Preventive effect of ozone on the development of white spot lesions during multibracket appliance therapy

Angle Orthod. 2009 Jan;79(1):64-9. doi: 10.2319/100107-468.1.


Objective: To test the null hypotheses: (1) there is no difference in the caries protective effect of ozone and Cervitec/Fluor Protector during multibracket (MB) appliance therapy, and (2) DIAGNOdent and quantitative light-induced fluorescence (QLF) are not superior to a visual evaluation of initial caries lesions.

Materials and methods: Twenty right-handed patients with a very poor oral hygiene who required full MB appliance therapy were analyzed during 26 months. In a split-mouth-design, the four quadrants of each patient were either treated with ozone, a combination of Cervitec and Fluor Protector, or served as untreated controls. The visible plaque index (VPI) and white spot formation were analyzed clinically. DIAGNOdent and QLF were used for a quantitative assessment of white spot formation.

Results: The average VPI in all four dental arch quadrants amounted to 55.6% and was independent of the preventive measure undertaken. In the quadrants treated with Cervitec/Fluor Protector, only 0.7% of the areas developed new, clinically visible white spots. This was significantly (P < .05) less than in the quadrants treated with ozone (3.2%). The lesions detected with QLF only partially corresponded to the clinically detected white spots, while DIAGNOdent proved to be unable to detect any changes at all.

Conclusions: The caries protective effect of Cervitec/Fluor Protector during MB therapy was superior to ozone, and a visual evaluation of initial caries lesions was superior to both DIAGNOdent and QLF.

MeSH terms

  • Adolescent
  • Cariostatic Agents / therapeutic use*
  • Chlorhexidine / therapeutic use
  • Dental Caries / diagnosis
  • Dental Caries / etiology
  • Dental Caries / prevention & control*
  • Drug Combinations
  • Female
  • Fluorescence
  • Fluorides, Topical / therapeutic use
  • Humans
  • Lasers
  • Light
  • Male
  • Orthodontic Brackets / adverse effects*
  • Oxidants, Photochemical / therapeutic use*
  • Ozone / therapeutic use*
  • Polyurethanes / therapeutic use
  • Silanes / therapeutic use
  • Thymol / therapeutic use


  • Cariostatic Agents
  • Drug Combinations
  • Fluorides, Topical
  • Oxidants, Photochemical
  • Polyurethanes
  • Silanes
  • chlorhexidine, thymol drug combination
  • Thymol
  • Fluor Protector
  • Ozone
  • Chlorhexidine