The Efficacy of Ozonated Water in One-stage Full-mouth Disinfection amongst Chronic Periodontitis Patients: A Randomised Control Trial

Introduction: Periodontal disease, causing tooth-supporting structure damage due to bacterial build-up, is linked to various risk factors. Traditional treatment involved scheduled scaling and root planing. Full-mouth disinfection (FMD), introduced in 1995, involves comprehensive cleaning and chlorhexidine (CHX) application within 24 h to prevent bacterial spread. CHX, a potent antimicrobial, is widely used in FMD, but concerns about emerging resistance have led to the exploration of alternatives like ozonated water, which has shown promising antimicrobial properties and the potential to improve periodontal health. Materials and Methods: This is a randomised controlled trial involving 40 participants with Stage II or III periodontitis who were randomly grouped into two groups. Group A was advised to use 0.2% CHX solution, and Group B used a 10 µg concentration of ozonated water. Both the groups cleaned their dorsum of the tongue, rinsed their mouth, had a pharyngeal spray and had periodontal pockets irrigated using the respective solutions. Plaque index, papillary bleeding index, gingival index, relative attachment level and probing depth were measured at baseline, 3 months and 6 months. Results: Significant differences were found at baseline, 3-month and 6-month values of periodontal index, papillary bleeding index, probing depth, gingival index and relative attachment level amongst Group A and B participants. Differences were noted in between Groups A and B in the periodontal index at 6 months between CHX and ozonated water and between 3 and 6 months for probing depth. Around 68%, 70%, 66%, 68% and 63% improvements were noted in the periodontal index, probing depth, gingival index, papillary bleeding index and relative attachment loss amongst Group B. Conclusion: Ozonated water represents a promising adjunctive therapy for chronic periodontitis, demonstrating significant clinical efficacy in one-stage FMD protocols.