Management of gingival inflammation in orthodontic patients with ozonated water irrigation--a pilot study

Ozonated water irrigation has recently been tried for its antimicrobial and anti-inflammatory effects in treatment of periodontitis. During orthodontic treatment, gingival inflammation occurs along with increased lactate dehydrogenase (LDH) enzyme levels in gingival crevicular fluid (GCF). Thus, the aim of this pilot study was to evaluate the clinical effects of a single subgingival irrigation with ozonated water on gingival inflammation in orthodontic patients and also to correlate the clinical effects with LDH enzyme activity in GCF.

Fifteen systemically healthy orthodontic patients (seven men and eight women, mean age 17.3 years) with full-mouth brackets were included in this prospective, cross-sectional, clinical and laboratory investigation. Clinical parameters, LDH enzyme activity and GCF volume were measured at baseline (0 day) followed by subgingival irrigation with 0.01 mg l(-1) ozonated water. These parameters were again assessed on 14th and 28th day.

There was significant (P < 0.05) reduction in values of clinical parameters, GCF LDH activity and GCF volume after subgingival irrigation with ozonated water. Also, a significant correlation (r = 0.50, P = 0.01) was observed only between the post-treatment changes of plaque index and LDH values, among the clinical parameters assessed.

A single subgingival irrigation of 0.01 mg l(-1) ozonated water can effectively reduce the gingival inflammation in orthodontic patients, which is also reflected in the reduction of LDH enzyme levels. However, further randomized controlled trials are required to validate the use of ozone irrigation in orthodontic patients for plaque control measures.