistry |
In prosthetics, ozonated water is used post-preparation to disinfect and stimulate metabolism in the sulcus area if damage has occurred. |
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| Advances in pH-Responsive Nanocarriers for Oral Drug Delivery |
| pH-responsive nanocarriers represent the predominant drug delivery systems utilized within the oral cavity. These nanocarriers are designed to facilitate pH-responsive release through incorporation of groups such as amines or acid-labile bonds. pH fluctuations trigger protonation/deprotonation or bond cleavage, thereby facilitating drug release. Nanocarriers are predominantly categorized based on their polymer composition, with various polymers being utilized for their preparation.2 |
| DMAEMA (dimethylaminoethyl methacrylate) is a cationic monomer, and its polymer (p(DMAEMA)) is frequently employed as a drug delivery vehicle owing to its pH-responsive characteristics. The chemical structure of DMAEMA includes a tertiary amine group with a pKa of 7.5. In acidic conditions, the tertiary amine group undergoes protonation, leading to structural changes (swelling) and increased hydrophilicity. Conversely, at pH levels above its pKa, the amine group deprotonates, rendering it hydrophobic. This property is crucial for loading hydrophobic drugs.2 |
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| Poly (ethylene glycol) (PEG) is among the most utilized hydrophilic polymers in drug delivery and nanotechnology. It is widely recognized for its "stealth" properties, minimizing interactions with blood components and thereby preventing the rapid clearance observed with other drug carriers. PEG also exhibits excellent biocompatibility. Additionally, PEG serves to stabilize polymeric nanocarriers by reducing the likelihood of particle agglomeration through steric stabilization.2 |
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| Chitosan (CS) is a copolymer derived from deacetylating chitin using alkaline chemicals. As the sole naturally occurring polycationic polysaccharide, it forms complexes with anionic molecules, leveraging its biodegradability and biocompatibility. These attributes have spurred advancements in nanotechnology and glycol chemistry, making CS-based nanoparticles a promising drug delivery option in biomedical and pharmaceutical industries.2 |
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| Mesoporous silica nanoparticles (MSNs) are inorganic porous materials extensively researched as a drug delivery platform since 2001. They possess advantageous properties such as tunable pore size, high pore volumes for efficient cargo loading, and a large specific surface area conducive to surface functionalization.2 |
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| Tertiary Amine Modified Restorative Resin (TARAS) demonstrated pH-responsive antibacterial and antibiofilm effects, effectively reducing S. mutans viability to less than 20% in acidic conditions compared to pH levels above 5.2 |
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| Conclusion: |
| Ozone therapy and pH-responsive nanocarriers represent significant advancements in dental care. Ozone therapy offers a revolutionary, minimally invasive approach to caries treatment, eliminating the need for traditional drilling and anaesthesia, and providing numerous benefits such as pain relief, anti-inflammatory effects, and enhanced patient comfort. |
| On the other hand pH-responsive nanocarriers promise precise and controlled drug delivery within the oral cavity, leveraging advanced materials like DMAEMA, PEG, chitosan, and mesoporous silica nanoparticles. Together, these innovations are paving the way for more effective, patient-friendly dental treatments, transforming the landscape of modern dentistry. |
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| GGI-CO-A1-AQS-300039538-WM-G24-0538 |
| References: |
| 1. |
AlMogbel A A, Albarrak M I, AlNumair S F (April 12, 2023) Ozone Therapy in the Management and Prevention of Caries. Cureus 15(4): e37510.DOI 10.7759/cureus.37510. Click here to view the original article |
| 2. |
He, Y.; Vasilev, K.; Zilm, P. pH-Responsive Biomaterials for the Treatment of Dental Caries—A Focussed and Critical Review. Pharmaceutics 2023, 15, 1837. https://doi.org/10.3390/ pharmaceutics15071837. Click here to view the original article |
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