Evaluation of Ozone Therapy in Endodontic Treatment of Teeth with Necrotic Pulp and Apical Periodontitis: A Randomized Clinical Trial

J Endod. 2021 Dec;47(12):1820-1828. doi: 10.1016/j.joen.2021.09.006. Epub 2021 Sep 22.

Abstract

Introduction: The aim of this study was to compare the effect of different application techniques of ozone on the prevalence of postendodontic pain in patients undergoing single-visit root canal treatment.

Methods: hundred eight patients with necrotic pulp in single-rooted teeth and apical periodontitis participated in the trial. A standard single-visit endodontics protocol was followed with 5.25% sodium hypochlorite and rotary nickel-titanium files. After shaping and cleaning, patients were randomly allocated into the following groups: group 1 (n = 21), ozone treatment with no activation (NA); group 2 (n = 22), ozone treatment with manual dynamic activation (MDA); group 3, (n = 21), ozone treatment with passive ultrasonic activation (PUA); group 4 (n = 23), ozone treatment with sonic activation (SA); and group 5 (n = 21), no ozone treatment (the control group). Patient levels of discomfort were recorded at 6 different time intervals using the visual analog scale (VAS). Comparison of the mean difference between the groups and time intervals was performed using 2-way analysis of variance followed by a post hoc Bonferroni test. The level of significance was set at 5%.

Results: VAS scores were highest for the control > NA > MDA > SA > PUA groups. A statistically significant reduction in VAS scores was observed in the PUA and SA groups in comparison with the NA, control, and MDA groups. Timewise comparison showed a highly significant decline in VAS scores at all time intervals (P < .001).

Conclusions: Ultrasonic and sonic activation of ozone resulted in less pain in patients undergoing single-visit endodontics compared with no ozone treatment.

Keywords: Manual dynamic activation; ozone treatment; passive ultrasonic activation; randomized controlled trial; sonic activation; visual analog pain scale.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Pulp Cavity
  • Dental Pulp Necrosis / drug therapy
  • Humans
  • Ozone* / therapeutic use
  • Periapical Periodontitis* / drug therapy
  • Postoperative Pain
  • Root Canal Irrigants / therapeutic use
  • Root Canal Preparation
  • Root Canal Therapy
  • Sodium Hypochlorite / therapeutic use

Substances

  • Root Canal Irrigants
  • Ozone
  • Sodium Hypochlorite