Adjunctive Use of Ozone Therapy in Treating Periodontitis in Smokers: A Prospective Split-Mouth Study

To evaluate the short-term effectiveness of adjunctive ozone therapy combined with scaling and root planing (SRP) in smokers with Stages II and III periodontitis.

This prospective randomized split-mouth study included 26 smokers with Stages II or III periodontitis. In each participant, one side received SRP alone (control) and the contralateral side received SRP plus ozone therapy (test). Probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 6 weeks. Paired t-tests were initially used then more appropriately account for the split-mouth design and repeated measurements within the same participant, linear mixed-effects models were then fitted. Adjusted models additionally included age, periodontitis stage, smoking duration, and smoking.

The mean age of participants was 35.23 ± 8.64 years, and the mean number of teeth was 26.76 ± 4.50. All clinical parameters improved after treatment. In mixed-model analyses, baseline values were comparable between study and control sides. In the adjusted model, the ozone-treated side showed significantly greater additional improvement than the control side for PD (β = -0.346 mm, 95% CI: -0.633 to -0.059; p = 0.019), CAL (β = -0.462 mm, 95% CI: -0.713 to -0.211; p  < 0.001), BOP (β = -0.063, 95% CI: -0.108 to -0.018; p = 0.007), and PI (β = -0.077, 95% CI: -0.129 to -0.025; p = 0.004).

The adjunctive use of ozonated water with SRP was associated with greater short-term improvements in periodontal clinical parameters compared with SRP alone in smokers with Stages II and III periodontitis.

Smoker's experience severe forms of periodontitis. Ozone demonstrated positive effects in reducing plaque-related outcomes when used as an adjunct to SRP.