Clinical Oral Investigations

, Volume 23, Issue 2, pp 785–792 | Cite as

Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal

  • Jelena KrunićEmail author
  • Nikola Stojanović
  • Ljiljana Đukić
  • Jelena Roganović
  • Branka Popović
  • Ivana Simić
  • Dragica Stojić
Original Article



To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).

Materials and methods

Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.


Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp.


Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.

Clinical relevance

Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.


Ozone Incomplete caries removal Antibacterial effect Residual caries Biocompatibility 


Funding information

This study was supported by the grant of Ministry of Science and Technology (No. 19/06-020/961-174/12), Republic of Srpska, Bosnia and Herzegovina.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in study were in accordance with the ethical standards of the Institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jelena Krunić
    • 1
    Email author
  • Nikola Stojanović
    • 1
  • Ljiljana Đukić
    • 2
  • Jelena Roganović
    • 2
  • Branka Popović
    • 3
  • Ivana Simić
    • 4
  • Dragica Stojić
    • 2
  1. 1.Department of Dental Pathology, Faculty of MedicineUniversity of East SarajevoFocaBosnia and Herzegovina
  2. 2.Department of Pharmacology in Dentistry, School of Dental MedicineUniversity of BelgradeBelgradeSerbia
  3. 3.Department of Human Genetics, School of Dental MedicineUniversity of BelgradeBelgradeSerbia
  4. 4.Department of Oral Rehabilitation, Faculty of MedicineUniversity of East SarajevoFocaBosnia and Herzegovina

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