APRIL 2002 SUBMISSION - Clinical reversal of fissure & occlusal caries using ozone

Dr Julian Holmes, Adentec & UKSmiles, 3, Old Row Court, Rose Street, Wokingham, Berkshire, United Kingdom, and E. LYNCH, Restorative Dent and Gerodontology, Queens University Belfast, Northern Ireland, United Kingdom -

Objectives: This study assessed the efficacy of a novel ozone delivery system1 on primary occlusal carious lesions (POCL). - Methods: In this preliminary study in a general dental practice, 80 patients with 214 POCL were recruited. All patients were offered a choice of treatment options, which consisted of 1. no treatment 2. ozone treatment 3. traditional fissure sealants 4. air abrasion and fissure sealants 5. traditional tooth tissue removal and filling placement depending on the degree of caries present. The DIAGNOdent2 was employed to objectively quantify POCL's after through stain removal with a bi-carbonate3 system. After an average of 2 months, treated POCL were clinically re-assessed. The DIAGNOdent2 was again employed to objectively quantify POCL's. - Results: After 4 months, 193 patients had completed dental ozone treatment; this group consisted of 261 teeth treated and 427 surface values recorded. By April 2002, 203 teeth had been recalled for reevaluation. There were no observed adverse events. 95% of surfaces examined showed signs of caries reversal when scored with the DIOGNOdent, and a Student 't' Test showed significant differences in the data set at the 99.99% confidence level. In addition, POCL treated from March 2002 are also categorised into a Clinical Severity Index (CSI) as follows for further research into a simple in- & inter-practice evaluation. 1. requiring drilling and filling (defined as deemed to have infected dentine where clinical infected demineralisation of the underlying dentine is deemed to be present). 2. possibly requiring drilling and filling (defined as possibly deemed to have infected dentine where clinical infected demineralisation of the underlying dentine is possibly considered to be present). 3. requiring a pharmaceutical approach but not drilling and filling (defined as deemed to have infected demineralised dentine which is reversing and getting smaller. This scenario is where clinical remineralisation of the underlying dentine is considered to be in the process of remineralising the demineralised dentine but is not yet complete). 4. arrested (defined as deemed to have had infected dentine which reversed and where clinical remineralisation of the underlying dentine is considered to be complete, with no infection remaining in the dentine - Conclusions: This treatment regime using ozone alone may be considered to be an effective alternative to conventional "drilling and filling". 1 HealOzone unit, CurOzone USA. 2 DIAGNOdent, Kavo, Germany 3 ProphyFlex, Kavo, Germany