Anti-microbial efficiency of gaseous ozone’s combined use with fluoride and chlorhexidine on time-related oral biofilm

Abstract

Oral biofilm formation is the main reason for both caries progression and soft tissue diseases. Preventing the formation and promotion of biofilm has been known as the first attempt to prevent the development of caries and soft tissue problems in the oral cavity. The present study aimed to assess the effect of ozone and its combined use with chlorhexidine (CHX) and fluoride on the complex biofilm formation of pediatric patients under in situ conditions. Extracted bovine teeth were sterilized and cut into 2 × 3 mm 2 sections. The samples were placed in removable maxillary plates and 10 healthy individuals (6 boys, 4 girls; aged 7–14 years) were asked to wear these plates for 6, 24 and 48 hours. Afterwards, the tooth samples were removed, and anti-plaque agents were applied to the time-related plaque formation. Plaque thickness and viable bacterial percentages were detected by confocal laser scanning microscopy. All materials used in the study decreased the plaque formation and the percentage of viable microorganisms compared with the control group (physiological saline). In 6- and 24-hour biofilm evaluations, ozone-CHX was the most effective group in decreasing the plaque thickness ( P > 0.05). Ozone-CHX and Ozone-Fluoride groups were found to be better in 48-hour biofilm assessments in caries-free group ( P > 0.05). Ozone-CHX group showed a better inhibitory effect on the viability of microorganisms in 6-, 24- and 48-hour biofilm formations ( P < 0.05). Although CHX has been known as the gold standard for inhibiting the oral biofilm formation, according to the results of the study, gaseous ozone and its combined use with CHX have shown better results in reducing the biofilm thickness and viable bacterial percentages of in situ formed time-related biofilm formation in pediatric patients. The use of gaseous ozone can be preferred in clinical conditions in pediatric patients instead of the CHX agents.

The Importance of Toothbrushing and Oral Hygiene in Maintaining Oral Health

“…The primary cause of caries and periodontal diseases is oral biofilm development. The central strategy for mitigating the occurrence and progression of caries and periodontal tissue complications within the oral cavity involves preventing and inhibiting biofilm formation and proliferation [3][4][5][6][7][8][9][10][11][12][13][14].…”

“…Oral diseases are preventable and treatable, particularly in their early stages, through simple actions like regular toothbrushing, using technologies such as fluoride, and applying pit and fissure sealants [3,4,10,11,[15][16][17]. These conditions significantly impact the quality of life for populations, resulting in pain, sepsis, suffering, discomfort, reduced school attendance, decreased work efficiency, deformities, and, in severe cases, even death [18][19][20].…”