Mechanisms and clinical applications of ozone and ozonated oil as antimicrobial systems

With the growing severity of antibiotic resistance, the development and application of novel antimicrobial agents are becoming increasingly urgent. Since the application of ozone in blood purification in the 19th century, the unique biological effects of ozone have gradually attracted widespread attention. In this review, we first provide a brief overview of the development of ozone in clinical therapy. Based on the different applications of ozone in the body, the detailed action mechanisms are discussed. Specifically, ozone, as an antibacterial agent, plays a crucial role in maintaining the antioxidant-oxidant balance and regulating the immune system. When using ozone gas for the treatment of skin and dental diseases, the method of administration needs to be strictly controlled to avoid severe reactions. In addition, ozone ultrafine bubble water, as a supplementary form of ozone water, offers more significant advantages and longer storage time, proving highly effective in the treatment of periodontal diseases. Furthermore, combining ozone with specific oils or even encapsulating it in nanoparticles represents innovative and promising approaches to overcome its inherent instability and considerably strengthen its therapeutic potential. Future research should focus on two key directions: first, developing novel ozone carriers to provide personalized treatment plans for patients with varying clinical needs; second, exploring combination strategies for ozone with multiple drugs to enhance therapeutic efficacy through synergistic mechanisms while reducing adverse drug reactions.