Adjunctive effect of gaseous ozone on inflammatory biomarkers and microbial profile in grade C molar-incisor pattern periodontitis: a randomized split-mouth placebo-controlled clinical trial.

BACKGROUND

This randomized, split-mouth study aimed to evaluate the effects of adjunctive gaseous ozone therapy versus nonsurgical periodontal treatment (NSPT) alone on inflammatory cytokine levels in gingival crevicular fluid (GCF), periodontal pathogens, and clinical periodontal parameters in grade C periodontitis patients with a molar-incisor pattern (C/MIP).

METHODS

Seventeen (8 males and 9 females), aged 23–42 years (mean ± SD = 31.80 ± 5.26 years) systemically healthy C/MIP patients were included in the study. After NSPT was performed on all patients, topical gaseous ozone was applied to the test quadrant. This randomized split-mouth clinical trial allocated contralateral sites to test or control groups by coin toss. Clinical parameters (Plaque index, gingival index, bleeding on probing, probing depth), total GCF levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-8 (analyzed via ELISA), and the presence of major periodontal pathogens including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia (quantified by qPCR) were evaluated at baseline, 1 month, and 3 months post-treatment. Statistical analyses included both parametric (Student’s t-test, Paired Samples t-test) and non-parametric tests (Mann–Whitney U test, Wilcoxon signed-rank test, Spearman’s rank correlation test), depending on data distribution.

RESULTS

Both groups showed significant clinical improvement at 3 months, with no inter-group differences. However, the total amount of IL-8 in GCF levels significantly decreased after adjunctive ozone therapy (p = 0.008). A transient reduction in Prevotella intermedia was observed only in the control group. No significant microbial differences were found between groups at any time point.

CONCLUSIONS

Adjunctive gaseous ozone therapy showed a significant reduction only in IL-8 levels, without additional clinical or microbiological benefits over NSPT alone in C/MIP patients. TRIAL REGISTRATION: The study has been registered at ClinicalTrials.gov with the registration number-first posted date: NCT05971706-2023–08-02.