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Clinical Oral Investigations
Published in: Clinical Oral Investigations 4/2017

01-05-2017 | Original Article

Comparison of ozone gas and sodium hypochlorite/chlorhexidine two-visit disinfection protocols in treating apical periodontitis: a randomized controlled clinical trial

Authors: Stefan Kist, Maximilian Kollmuss, Jette Jung, Sören Schubert, Reinhard Hickel, Karin Christine Huth

Published in: Clinical Oral Investigations | Issue 4/2017

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Abstract

Objectives

In this single-blinded, prospective, randomized, controlled clinical trial, the effectiveness of an ozone gas or NaOCl/CHX disinfection protocol was compared within the root canal treatment of apical periodontitis.

Materials and methods

Sixty permanent teeth were randomly allocated to one technique. The clinical/radiographic assessment criteria included clinical symptoms, periapical index (PAI), and size of the apical lesion. In both groups, the root canal was mechanically cleaned and irrigated with NaCl and EDTA. Ozone gas (32 g m−3) or NaOCl (3 %) was applied followed by a 1-week inter-appointment dressing (Ca(OH)2). As final disinfection, ozone gas (ozone group) or CHX 2 % (NaOCl group) was applied. Microbial samples were taken after preparing the access cavity, after chemo-mechanical treatment and after inter-appointment dressing by sterile paper points. Microbial identification was performed by mass spectroscopy (MALDI-TOF-MS) and 16S-rRNA gene sequencing. The treated teeth were blindly re-evaluated after 6/12 months. Success rates, the decrease in PAI, the size of apical lesions and bacterial reduction were compared between groups (Fischer’s exact test, Mann-Whitney U test).

Results

There were no significant differences between the success rates (ozone group: 96.2/95.5 % after 6/12 months; NaOCl group: 95.5/95.2 % after 6/12 months). The differences in the decreases in PAI values and apical lesion sizes were also insignificant after 6 and 12 months. The bacterial reduction showed no significant differences between groups after chemo-mechanical treatment and after inter-appointment dressing. The most commonly found bacterial genera were Streptococcus spp., Parvimonas spp. and Prevotella spp.

Conclusions

The here used ozone gas and NaOCl/CHX protocols showed no difference in bacterial reduction in the sampled areas of the root canals.

Clinical relevance

Within the limitations of the study, ozone gas seems to be a possible alternative disinfection agent within the root canal treatment of apical periodontitis.
Appendix
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Metadata
Title
Comparison of ozone gas and sodium hypochlorite/chlorhexidine two-visit disinfection protocols in treating apical periodontitis: a randomized controlled clinical trial
Authors
Stefan Kist
Maximilian Kollmuss
Jette Jung
Sören Schubert
Reinhard Hickel
Karin Christine Huth
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 4/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-016-1849-5

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