Efficacy of ozone therapy in dentistry with approach of healing, pain management, and therapeutic outcomes

Background: why ozone is being studied across dental treatments

Ozone has long attracted interest in dentistry for its antimicrobial action and its possible role in supporting tissue healing and easing discomfort after treatment. It has been trialled in several areas of dental care, from periodontal (gum) therapy and root canal treatment to healing after implant surgery and the management of sensitive teeth. Individual trials have pointed in promising directions, but the results have been scattered across different procedures and outcomes. This review set out to bring that evidence together and ask a focused question: across well-designed clinical trials, where does ozone actually help, and where does it not?

Study design: systematic review of 11 randomised controlled trials, 2018-2024

The authors carried out a systematic review, searching Web of Science, PubMed and Scopus for studies published between January 2018 and December 2024. From that search they identified 11 randomised controlled trials that tested ozone in a dental setting - the strongest form of clinical evidence, because patients are randomly assigned to ozone or a comparison treatment. The included trials spanned periodontal therapy, endodontics (root canal treatment), soft-tissue healing after dental implant placement, dentinal hypersensitivity and restorative dentistry, with ozone delivered in gaseous, water and oil forms depending on the procedure.

Findings: benefits in periodontal, endodontic and implant care, but a caution in restorative dentistry

Across the included trials, ozone therapy was linked to improved periodontal health, better soft-tissue healing after dental implant surgery, and reduced discomfort after treatment. Combining scaling and root planing (a deep clean of the gums) with gaseous ozone produced superior periodontal response rates compared with the standard clean alone. In endodontics, using ozone during root canal procedures was associated with less post-treatment pain, and ozonated materials showed promise in managing dentinal hypersensitivity. One clear caution emerged: ozone is not recommended in restorative dentistry, because it may reduce the bond strength between filling materials and dentine.

What the authors concluded

The authors concluded that the evidence supports integrating ozone therapy into dentistry as an adjunctive treatment - that is, alongside conventional dental care rather than in place of it. They also stressed that more research is needed to clarify how ozone works, to optimise how and when it is applied, and to evaluate long-term outcomes for patient safety and treatment effectiveness.

Limitations of this study

As a review, the strength of its conclusions depends on the trials it draws from. Eleven randomised controlled trials is a modest evidence base spread across several very different procedures, so the number of trials behind any single application is small. The included studies varied in how ozone was delivered, at what concentration and for how long, which makes direct comparison difficult and limits firm dosing guidance. The finding on dentinal bond strength is an important reminder that ozone is not uniformly beneficial across dental applications. As the authors note, larger and longer trials are needed before ozone's role in routine dental practice can be firmly established.