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Ozone therapy for the treatment of dental caries

  • Review
  • Intervention




Dental caries is a bacterially mediated disease characterised by demineralisation of the tooth surface, which may lead to cavitation, discomfort, pain and eventual tooth loss. Ozone is toxic to certain bacteria in vitro and it has been suggested that delivering ozone into a carious lesion might reduce the number of cariogenic bacteria. This possibly could arrest the progress of the lesion and may, in the presence of fluoride, perhaps allow remineralisation to occur. This may in turn delay or prevent the need for traditional dental conservation by 'drilling and filling'.


To assess whether ozone is effective in arresting or reversing the progression of dental caries.

Search methods

We searched the Cochrane Oral Health Group's Trials Register (to 7 November 2003); Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2003, Issue 3); MEDLINE and PREMEDLINE (OVID) (1966 to November 2003); EMBASE (OVID) (1980 to November 2003); CINAHL (OVID) (1982 to November 2003); AMED (OVID) (1985 to November 2003). Quintessence was handsearched through 2002 and KaVo were contacted as manufacturers of the HealOzone apparatus for any additional published or unpublished trials.

Selection criteria

Inclusion was assessed independently by at least two reviewers. Trials were only included if they met the following criteria: randomisation in a controlled trial; single surface in vivo carious lesion accessible to ozone application; clear allocation concealment; ozone application to the lesions in the intervention group; no such application of ozone in the control group; outcomes measured after at least 6 months.

Data collection and analysis

Reviewers independently extracted information in duplicate. A paucity of comparable data did not allow meta-analytic pooling of the included studies.

Main results

Three trials were included, with a combined total of 432 randomised lesions (137 participants). Forty-two conference papers, abstracts and posters were excluded (from an unknown number of studies). The risk of bias in all studies appeared high. The analyses of all three studies were conducted at the level of the lesion, which is not independent of the person, for this reason pooling of data was not appropriate or attempted. Individual studies showed inconsistent effects of ozone on caries, across different measures of caries progression or regression. Few secondary outcomes were reported, but one trial reported an absence of adverse events.

Authors' conclusions

Given the high risk of bias in the available studies and lack of consistency between different outcome measures, there is no reliable evidence that application of ozone gas to the surface of decayed teeth stops or reverses the decay process. There is a fundamental need for more evidence of appropriate rigour and quality before the use of ozone can be accepted into mainstream primary dental care or can be considered a viable alternative to current methods for the management and treatment of dental caries.



臭氧(Ozone)在蛀牙(dental caries)治療的使用

蛀牙是一種細菌引發的疾病,特徵是牙齒表面的去礦化(demineralisation),這樣會導致窩動的產生、不適感、疼痛和最終的牙齒喪失。臭氧在細胞實驗中證實對於數種細菌而言是有毒的,因此可能可以暗示將臭氧使用在蛀牙缺損的部位,可能可以減少該區域引發蛀牙細菌的數量。這樣或許可以減緩病灶區的進程,若合併氟化物使用甚至可能會讓再礦化發生。這樣可能可以延後甚至防止傳統牙科治療方式‘drilling and filling’的使用需要。




我們搜尋以下的資料庫:Cochrane Oral Health Group's Trials Register (to 7 November 2003)、Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2003)、MEDLINE and PREMEDLINE (OVID, 1966 to November 2003)、EMBASE (OVID, 1980 to November 2003)、CINAHL (OVID, 1982 to November 2003)、AMED (OVID, 1985 to November 2003)。Quintessence期刊則是從2002延開始做手動搜尋,同時也連絡臭氧治療機HealOzone的製造商KaVo,以取得任何更進一步有發表或是未發表過的臨床測試資料。




檢閱者要將篩選出的資料分成一式兩份,缺乏可對照比較的數據無法讓篩選進來的研究做metaanalytic pooling。


共三個試驗符合標準,總計有432個隨機病灶(137位受試者)。共有42篇參考文獻、摘要與貼示報告遭到排除(試驗的總數目不詳)。所有試驗的誤差風險都很高,這三個試驗的分析著重在病灶部分,而沒有去考慮受試者的因素,因此這些試驗的數據並不是最精確的。每個試驗因為是使用不同方式來評斷臭氧對蛀牙的進程,因此結果並不一致。這些試驗中有一些二次結果(secondary outcomes),其中一個有提到副作用的產生。


此在因為具有高度誤差風險以及實驗結果缺乏一致性,因此並沒有足以信賴的證據可以證明臭氧表面處理可以終止或是逆轉蛀牙的發展進程。因此基本上要接受臭氧做為乳牙照護(primary dental care)的主流,或是做為恆牙蛀蝕傳統處理的替代方式之前,可能需要更多精確且有品質的證據。



此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


沒有證據可以證明臭氧療法可以反轉或中止牙齒蛀蝕。 蛀牙會疼痛,在治療方面較昂貴且會導致牙齒喪失,有學說認為使用臭氧可以終止或逆轉蛀牙進程。但在這次的文獻回顧中,沒有有效的證據可以證明臭氧在此方面的功效。我們需要更高品質的試驗來驗證這個說法的有用與否,在此之前臭氧不應該當成傳統牙科治療方法的替代方案。








本レビューでは、the Cochrane Oral Health Group's Trials Register(2003年11月7日まで);Cochrane Central Register of Controlled Trials(CENTRAL)(コクラン・ライブラリ,2003年3号);MEDLINEとPREMEDLINE(OVIDを利用,1966年~2003年11月まで);EMBASE(OVID利用,1980年~2003年11月まで);CINAHL(OVID利用,1982年~2003年11月まで);AMED(OVID利用,1985年~2003年11月まで)を検索した。2002年度分のクインテッセンス誌をハンドサーチし、さらなる公表されているまたは未公表の試験のためにHeal Ozoneの製造元であるKaVoにコンタクトをとった。










監  訳: 佐野 哲也,内藤 徹,JCOHR,2008.4.1

実施組織: 厚生労働省委託事業によりMindsが実施した。

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Plain language summary

Ozone therapy for the treatment of dental caries

There is no evidence that ozone therapy can reverse or stop tooth decay.
Tooth decay can be painful, is expensive to treat and can lead to the loss of teeth. It has been suggested that treatment of a decayed tooth with ozone will stop or reverse the decay process. This review of trials found no sound evidence that ozone is capable of reversing or stopping the progression of tooth decay. High quality research is needed to show whether or not it works. Ozone should not be considered an alternative to current treatment methods in dental practices.

Ringkasan bahasa mudah

Terapi ozon untuk rawatan karies pergigian

Tiada bukti yang menunjukkan terapi ozon boleh memulihkan atau menghentikan kerosakan gigi.
Kerosakan gigi adalah sakit, mahal untuk dirawat dan boleh menyebabkan kehilangan gigi. Adalah dicadangkan rawatan gigi yang rosak dengan ozon akan menghentikan atau memulihkan proses kerosakan. Ulasan kajian-kajian ini tidak membuktikan bahawa ozon boleh memulihkan atau menghentikan proses kerosakan gigi. Kajian bermutu tinggi diperlukan untuk menunjukkan sama ada ozon berkesan atau tidak. Ozon tidak boleh dianggap sebagai alternatif kepada kaedah rawatan masa kini dalam amalan pergigian.

Catatan terjemahan

Diterjemahkan oleh Noorliza Mastura Ismail (Kolej Perubatan Melaka-Manipal). Disunting oleh Mohd. Shaharudin Shah Che Hamzah (Universiti Sains Malaysia). Untuk sebarang pertanyaan berkaitan terjemahan ini sila hubungi