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Journal of Oral Science & Rehabilitation No. 2, 2017

O z o n e t r e a t m e n t f o r d e n t i n a l h y p e r s e n s i t i v i t y and insulating effect on thermal and chemical stimuli.6 6. Varnishes: These have an obstructive and an- tibacterial action, contain fluorides and often chlorhexidine. They adhere to the dentin and gradually release the two active substances. 7. Fluorides: Fluoride acts on the hydroxyapatite crystals of enamel, transforming them into fluorapatite, with binding characteristics that are more stable and resistant to the action of an acidic pH and determine the precipitation of calcium phosphate into the tubules. 8. Pastes containing casein phosphopeptide and amorphous calcium phosphate: These sub- stances favor the remineralization processes of the dental surfaces. The casein phospho- peptide maintains the calcium and phosphate in a noncrystalline amorphous state and acts as an adhesive, adhering to the hard and soft tissue of the oral cavity by slowly releasing calcium and phosphate ions, which penetrate into the enamel, forming apatite crystals.3 O z o n e Ozone (O3) is a natural gaseous molecule defined as an allotropic form of oxygen. The idea of using ozone in medicine has developed slowly during the last century and was stimulated by the lack of antibiotics and the antiseptic prop- erties of ozone. Its liquid form is able to pene- trate into the tissue and mucous membranes. The effects of ozone in the organism depend on its chemico- physical characteristics, high reac- tivity and oxidative potential: antimicrobial, anti- inflammatory, analgesic, immunostimu- lant, anti-hypoxic and biosynthetic.7 Owing to its high oxidative potential, ozone oxidizes the cellular components of bacterial cells, thereby modifying the intracellular components with consequent loss of function of organelles. When the cell membrane is damaged during this pro- cess, the cell is destroyed. In conclusion, ozone causes the lysis of the cell. Ozone activities: 1. Antimicrobial: – Damage to the cytoplasmic membrane – Oxidation of intracellular components 2. Analgesic 3. Immunostimulant: – Activation of the humoral immune system – Immunoglobulin synthesis 4. Anti-hypoxic 5. Increased phagocyte activity 6. Activation of biological antioxidants: – Activation of the aerobic processes (Krebs cycle, glycolysis, beta-oxidation of fatty acids) – Increase of cellular metabolism (ribosomes and mitochondria) 7. Biostimulating: – Synthesis of interleukins, leukotrienes and prostaglandins – Immunoglobulin synthesis. The main fields of application of ozone therapy in dentistry include – conservative treatment of carious lesions; – nonsurgical periodontal therapy; – oral pathology (cheilitis, ulcers, osteonecrosis); and – oral surgery. T r e a t m e n t o f d e n t i n a l h y p e r - s e n s i t i v i t y w i t h o z o n e t h e r a p y Dentin consists of 76% minerals, 20% organic matrix and 10% water. The main component of the organic matrix is collagen.4 Since ozone reacts quickly to compounds containing double bonds (such as C = C, C = N and N = N, bonds and organic amine bonds contained in the col- lagen),7 dentin represents an ideal substrate for its action. The mechanism of oxidation of ozone is based on the direct and indirect effects of the reaction. Direct oxidation is a selective reaction during which ozone reacts rapidly with organic material containing double bonds, organic groups or amines. The indirect reaction leads instead to the production of hydroxyl radical groups, extremely unstable compounds that have an oxidative power even stronger than that of ozone. Hydroxyl radicals do not affect the inorganic tissue, but attack the organic compo- nents of the dentin.8 These reactions, both direct and indirect, are responsible for the preferential attack of ozone on peritubular demineralized dentin, leading to an increase in the diameter of the dentinal tubules. Therefore, the use of ozone, not allowing the direct obstruction of the tu- bules, does not reduce the feeling of hypersen- sitivity; consequently, it is not expected that the use of ozone will reduce the pain sensation of dentinal hypersensitivity, at least not by means of the occlusion of the dentinal tubules. How- ever, other studies have suggested that ozone increases the patency of the dentinal tubules, 18 Volume 3 | Issue 2/2017 Journal of Oral Science & Rehabilitation

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