ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Inconclusive Effectiveness Of Healozone In Managing Pit And Fissure Caries
Clinical Question How effective is ozone treatment in management of early occlusal pit and fissure caries compared to fissure sealants?
Clinical Bottom Line There is currently no reliable evidence that application of ozone gas to the surface of decayed teeth stops or reverses the decay process. Furthermore, there is not enough evidence from published RCTs on which to judge the effectiveness of ozone for the management of occlusal pit and fissure caries comparatively with current restorative methods of managing early dental caries with sealants/restorations. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16707073Brazzelli/2006Five full-text reports and five studies published as abstracts met the inclusion criteria. The five full-text reports consisted of two randomised controlled trials (RCTs) assessing the use of HealOzone for the management of primary root caries and two doctoral theses of three unpublished randomised trials assessing the use of HealOzone for the management of occlusal caries.Systematic Review
Key resultsOne unpublished study did not show any significant benefits of HealOzone for the management of non-cavitated pit and fissure lesions in the permanent dentition. Adding ozone to a fissure sealant did not seem to produce better sealant retention in occlusal lesions extending 2–4 mm into dentine either.On the whole, there is not enough evidence from published RCTs on which to judge the effectiveness of ozone for the management of both occlusal caries.
#2) 15266519Rickard/2004Three trials were included, with a combined total of 432 randomised lesions (137 participants). Cochrane Systematic Review
Key resultsThe risk of bias in all included studies in the review appeared high. The analyses of all three studies were conducted at the level of the lesion, which is not independent of the person. Also, effective masking of outcome assessors and allocation concealment was unclear. For these reasons, pooling of data was not appropriate or attempted in this Cochrane study. Individual studies showed inconsistent effects of ozone on caries, across different measures of caries progression or regression.
Evidence Search Pubmed: “Healozone” OR "Ozone"[Mesh] AND "Dental Caries"[Mesh]
Comments on
The Evidence
Overall, the quality of the included studies of both systematic reviews was modest, with many of the included studies depending on findings produced by the DIAGNOdent and Electric Caries Meter-devices which have been found to have varying sensitivity and specificity values.There is also a fundamental need for more evidence of appropriate rigour and quality before there can be a conclusive evidence to support the use of ozone in mainstream primary dental care and be considered a viable alternative to current methods for the management and treatment of dental caries.
Applicability On the whole, there is not enough evidence from published RCTs on which to judge the effectiveness of ozone for the management of occlusal caries, hence limiting the applicability of the studies to clinicians to recommend the usage of ozone treatment.
Specialty/Discipline (Public Health) (Endodontics) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) (Basic Science)
Keywords Healozone, ozone, dental caries, preventive dentistry
ID# 277
Date of submission: 11/11/2009spacer
E-mail Loke@uthscsa.edu
Author Weiqiang Loke, DDS
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Faculty mentor/Co-author
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Amir Hassan (San Antonio, TX) on 04/03/2012
A PubMed search on this topic was completed on April 2, 2012. The publications listed in the CAT are the most recent and the highest level of evidence related to this clinical question.
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