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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Systematic Review

Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment: A Meta-Analysis of Topical Applications

by
Alessia Pardo
1,†,
Annarita Signoriello
1,†,
Gabriele Brancato
1,
Raffaele Brancato
1,
Elena Messina
1,*,
Paolo Faccioni
1,*,
Stefano Marcoccia
2,
Gianna Maria Nardi
3 and
Giorgio Lombardo
1
1
Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Pediatrics and Gynecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
2
Dentistry Unit, Department of Surgery, Mater Salutis Hospital, Via Gianella 1, 37045 Legnago, Italy
3
Department of Odontostomatological and Maxillofacial Sciences, “Sapienza” University of Rome, 00185 Roma, Italy
*
Authors to whom correspondence should be addressed.
†
Alessia Pardo and Annarita Signoriello share the first position in the list of authors.
J. Clin. Med. 2025, 14(14), 5124; https://doi.org/10.3390/jcm14145124
Submission received: 23 June 2025 / Revised: 10 July 2025 / Accepted: 15 July 2025 / Published: 18 July 2025
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
Versions Notes

Abstract

Background: Additional therapies (e.g., laser, photodynamic therapy, and ozone) have been reported to improve mechanical instrumentation and immune response in non-surgical periodontal therapy (NSPT). With this systematic review we evaluated the effectiveness of ozone therapy in reducing inflammation and progression of periodontal disease. Methods: Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched for randomized and clinical trials on ozone therapy (gas, liquid, gel/oil) combined with NSPT. The study design followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the risk of bias was assessed using the RoB-2 tool. Results: Eight of the twenty-two studies reviewed reported on gaseous ozone, nine on ozone water, and five on ozonated oil/gel as an adjunct to mechanical periodontal instrumentation, often with scaling and root planing (SRP). Ozone was found to be more effective than SRP alone in treating inflammation, as measured with the gingival index (VMD −0.32; 95% confidence interval (CI) (−0.41; −0.24); p < 0.00001) and compared to chlorhexidine (CHX) (ozone gel; VMD −0.10; 95% CI (−0.20; −0.01); p = 0.03). The study findings were inconsistent, however, with several reporting clinical and microbiological benefit while others observed no marked improvement with the addition of ozone therapy to NSPT. Conclusions: While ozone therapy may represent a useful adjunct to NSPT, further research with larger study groups is warranted to determine its effectiveness.
Keywords: non-surgical periodontal therapy; ozone therapy; periodontitis non-surgical periodontal therapy; ozone therapy; periodontitis

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MDPI and ACS Style

Pardo, A.; Signoriello, A.; Brancato, G.; Brancato, R.; Messina, E.; Faccioni, P.; Marcoccia, S.; Nardi, G.M.; Lombardo, G. Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment: A Meta-Analysis of Topical Applications. J. Clin. Med. 2025, 14, 5124. https://doi.org/10.3390/jcm14145124

AMA Style

Pardo A, Signoriello A, Brancato G, Brancato R, Messina E, Faccioni P, Marcoccia S, Nardi GM, Lombardo G. Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment: A Meta-Analysis of Topical Applications. Journal of Clinical Medicine. 2025; 14(14):5124. https://doi.org/10.3390/jcm14145124

Chicago/Turabian Style

Pardo, Alessia, Annarita Signoriello, Gabriele Brancato, Raffaele Brancato, Elena Messina, Paolo Faccioni, Stefano Marcoccia, Gianna Maria Nardi, and Giorgio Lombardo. 2025. "Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment: A Meta-Analysis of Topical Applications" Journal of Clinical Medicine 14, no. 14: 5124. https://doi.org/10.3390/jcm14145124

APA Style

Pardo, A., Signoriello, A., Brancato, G., Brancato, R., Messina, E., Faccioni, P., Marcoccia, S., Nardi, G. M., & Lombardo, G. (2025). Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment: A Meta-Analysis of Topical Applications. Journal of Clinical Medicine, 14(14), 5124. https://doi.org/10.3390/jcm14145124

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