Ozone in Endodontics and Periodontics: Oxygen as Medicine

Oxygen as the Original Medicine

Long before pharmaceuticals, nature used oxygen to heal.Every cell depends on it, every immune response begins with it, and every wound closes because of it.

Ozone (O₃) — a triatomic, energized form of oxygen — brings that power directly into dentistry.

At Amore Dentistry, ozone isn’t a luxury add-on; it’s an essential biologic tool.We use it to detoxify, oxygenate, and regenerate — safely and naturally.

“Ozone doesn’t fight the body’s biology — it fuels it.”

What Is Ozone?

Ozone is simply oxygen (O₂) with an extra atom (O₃).That third atom is unstable — it seeks to return to O₂ by donating oxygen to its environment.

This oxidation process selectively destroys pathogens (bacteria, viruses, fungi, and biofilms) while leaving healthy tissue unharmed.

In dentistry, ozone can be applied as:

• Ozonated water (for irrigation and rinses)

• Ozone gas (for infiltration or insufflation)

• Ozonated oils (for topical healing)

Each form works synergistically to cleanse, oxygenate, and promote microcirculatory flow.

Mechanism of Action: Selective Oxidation

Here’s why ozone is such a biologically elegant therapy:

Kills pathogens through oxidative burst — Ozone disrupts microbial cell membranes and viral capsids, destroying pathogens without antibiotics or chemicals

Stimulates oxygen metabolism — Improves local oxygenation and ATP production.

Modulates the immune system — Balances inflammation through cytokine regulation.

Enhances microcirculation — Increases nitric oxide and red blood cell deformability for better perfusion.

Promotes wound healing — Activates fibroblasts and growth factor release.

Healthy human cells have antioxidant enzymes (like catalase and superoxide dismutase) that protect them — pathogens don’t.That’s why ozone selectively targets what doesn’t belong.

Ozone in Endodontics: Beyond Root Canals

Traditional endodontics relies on mechanical cleaning and chemical irrigation (like sodium hypochlorite).But biofilms — especially those containing Enterococcus faecalis — can persist in microscopic tubules beyond a file’s reach.

Ozone, in contrast, diffuses through dentinal tubules and periapical tissue — eradicating pathogens without toxicity.

Clinical benefits include:

• Complete disinfection of canals and accessory anatomy

• Neutralization of bacterial endotoxins

• Reduced post-operative pain and swelling

• Enhanced tissue oxygenation for periapical healing

At Amore Dentistry, ozone is integrated into both biologic root canal alternatives and cavitational cleanouts — ensuring that detoxification happens without damaging surrounding bone or immune balance.

Ozone in Periodontics: Regeneration Through Oxygen

Periodontal disease is not simply infection — it’s inflammation plus biofilm imbalance.

Ozone addresses both.

When applied as ozonated water irrigation or gas insufflation, it:

• Reduces P. gingivalis and anaerobic pathogens

• Oxygenates pocket depths

• Stimulates epithelial regeneration and collagen synthesis

• Improves gum tone and color

In combination with scaling and ozone gel placement, we often see tissue reattachment and improved pocket depths within weeks.

Patients describe their mouths feeling “cleaner and lighter” — that’s oxygen flow returning to tissue that had been starved.

Synergy with PRF and Photobiomodulation

Biologic healing thrives when modalities work in unison.That’s why we often pair ozone with PRF and photobiomodulation (PBM) for complete regeneration.

• PRF brings fibrin, platelets, and growth factors.

• Ozone clears pathogens and oxygenates the matrix.

• PBM activates mitochondria to accelerate repair.

Together, they create what I call the “triad of biologic regeneration.”The tissue becomes clean, nourished, and energetically active — without pharmaceuticals or foreign materials.

A Closer Look: Ozone in Cavitation and Surgical Detox

When removing root-canaled or infected teeth, we always irrigate the socket with ozonated water, then gas-infiltrate the bone cavity for 30–60 seconds.

This eliminates anaerobic residues, neutralizes biotoxins, and oxygenates the medullary bone.

Combined with PRF membranes and open wound healing, patients experience:

• Reduced inflammation and pain

• Rapid granulation

• Pink, oxygen-rich tissue tone

• No post-operative infection

Ozone turns surgery into true detoxification.

Clinical Research and Evidence

Ozone therapy’s safety and efficacy are well-documented in both dental and medical literature:

• Endodontics: Ozone irrigation eliminates E. faecalis biofilms in vitro and in vivo (Huth et al., 2006).

• Periodontics: Ozone reduces bacterial load and promotes clinical attachment gain (Ramzy et al., 2005).

• Wound Healing: Ozone accelerates epithelial closure and angiogenesis (Bocci et al., 2009).

• Immunomodulation: Ozone regulates antioxidant systems and cytokine expression (Smith et al., 2017).

These aren’t experimental findings — they’re evidence of oxygen’s timeless intelligence.

Patient Experience: Clean Energy Healing

When patients ask, “What does ozone feel like?”I tell them: “It feels like breathing space into your cells.”

There’s no burning, no sting — just clarity.Inflammation subsides, tissues brighten, and recovery feels faster and calmer.

One patient with chronic gum infections said,

“It’s like my gums could finally breathe again.”

That’s the goal — to restore breath, flow, and oxygen where stagnation once lived.

Safety and Standards

Medical-grade ozone is generated from pure oxygen using certified equipment (per IAOMT and FDA guidelines).It’s applied in precise concentrations — typically 10–60 μg/mL, depending on indication.

When used correctly, ozone is:

• Non-toxic

• Non-allergenic

• Safe for all ages

• Environmentally clean

It’s not about “more ozone.” It’s about the right dose for the right tissue.

Key Takeaways

Ozone is activated oxygen — nature’s detoxifier. In endodontics, it eliminates pathogens deep within tubules. In periodontics, it restores oxygen and balance to tissues. Synergistic with PRF and photobiomodulation for complete healing. Safe, natural, and powerfully regenerative when guided by biology.

Conclusion: Oxygen Is the Beginning and the End of Healing

Ozone reminds us that healing doesn’t require invention — it requires reconnection.

By reintroducing oxygen — the molecule life was built on — we restore the body’s capacity to clean, renew, and regenerate.

At Amore Dentistry, we see ozone not as a procedure, but as philosophy:clean, conscious, and cooperative with life itself.

Because when oxygen returns, healing remembers.

References

1. Huth KC, et al. “Effectiveness of ozone against endodontopathogenic microorganisms in root canals.” J Endod. 2006. PubMed

2. Ramzy MI, et al. “Management of aggressive periodontitis using ozone therapy.” J Periodontol. 2005. PubMed

3. Bocci V. Ozone: A New Medical Drug. Springer, 2009.

4. Smith NL, Wilson AL, Gandhi J. “Ozone therapy: Clinical review and molecular mechanisms.” Med Gas Res. 2017. PubMed

5. IAOMT Clinical Report. “Oxygen and Ozone in Biologic Dentistry.” 2023.