Ozone Treatment of Root Caries after 18-Months

J. HOLMES, Queen's University of Belfast, United Kingdom

Objectives: The objective was to assess the efficacy of an ozone delivery system1 combined with the daily use of a remineralising toothpaste, mouthrinse and spray1 for the management of non cavitated leathery primary root carious lesions (PRCL’s) in an ageing patient group (>60, mean 70.8yrs, SD+ 6).

Methods: A total of 89 patients with 2 leathery lesions each (178 PRCL’s in total) in the middle severity lesion group 2 (J Dent Res 1993,73: 623-629) were recruited. The lesions were randomly assigned into two groups; treated with ozone, or no ozone and received a professionally applied remineralising solution1. The Ozone treatment was applied by a different operator than the one recording the clinical criteria used to define the severity of the lesions. When no Ozone was applied the cup and suction system were placed on the control lesion for the same time interval as on the test lesions. Remineralising pastes, mouthrinses and sprays were also dispensed to each patient with instructions. At baseline, 3, 6, 12 and 18 months, the lesions were clinically assessed as soft, leathery or hard, scored with the validated root caries severity index and received treatment as at baseline.

Results: 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. Conclusions: Leathery non cavitated primary root caries can be treated non-operatively with ozone. This novel treatment regime using ozone is an effective alternative to conventional "drilling and filling". 1HealOzone unit, CurOzone USA and KaVo Eighty-nine subjects started this study at baseline. At 18 months, 87 subjects had completed the study. Two subjects had moved out of the practice area, and were not available for the 12 or 18 month reassessment visits. There were no observed or reported adverse events at any of the treatment sessions or afterwards (Table 1). After three months, in the ozone-treated group, 61 PRCL’s (69%) had become hard and none had become worse, whilst in the control group, four PRCL’s (4%) had become worse (p<0.01). At the six month recall, in the ozone group, seven PRCL’s (8%) remained leathery, the remaining 82 (92%) PRCL’s had become hard, whilst in the control group, 10 PRCL’s had become worse (11%) and one had become hard (p<0.01). At 12 and 18 months, 87 subjects attended. In the ozone group at 12 months, two PRCL’s remained leathery, compared to 85 (98%) that had hardened, whilst in the control group 21 (24%) of the PRCL’s had progressed from leathery to soft, i.e. became worse, 65 PRCL’s (75%) were still leathery, and one remained hard (p<0.01). At 18 months, 87 (100%) of ozone-treated PRCL’s had reversed, 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 and only one of the control PRCL’s had reversed (p<0.01).