A systematic review on the role of ozone therapy in periodontitis

Bacterial infection triggers periodontitis, which is a long-standing inflammatory disease of the oral cavity that damages the tissues supporting the teeth. Ozone therapy, known for its antimicrobial, anti-inflammatory, and biostimulatory effects, has been applied as an adjunct in periodontal treatment. This review evaluates its efficacy in lowering inflammatory markers, including matrix metalloproteinase-8 (MMP-8), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) and its potential to enhance the repair of periodontal tissues. A thorough search of major bibliographic databases, such as PubMed, Scopus, and Google Scholar, was carried out. Studies investigating alterations in inflammatory biomarkers among patients receiving ozone therapy for periodontitis, which examined both before and after the interventions, were considered for inclusion. Data extraction emphasized both the levels of these biomarkers and clinical measures reflecting periodontal recovery. The review indicates that ozone therapy significantly reduces inflammatory biomarkers, particularly MMP-8, IL-1β, and TNF-α, inhibits periodontal tissue degradation, and promotes healing by modulating both microbial activity and host response. Ozone therapy shows promise as an adjunctive treatment for periodontitis by reducing inflammation and supporting tissue repair. However, additional randomized clinical trials are warranted to confirm its long-term efficacy and the standardization of treatment protocols.