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© Dr Julian Holmes 2013

IAOHD Las Vegas 2013

Dr Julian Holmes

President IAOHD


• Bill Domb sent me some quotes from Seth Godin, and I have added a

couple of my own that I have reinterpreted and I share with you now; they

concern ‘spectators’, ‘watch & wait’ and ‘questions and suggestions’.

• "Bennett's play feels less like a class comedy than an old man's rage against

the sterility of today's cautious, over-organised society, where all boxes

must be computer-ticked, and all human spirit and oddity processed away,"

said Ismene Brown in her review for The Arts Desk. • BBC Arts & News Reviews, 8 November 2012

• Society is encouraging ‘spectators’, rather than innovators and risk-takers

• We belong to the ‘Nanny-State’ profession where to be different is

punishable

– Dr Ray Bertolotti and the ADA & Ozone lectures



• Bill Domb sent me some quotes from Seth Godin, and I have added a

couple of my own that I have reinterpreted and I share with you now; they

concern ‘spectators’, ‘watch & wait’ and ‘questions and suggestions’.

• "Bennett's play feels less like a class comedy than an old man's rage against

the sterility of today's cautious, over-organised society, where all boxes

must be computer-ticked, and all human spirit and oddity processed away,"

said Ismene Brown in her review for The Arts Desk. • BBC Arts & News Reviews, 8 November 2012

• Ozone does not fit into ‘accepted’ practice in some countries, and some

have been prosecuted educating & treating their patients.

• Have we surrendered ‘care’ to the lawyers and regulators?



• The presentations you will hear over the next 4 days are the culmination of

years of being on the edge of ‘respectable’ health care.

• Everyone of my colleagues, Board members, and in fact, you as our

audience, has ceased being a health-care ‘spectator’, and taken a huge risk

in wanting to take back control.

• We all face the same risks; risk of failing, being ridiculed for alternative

care, shunned by others, being shut down by our regulatory bodies for the

‘protection’ of the public (but more like to preserve the status-quo)

• For us, it is all about making a difference; in our work, for our patients, for

the wider public and to effect change from accepted dogma



• We all have shown the ability to follow instructions; that’s how we passed

our Board Exams, learnt to drive on the freeway, book our plane ticket on

line – even register for this conference!

• Tho’ our www registration page needs a few changes so we can offer

discounts for 3 people sharing the same bed, a different discount if you

work part time, and a choice of tea leaves, rose petals, chocolate or

champagne on your pillow at turn-down.

• OK I jest with you, but the point is, as a clinician and researcher, I can give

you a set of rules to follow to treat say an area of decay. What I really

would like you to do is try it, then tell me how you changed the protocol to

get a better result; ‘spoon-feeding’ vs ‘knowledge-quest’ to progress

• I want you to think and ask questions. In fact, I demand you be critical and

assess the information we all give you over the next 4 days.



• In dentistry, the days of ‘watch and wait’ and ‘amputatation’ are long over

• We can measure and look inside that small white area on a tooth and tell

our patients exactly what is going on.

• But for the majority of patients, they are told ‘well, lets see what that small

lesion looks like in 6, 9, 12 months time.

• Maybe there will be no change. For many, there a surprisingly large hole to

climb inside

• Failure to diagnose with modern technology is not excusable any longer



• Some of our presenters like questions as they go; others, for you to write

the questions down, and then ask them at the end. We will try to guide you

who likes what!

• What I and everyone here does not want is ‘silence’! As a researcher and

presenter, I want feed back; tell me what you think of the presentation, was

it too detailed, too vague; did you understand it, and was it relevant!

• I want you to leave all – well almost all! – your inhibitions at the door

• Do not be afraid to ask. Chances are if you did not understand, then others

will be in the same boat as you - there’s a multi-choice Q&A for your CE

at the end before you leave, and I’m marking it!

• I can’t talk for the other presenters and Board members, but I hope not to

have too many emailed questions next week, because I’ll be the first to ask

you ‘why didn’t you ask that question when I was in front of you?’ when

you have 4 days of almost 1-2-1 contact possible



• What are the long-term IAOHD aims?

– Grow our Membership

– Arrange and organise scientific meetings

– Arrange training

– Fund research by IAOHD members

– Offer the regulatory authorities a framework for ozone therapy

approval

– Fund students to study and practice ozone therapies

– Act as an umbrella organisation for the many smaller ozone

organisations around the world to share research across the different

health-care professions

– Encourage new members to Board to allow us to ‘retire’!



• a defining difference between medicine and dentistry

• when a patient sees a medical doctor with an

infection, there is no expectation that the infected

body part will be cut off or amputated







• the same patient’s expectation when seeing a dentist

with a painful tooth is that a part of the body – the

tooth – will be drilled or amputated



ozone in clinical care

modern care with ozone

two divergent ozone treatment methodologies

ozone-treated

liquids ozone gas

O3




ozone-treated

liquids ozone gas

O3


O O12,1 nm

0 kJ/mol

allotropes of oxygen - oxygen

dioxygen = O2 (common oxygen), 3rd most abundant element, 21% of air

O2 + 4H+ + 4e = 2H2O E0 = +1,229 V

O2 + 2H2O + 4e = 4OH- E0 = +0,401 V

O2 + 4H+(10-7 mol/L) + 4e = 2H2O E0 = +0,815 V


O

O

O

13 nm

116,6 °

142 kJ/mol

allotropes of oxygen - ozone

Ozone = O3 don’t confuse with activated oxygen which is O- and is a free

radical)

O3 + 2H+ + 2e = O2 + H2O E0 = +2,07 V

O3 + 2H2O + 2e = O2 + 2OH- E0 = +1,24 V

O3 + 2H+ (10-7 mol/L) + 2e = O2 + H2O E0 = +1,65 V


ozone generation reactions

main ozone formation reaction is [O + O2 = O3]

10 oxygen species

79 + other reactions.

e + O2 = 2O + e

e + O2 = O- + O

O- + O2 = O2- + O

e + O3 = O2- + O

O3 + O2 = O2 + O2 + O

e + N2 = 2N + e

e + N2 = N2 + e

N + O2 = NO + O

N2 + O2 = N2 + O2* = N2O + O

N2 + O2 = N2 + O2* = N2 + 2O

O + NO + M = NO2 + M

NO + O3 = NO2 + O2

nitrogen compounds in ozone generated

from air cause more discussion and

disagreement between health care

workers involved in ozone therapy.

occur during ozone formation from air: e.g

using medical-grade oxygen feeds, it is possible

to cut out the nitrogen compounds in ozone


research in health care The Locomotive News and Railway Contractor; 1937


• Safety of ozone

• 1978 FDA Report

• 1.5 million people hospitalised by pharmaceutical side effects

• 140,000 deaths from prescription drug usage

• 1980 German Medical Society Report for Ozone Therapy

• 5.6 million ozone treatments carried out

• 40 reported cases of side effects (0.000007%)

• No deaths from ozone ever reported

research in health care literature overview:


Wentworth P, McDunn JE, Wentworth AD, Takeuchi C, Nieva J, Jones T, Bautista

C, Ruedi JM, Gutierrez A, Janda KD, Babior BM, Eschenmoser A, Lerner RA.

Evidence for Antibody-Catalyzed Ozone Formation in Bacterial Killing and

Inflammation. Science 298, 2195-2199. 2002

Recently, we showed that antibodies catalyze the generation of hydrogen peroxide (H2O2) from singlet molecular

oxygen (1O2*) and water. Here, we show that this process can lead to efficient killing of bacteria, regardless of the

antigen specificity of the antibody. H2O2 production by antibodies alone was found to be not sufficient for bacterial

killing. Our studies suggested that the antibody-catalyzed water-oxidation pathway produced an additional

molecular species with a chemical signature similar to that of ozone. This species is also generated during the

oxidative burst of activated human neutrophils and during inflammation. These observations suggest that

alternative pathways may exist for biological killing of bacteria that are mediated by potent oxidants previously

unknown to biology.

Department of Chemistry,

Department of Immunology,

Department of Molecular and Experimental Medicine and The Skaggs Institute for

Chemical Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La

Jolla, CA 92037, USA.

research in health care


Marx J. Immunology. Antibodies kill by producing ozone. Science. 2002 Nov

15;298(5597):1319.

Babior BM, Takeuchi C, Ruedi J, Gutierrez A, Wentworth P Jr. Investigating

antibody-catalyzed ozone generation by human neutrophils. Proc Natl Acad Sci U S A.

2003 Mar 18;100(6):3031-4. Epub 2003 Feb 24.

Kettle AJ, Clark BM, Winterbourn CC. Superoxide converts indigo carmine to isatin

sulfonic acid: implications for the hypothesis that neutrophils produce ozone. J Biol

Chem. 2004 Apr 30;279(18):18521-5. Epub 2004 Feb 20.



• bacteria

• evolved of millions of years

• complex communities

• specialized colonies

• nutrient pathways

• chemical signals to other bacterial types

• protected by the protein pellicle on a tooth surface

• mature carious lesions = about 455 bacterial species

• bio & genetic engineering / cloning

• (Prof Julian Marr, 2001)

research in dental care


• bacteria – exhibit mutual interdependence

• bacterial niche evolves from alkaline to acidic

• by-products or ‘biomolecules’ from one group, feed

or become the substrate for the next group down the

chain

• removal of one bacterial group or more slows the

decay, does not halt it




Caries

defined as an infection of the hard dental tissues of enamel and dentine

resulting in mineral loss, lesion cavitation, with the eventual death of

the tooth pulp, followed by infection, tooth loss, host death


1H NMR spectrum of a pre-ozone treated

carious root dentine biopsy specimen

8.5 8.0 7.5 7.0 6.5 6.0 5.5

Form

4.0 3.5 3.0 2.5 2.0 1.5 1.0

4.0 3.5 3.0 2.5 2.0 1.5 1.0

Met-S-CH3

Met-SO-CH3

Ace

~



0 1 2 3 4

SoftHard Leathery

Progression

Reversal

0 1 2 3 4

SoftHard Leathery

ProgressionProgression

ReversalReversal

Lynch E. The measurement of root caries for research purposes. J Dent Res 1986;

65: 510.

Holmes J; Clinical reversal of root caries using ozone, double-blind, randomised,

controlled 18-month trial. Gerodontology 2003; 20: 106-114.


• bacteria – mutual interdependence

• bacterial niche evolves from alkaline to acidic

• by-products or ‘bio-molecules’ from one group, feed or become the

substrate for the next group down the chain

• removal of one bacterial group or more slows the decay process, does not

halt it

• removal of bacteria only – lesion takes about 4 to 6 weeks to

establish the full acidic niche

• removal of the bacteria and the biomolecules, extends this

window of opportunity to 15 to18 weeks



• Ozone provides the key to caries reversal

• Ozone per-se does not cause remineralisation

• Ozone changes the biochemistry from acidic to basic

• This change in the pH of the niche environment leads to

• mineral uptake exceeding mineral loss remineralisation

• the lesion hardens, the process causes a glass-like surface

• the carious process halts/reverses.







• the same patient’s expectation when seeing a dentist

with a painful tooth is that a part of the body – the

tooth – will be drilled or amputated



• dull

• leathery

• shiny, ‘healthy’

• hard, remineralised

easy to apply + great results

~ just 8 weeks - is there a need to fill?

Photographs © Professor Edward Lynch, UK


• Charlotte; 12 yrs old, platelet count of 12

• pre-tx: DIAGNOdent (all lesions 70+). needs urgent dental care

• traditional dental therapy (la, drill & fill) impossible

• recall & review at 4~6 weeks, FujiVII temp seals

~ initial research results; Charlotte, 2002

© Dr Julian Holmes

what about ? ozone therapies in dental care



21-10-02

15-04-04

21-10-02

15-04-04

Before O3

After O3




21-10-02

15-04-04

Before O3

After O3

O3 treatment started

21-10-02.

Review 15-04-04, 18-months

after the first application of O3




21-10-02

15-04-04

21-10-02

Before O3

After O3


21-10-02.





why the poor results?

enamel

dentine inverted fissure

organic plug



enamel

dentine

demineralising

enamel zone

visible as white spot

formation; caries inception

usually just below the surface

mineral loss


enamel defects

in fissure wall

- undetectable by any

technology at present

decalcified or

hypocalcific

enamel

- caries in this zone is

undetectable by probe

- detect with laser or

trans-illumination

de-mineralizing

dentin


how does tooth decay start?

organic plug

- the ‘nice’ brown stain

dental technicians and

dentists like to reproduce

on crowns!

- why do dentists

reproduce initial decay

on false teeth?



how does tooth decay start?

enamel cavitation

- visible caries

- established acid niche

- mineral loss

- further cavitation &

tissue loss

- sensitivity &/or pain


what ozone can do

• what did we learn?

• organic plug must be removed for accurate diagnosis

• organic plug has no structure for remineralisation

• caries needs to be exposed for maximum ozone penetration

• un-structured dentine needs to be removed for remineralisation

• remineralisation takes time

• open, self-cleansing cavities remineralise faster – 3-4 weeks in optimal conditions

• covered cavities take up to 4 months – eg where glass ionomer has been placed


what ozone can do • early occlusal caries

• advanced occlusal caries (with help)

• secondary caries

• root caries

• cavity disinfection

• root canal disinfection

• surface disinfection prior to crown/veneer cementation

• desensitisation

• hardening of advanced caries

• accelerate healing of soft and hard tissues

• inactivate bacteria, spores, fungi, viruses, prions

• remove biofilms

• surface / instrument sterilisation

• form new ozonoid compounds in plant oils

• & lots more!


what ozone cannot do!

• regenerate teeth

• replace lost enamel or dentine

• revitalise non vital teeth

• treat infections in 20, 30 or 40 seconds in most cases

• remove dark carious staining in 60 seconds

• reach deeper into the tooth than 5-6 mm in 20 seconds

• eliminate the need for rotary instruments

• make everyone younger unfortunately!


• ozone reduces time of treatment

• cost effective treatment

• usually no anaesthetics required

• Holmes J & Lynch E. Reversal of occlusal caries using air abrasion,

ozone and sealing. IADR Abstract, 2004

• Domingo H, Holmes J, Abu-Naba’A L, et al . Economic savings treating

root caries with ozone or air abrasion. IADR Abstract 2004

research in dental care literature overview:


• the use of ozone

• saves tooth tissue

• maintains tooth vitality

• avoids pulpal exposure

• Holmes J. ART and Ozone; combination therapies that are changing the

face of dental care. IADR abstract, 2004 (IADR Irish Division Meeting,

Belfast )



does ozone interfere with dental material bond strengths or material retention?

Abu-Naba'a L, Al Shorman H, Lynch E. 6-months Fissure Sealant Retention Over

Ozone treated Occlusal Caries. IADR Abstract 2003, 2004

Campbell D, Hussey D, Cunningham L, Lynch E. Effect of Ozone on Surface

Hardness of Restorative Materials. IADR Abstract 2003.




Magni E, Ferrari M, Papcchini F, Hickel R, Ilie N. Effect of ozone treatment on one-

day and aged composite repairs. IADR Abstract 2009

Conclusion:

The application of ozone determines a significant reduction of the 24h composite-

repair strength only if a silane is used as intermediate agent.

On aged composite repairs an ozone pretreatment does not produce any

detrimental effect on the composite-repair strength.

?is ozone denaturing silane coupling agent? – probably yes!




Garcia EJ. Influence of Ozone Treatment Pre- or Post Bonding Procedures. IADR

Abstract 2010

Results: Ozone water treatment showed higher bond strength values for the pre-

bonding group and lower bond strength values for the post-bonding group (p =

0.007).

Conclusions: aqueous and gaseous ozone, can be recommended as antibacterial

treatment before bonding procedures.



predictable results

Holmes J. Clinical reversal of root caries using ozone, double-blind, randomised,

controlled 18-month trial. Gerodontology 2003; 20: 106-114.



patients prefer this non-invasive treatment system to “drilling & filling”

Domingo H, Abu-Naba'a L, Al Shorman H, Holmes J et al. Reducing Barriers to

Care in Patients Managed with Ozone. IADR Abstract 2003.

Megighian GD, Dal Vera M. Reducing Barriers to Care in Patients Managed with

Ozone in a General Dental practice in Italy. IADR Abstract 2003

Abu-Naba'a L, Al Shorman H, Lynch E. Patient's Attitude to Treatment of Pit and

Fissure Caries with Ozone. IADR Abstract 2004.

Steier L, Steier G, Domingo H, Lynch E. Older Patients Attitudes to Managing

Caries with Ozone. IADR Abstract 1473, 2006



patients prefer this non-invasive treatment system to “drilling & filling”

Lussi A and Dähnhardt JE, University of Berne, Switzerland. Treatment of non-

cooperative children. First results after 4 mths. IADR Abstract 2004.

Compliance of the parents

20% were sceptical at the beginning of the treatment after the first ozone treatment

100% wanted to continue after initial results



the key to predictability is the elimination of the acid niche environment; bacteria

and their bio-molecules

• Holmes, J & Lynch, E. Clinical Reversal of Occlusal Fissure Caries

Using Ozone.

• showed > 99.5% caries reversal at 24 months

• Holmes J. Clinical reversal of root caries using ozone, double-blind,

randomised, controlled 18-month trial. Gerodontology 2003; 20: 106-

114.

• showed 100% caries arrest and reverse after ozone tx

• control lesion with OH, F, Ca, PO, Zn only worsened



research has shown that caries up until now

has been;-

• poorly diagnosed

• involves amputation, ‘drill n’ fill’

• treatment is poorly accepted by public

• treatment poorly executed average filling lifetime low

• resulting in increasing spiral of costs

• resulting in larger and more complicated restorations often followed by RCT and

extractions

• dentists make their own bad press!


‘The entry of a patient into the cycle of drill

and fill is irreversible. Once a hole is drilled

into a tooth, the patient always will have it;

and no matter how good a clinician each

dentist perceives themselves to be, any

restorative material will fail at some time.’

The key is ‘prevention’

Holmes J, 2003



~ diagnosis & evaluation the historical face of dentistry


KaVo DIAGNOdent

caries diagnosis

• measures fluorescence

• high correlation with the

ECM (Lode, Holland)

• validated index

Lussi A, Switzerland


~ diagnosis & evaluation; research results

Holmes J & Lynch E, 2001 (from Lussi A, Caries Research, 1999; 33, 297)

3+ mm into dentine CSI 5 > 30 Visible on X-rays -> DV

1-2mm into dentine CSI 4 25~29 ? visible on X-rays -> DV

at the edj CSI 3 20~24 stain -> DV

confined to enamel CSI 2 10~19 white spot -> DV

extent of carious lesion DIAGNOdent Values

a basic guide to the DIAGNOdent values & The CSI

caries diagnosis


caries diagnosis

Holmes J, 2007 (from Holmes J & Lynch E, 2001)



Strycharz-Dudziak M, Biezanek T, Chalas R,

Bachanek T; Ozone Therapy as a Treatment Method

of Initial Caries. IADR abstract 2515, 2010:

Results; 41% got worse after ozone treatment




21-10-02

15-04-04

21-10-02

Before O3

After O3


21-10-02.





Photographs © Dr Huda, Egypt 2006

• 40 seconds O3 on dentine • 10 minutes O3 on dentine

• effects of ozone on tooth dentine

• ozone shows superficial removal of superficial debris

• does ozone remove the smear layer ?

• does ozone remove peri-apical tubular debris ?



Effectiveness of Ozone with or without the Additional Use of Remineralizing Solution on Non-Cavitated Fissure Carious Lesions in Permanent Molars.

Atabek D, Oztas N.

Eur J Dent. 2011 Oct;5(4):393-9.

Results: A statistically significant difference was found between all of the control and experimental test lesions in each group (P<.001). However, there was no statistically significant difference between the ozone treated groups and those using the additional re-mineralizing solution (P>.001).

Conclusions; Ozone treatment either alone or combined with a re-mineralizing solution was found to be effective for remineralization of initial fissure caries lesions.



Ozone therapy in dentistry: A strategic review.

Saini R.

J Nat Sci Biol Med. 2011 Jul;2(2):151-3.

Abstract

The oral cavity appears as an open ecosystem with a dynamic balance between the entrance of micro-organisms, colonization modalities and host defences aimed at their removal.

Method; To avoid elimination, bacteria need to adhere to either hard dental surfaces or epithelial surfaces. The oral biofilm formation and development, and the inside selection of specific microorganisms have been correlated with the most common oral pathologies, such as dental caries, periodontal disease, and peri-implantitis. The mechanical removal of the biofilm and adjunctive use of antibiotic disinfectants or various antibiotics have been the conventional methods for periodontal therapy.

Conclusion; Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms, and its application in medicine and dentistry has been indicated for the treatment of 260 different pathologies. The ozone therapy has been more beneficial than present conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment. The exposition of molecular mechanisms of ozone further benefits practical function in dentistry.



Ozone and caries: a review of the literature.

Burke FJ.

Dent Update. 2012 May;39(4):271-2, 275-8. Review.

Abstract

Ozone, either in gaseous form or as ozonated water, has been available for use as a treatment for dental caries for a decade. This paper reviews the literature on the subject by examining the findings of publications in the peer review literature.

Method; Eighteen papers were identified by a literature search. From the review of these, it was concluded that, while some laboratory studies and some short duration clinical studies have suggested that ozone may be effective in the treatment of root caries or killing of oral micro-organisms.

Results; The clinical evidence for the use of ozone in treatment of caries is not compelling.

JH edit; Apart from reading previous published papers, this Prof did no research to verify the results!




Dentine Sensitivity


Patel P, Patel A, Kumar S, Holmes J

Evaluation of ozonated plant oil with or without adjunctive application of mineral wash containing calcium sodium phosphosilicate on the reversal of post-surgical root dentin hypersensitivity: a randomized, triple-blinded, controlled, parallel-armed clinical trial.

Submitted for Publishing

Abstract.

Objectives: The aim of this study was to evaluate the efficacy of an ozonated plant oil with or without adjunctive application of a mineral wash containing calcium sodium phosphosilicate on the reversal of post-surgical root dentin hypersensitivity.

Method and materials: A triple-blinded, randomised controlled clinical trial was conducted on 51 subjects with root dentin hypersensitivity. Subjects were randomly assigned to 4 groups: Group A, ozonated plant oil: Group B, ozonated plant oil and mineral wash: Group C, placebo plant oil and mineral wash: Group D, placebo plant oil only. Active treatment was carried out in-clinic and followed by at-home care with a remineralising paste. The response to various pain stimuli and perceived total sensitivity was periodically assessed with a visual analogue scale. Scanning electron microscopic study was also used to assess dentinal tubule occlusion and change in tubular surface area after treatment. Data sets were analysed by repeated measure ANOVA followed by Scheffe post hoc pair wise multiple comparisons.

Results: Group B subjects showed a significant decrease in root dentin hypersensitivity (RDH) and visual analogue scale (VAS) scores over the study period (P<.001), and the intergroup comparison revealed a significant result (P<.001). Similarly subjects in Group C also showed a significant reduction in RDH within the study period with intergroup comparison significance (P<.001). No significant (P>.05) difference was detected between Group A and Group D VAS and global sensitivity analysis. The scanning electron microscopic (SEM) study result showed significant (P<.001) enhanced dentine tubule occlusion and decreased tubular surface area in Group B specimens compared to all other Group specimens. Tubule occlusion and tubular surface area were not significantly (P>.05) different between Group A and Group D.

Conclusion: The results of this clinical and SEM study showed that ozonated plant oil (OPO), when used alone, is not efficient in reducing post-surgical RDH. However, when OPOs and a mineral wash containing calcium sodium phosphosilicate (CSP) are used together, there is a significant and positive impact on the reversal of post-surgical root dentin hypersensitivity.



Tubular occlusion of simulated hypersensitive dentin by the combined use of ozone and desensitizing agents.

Raafat Abdelaziz R, Mosallam RS, Yousry MM.

Acta Odontol Scand. 2011 Nov;69(6):395-400. Epub 2011 Apr 1.

Abstract

Objective: Ozone was suggested for treatment of hypersensitive dentin. The purpose of this study was to investigate the effect of ozone, with or without the use of desensitizing agents, on patency and occlusion of simulated hypersensitive dentin.

Materials & Methods: sixty standardized dentin slabs were randomly divided into six groups: distilled water (Control), ozone treatment, fluoride desensitizer (ALL Solutions, Dentsply), oxalate desensitizer (D/Sense Crystal, Centrix), combined use of ozone/fluoride and combined use of ozone/oxalate. Ozone gas was delivered from OzonyTronX (Mymed). Specimens were evaluated using a scanning electron microscope and digital image analysis before and after treatment.

Results: Statistical analysis using ANOVA and Mann-Whitney U-tests revealed significantly lower percentage of tubular occlusion with ozone treatment than distilled water at p = 0.05. Scanning electron microscope photomicrographs of oxalate desensitizer specimens revealed a thick homogenous precipitate with significantly higher percentage of tubular occlusion than fluoride desensitizer and distilled water. Combined use of ozone/fluoride resulted in a significantly higher percentage of tubular occlusion than fluoride desensitizer alone. However, no significant difference was found between oxalate desensitizer and combined use of ozone/oxalate.

Conclusions: The use of ozone gas is a viable adjunct to fluoride-containing desensitizers in enhancing tubular occlusion, but is not effective with oxalate desensitizers.



Evaluating the effect of an ozone delivery system on the reversal of dentin hypersensitivity: a randomized, double-blinded clinical trial.

Azarpazhooh A, Limeback H, Lawrence HP, Fillery ED.

J Endod. 2009 Jan;35(1):1-9. Epub 2008 Nov 8.

Abstract

Objectives; The aim of this study was to evaluate the effect of an ozone delivery system (HealOzone; KaVo, Biberach, Germany) in reducing dentin hypersensitivity.

Method; An 8-week, 3-visit, triple-blinded, randomized controlled clinical trial with 2 HealOzone machines (ozone/air) involving 44 subjects was conducted. The pain in response to tactile stimulus or desiccation was assessed by using a 100-mm visual analogue scale. Also, the global subjects' perception of sensitivity was assessed at each visit by using the visual analogue scale. No subjects reported an increase in pain or any adverse effect.

Results; All subjects reported a clinically significant reduction of pain at each follow-up relative to baseline; however, the difference between the study groups was not statistically significant. The effect of treatment of hypersensitive teeth with ozone reduces the pain sensation, but this effect cannot be distinguished from the placebo treatment. There was a large placebo effect that narrowed the range over which to detect treatment differences.

Conclusion; Ozone treatment had no effect on tooth hypersensitivity. [Evid Based Dent. 2010]

? Where’s the mineral wash, oral hygiene, diet advice????



Treating sensitive cervical areas with ozone. A prospective controlled clinical trial.

Dähnhardt JE, Gygax M, Martignoni B, Suter P, Lussi A.

Am J Dent. 2008 Apr;21(2):74-6.

Abstract

Purpose: To determine whether the treatment of hypersensitive teeth with gaseous ozone (Healozone, KaVo 1600 ppm) for 60 seconds reduces pain immediately after treatment and in the longer term.

Methods: In three private practices in Switzerland, 31 subjects suffering from hypersensitive teeth were treated with gaseous ozone over a period of 54 weeks (one test and one control tooth in each subject). A cross-over design was chosen. The pain level was measured with a Visual Analogue Scale before and after the treatment.

Results; The subjects' pain level was reduced by 55% +/- 5.5% immediately after the ozone treatment. Over time, the pain level decreased significantly in all groups: The pain level in the test teeth was significantly reduced in Weeks 0-22 (treatment group, P < 0.001) compared to the pain level before treatment. The pain level in the control group was also reduced significantly over time in Weeks 0-22 (no-treatment, P = 0.025) and in Weeks 22-54 (treatment group, P = 0.0065).

Conclusion; Comparing test and control teeth over time, there was no statistically significant difference in pain reduction (P = 0.58).

? Where’s the mineral wash, oral hygiene, diet advice????



Does Ozone Damage Nerve Tissue?



Dental Pulp Tissue

2005

0036 Effect of Ozone Treatment on Interleukin Levels in Dental Pulp

J. CHOU, D. BOYD, and G. TOMPKINS, University of Otago, Dunedin, New Zealand

Objective: To determine whether therapeutic levels of ozone stimulate production of the inflammatory cytokines interleukin-2 (IL-2) and interleukin-6 (IL-6) in healthy teeth.

Methods: Participants (9- 17 years old) with healthy teeth requiring extraction for orthodontic reasons were recruited. The teeth were cleaned with pumice and water and randomly assigned to test or control groups. Test teeth were exposed to 40 seconds of ozone treatment via an ozone generating machine (KaVo HealOzone); 20 seconds occlusally and 20 seconds buccally. The teeth were extracted either one day or one week later, and placed in chilled phosphate–buffered saline. The pulp was removed within 30 minutes of extraction and stored at -80°C until assayed. Pulpal concentrations of IL-2 and IL-6 were measured by ELISA (R & D systems).

Results: 32 pulps from nine participants were collected, weighed and analysed. In the one day extraction group (24 pulps), the mean concentration of IL-6 in the test group was 0.011 ± 0.007 pg/mg of pulp material, compared to 0.014 ± 0.008 pg/mg in the control group (p= 0.039; one-tailed paired t-test). The one week extraction group (eight pulps) showed a mean of 0.007 ± 0.002 pg/mg in the test group and 0.006 ± 0.002 pg/mg in the control group with no statistical difference (p= 0.216). IL-2 was below the level of detection (<7 pg/ml) in all tested pulps.

Conclusion: From the experiment, there was no evidence that ozone treatment stimulated an increase in the levels of IL-6 and IL-2 in healthy dental pulp. This suggests that ozone elicits negligible inflammatory responses (if not reduces levels of inflammation) when applied to healthy teeth, and may have potential for prophylactic treatment of patients with high caries risk. This work was supported by the Sir John Walsh Summer Studentship.



Does Ozone Damage Joints?



Role of intra-articular ozone gas injection in the management of internal derangement of the temporomandibular joint.

Daif ET.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jun;113(6):e10-4. Epub 2012 Feb 28.

Abstract

Objectives: This study was carried out to compare intra-articular ozone gas injection and drug therapy as conservative treatment modalities for internal derangement of the temporomandibular joint (TMJ).

Study Design: Sixty patients (49 female and 11 male) with bilateral internal derangement of the TMJs, disc displacement with reduction, were included in this study. They were divided randomly into 2 equal groups. The first group was treated by a direct injection of ozone gas into the superior joint space. Each joint received 2 mL ozone-oxygen mixture (ozone gas concentration 10 µg/mL). The injections were repeated 2 times per week for 3 weeks. The second group received nonsteroidal antiinflammatory drugs and muscles relaxants. The clinical signs and symptoms before and after the treatment were assessed according to Helkimo's clinical dysfunction index.

Results: The results showed that 87% of the patients who received ozone gas injections into the superior joint space (n = 26) either completely recovered (37%; n = 11) or improved (50%; n = 15). In the second group, 33% of the patients who were treated with nonsteroidal antiinflammatory drugs and muscle relaxants (n = 10) showed only an improvement in their clinical dysfunction indexes.

Conclusions: Based on the findings of the present study, we can consider that intra-articular ozone gas injection is a promising new treatment modality for internal derangement of the TMJ. However, further clinical and experimental studies are required to provide direct evidence for its mechanism of action and to substantiate our results.





ozone-treated

liquids ozone

gas

O3


ozone in routine care

Ozone-Treated Liquids - Water


75 / 177

O3

H+

OH-

O3

O3 O2

O3-

H+HO2O2

-

O2

HO3

O2

2O2

O3HO

decomposition of ozone in water

© Dr Julian Holmes 2013 76 / 177

HH22OO OOHH-- ++ HH

++ 22..44xx1100

--55 ss

--11

ppKKaa == 1155..77OOHH

-- ++ HH

++ HH22OO 11..44xx1100

1111 MM

--11ss

--11

OO33 ++ OOHH-- OO

22-- ++ HHOO

22 11..44xx1100

22 MM

--11ss

--11

22OO33 ++ HH22OO 33OO22 ++ HH22OO 11..55xx1100--33

MM--11

ss--11

HHOO22 OO

22-- ++ HH

++ 33..22xx1100

55 ss

--11

ppKKaa == 44..88OO

22-- ++ HH

++ HHOO

22 22..00xx1100

1100 MM

--11ss

--11

OO33 ++ OO22-- OO

33-- ++ OO22 11..66xx1100

99 MM

--11ss

--11

OO33 ++ HHOO22 HHOO

++ 22OO22 33..55xx1100

77 MM

--11ss

--11

HHOO33 OO

33-- ++ HH

++ 33..77xx1100

44 ss

--11

ppKKaa == 66..22OO

33-- ++ HH

++ HHOO

33 55..22xx1100

1100 MM

--11ss

--11

HHOO33 HHOO

++ OO22 11..11xx1100

55 MM

--11ss

--11

OO33 ++ HHOO HHOO

22 ++ OO22 11..55xx1100

66 MM

--11ss

--11

HHOO22 ++ OO

22-- OO22HH

-- ++ OO22 88..77xx1100

77 MM

--11ss

--11

HHOO ++ HHOO

HH22OO22 55..33xx1100

99 MM

--11ss

--11

HH22OO22 OO22HH-- ++ HH

++ 44..55xx1100

--22 ss

--11

ppKKaa == 1111..66OO22HH

-- ++ HH

++ HH22OO22 22..00xx1100

1100 MM

--11ss

--11

OO33 ++ OO22HH-- OO

22-- ++ HHOO

++ OO22 22..88xx1100

66 MM

--11ss

--11

Assumes pure RO Water


PEM-Duo

simple cross-infection control



Water Line Disinfection

Applications to any liquid line from irrigation, mains water into medical suites and hospitals, beer lines

in restaurants to water feeds in industry

- The ‘Health-Care Time-Bomb’! (No1) -


• the most common bacterial species in mains water is Micrococcus luteus and Sphingomonas spp., & are known opportunistic pathogens (O'Donnell et al 2006).

• Aspergillus amstelodami, Aspergillus fumigatus, Aspergillus spp. from Aspergillus glaucus group, Aspergillus repens, Citromyces spp., Geotrichum candidum, Penicillium aspergilliforme, Penicillium pusillum, Penicillium turolense, Sclerotium sclerotiorum; yeast-like fungi: Candida albicans, Candida curvata and other yeasts (Szymanska 2005).

• dental units from clinics in conservation, periodontology, and prosthodontics. Conservative dental units had the highest counts, followed by periodontology and prosthodontics (Al Shorman et al 2003, Al-Hiyasat et al, 2007)

• dental units have the potential to transmit periodontal pathogens between patients. (Montebugnoli et al 2004)

• in dental air-water aerosol, water is the main source of bacterial endotoxin contaminating the aerosol from dental hand pieces, even after sterilisation. (Szymanska 2005)

ozone in health care


Before O3/H2O Rx

Results:


10 minutes

flushing

5 minutes O3/H2O flushing 10 minutes O3/H2O flushing

10 minutes O3/H2O flushing 15 minutes O3/H2O flushing

Results:


• the most common bacterial species in mains water is Micrococcus luteus and Sphingomonas spp., & are known opportunistic pathogens (O'Donnell et al 2006).

• dental units have the potential to transmit periodontal pathogens between patients. (Montebugnoli et al 2004)

• in dental air-water aerosol, water is the main source of bacterial endotoxin contaminating the aerosol from dental hand pieces, even after sterilisation. (Szymanska 2005)

• some bacteria may be a cause of opportunistic infections in people with immunological disorders



Al Shorman AL, Abu-Naba L, Coulter WA, Lynch E. Ozone, An Effective Treatment For Dental Unit Water Lines. IADR Abstract 0711, 2002

Ozone (O3) has been used for purification of water due to its efficiency and lack of side effects.

Objectives: The aim of this study was to apply ozone to control the contamination of dental unit water lines (DUWL).

Methods: In this experiment the water lines in a dental unit with existing biofilm was treated with O3 and subjected to microbiological assessment.

Results: The bacterial count of samples collected showed a bacterial reduction from 5.2*103 CFU/ml before treatment to 300 CFU/ml after the first O3 application and then to 0 CFU/ml after the second application onwards.

Conclusions: The results suggest that O3 delivered in solution can play an important role in controlling the problem of contamination of DUWL. Investigations are being conducted to determine the minimum O3 required to solve this problem.



Puttaiah R, Lin SM, Cederberg R. Biofilm Control - Ozonation in an Automated Waterline Cleaning Dental Unit. IADR Abstract 0081, 2005

Objectives: To study the effects of water dissolved ozone as a sanitizer in an automated waterline cleaning dental unit to control microbial contamination.

Methods: 29 simulated between-patient cleaning cycles were performed utilizing 2ppm ozone in water. Each automated cleaning cycle lasted 5 minutes. Water/irrigant used for simulation of patient care and post-sanitization waterline flush was water sanitized by ozonation.

Results:

Baseline waterline samples showed viable mature biofilm.

Post study waterline samples showed no viable or non-viable biofilm.

Conclusions: Simulated between patient sanitization by ozonation of tap water generating about 2ppm of dissolved ozone was beneficial in controlling biofilms.



• Dickermann J M, Castrabertti AO, Fuller JE. Action of ozone on water-borne bacteria. J Eng Water Works Assoc 1954; 68: 11.

• Burleson GR, Murray TM, Pollard M. Inactivation of viruses and bacteria by ozone, with and without sonication. Appl Microbiol. 1975 Mar;29(3):340-4.

• Holmes, J. Ozone as a control for volatile sulphur compounds. ISBOR Abstract and Poster, 2002.

• Chih-Shan L and Yu-Chun W. Surface Germicidal Effects of Ozone for Microorganisms. IADR 2006.

• Buckley D, Lynch E, Grootveld MC. Efficacy of Ozonated Water Rinsing in Diminishing Volatile Sulphur Compounds. IADR Abstract 3584 2011:

• The question is ‘How much ozone is required over what time period to achieve inactivation and sterility?’

infection control


Coulter J, Fulton CR, Lynch E, Coulter WA. Ozonated water for disinfection of MRSA and C difficile IADR Abstract 0766, 2008.

Objectives: The aim of this project is to assess the efficacy of Ozonated water at different concentration and time intervals to disinfect gauze and surface biofilms of MRSA, or C. difficile spores.

Methods: Suspensions of bacteria were dried on to glass slides or 4 cm2 squares of cotton gauze and exposed to 3 ppm ozonated water for various time periods.

Results: 106 MRSA in broth suspension; in biofilm or dried on cotton fabric was reduced to 0 cfu/ml after 5 minutes exposure to 3 ppm ozonated water. Only spores of C difficile survived in air on biofilm or fabric. A spore suspension of 105 on fabric was reduced to zero with 5 min exposure to Ozonated water whilst the control samples were not significantly reduced.

Conclusion: Ozonated water was effective at decontaminating MRSA and C difficile when dried on to cotton fabric and solid surfaces and has potential for decontaminating surfaces in hospital wards and bed linen.




Soft Tissue Healing


Tranina AA, Correa L, Acai R, Urruchi W, Naclerio-Homem MG, Deboni MCZ. Ozonized water irrigations on dermal wound healing in rats. IADR Abstract 3466, 2009

Objectives: were to analyze the biological effects of ozonized water on soft tissue healing.

Methods: standard dermal wounds with 5 millimetres were performed by a punch on the dorsal skin of 48 Wistar male rats. The animals were divided in four groups: at one group (GO3>) the wounds were rinsed with ozonized water in concentration of 4ppm, at another one (GO3<) ozonized water was applied at 1ppm, a positive control group (Gwater) water was not ozonized and at the negative control group (Gnone) wounds were left without any irrigation.

Results: At 2 days, the histomorphologic analysis revealed that GO3> and GO3< groups presented more intense expression of inflammatory process that the positive control group; at the 14days, GO3> e Gnone presented similar histological analysis exhibiting features of a more evident healing process, showing more intense expression of collagen synthesis, and a well organized collagenic matrix formation. Immunohistochemistry revealed that the collagen type-I scoring was regular for all groups and that the groups irrigated with ozonized water presented a higher number of myofibroblasts.

Conclusion: The results demonstrated that ozonized water did not produce any toxic effect or delay on tissue healing progress and also, surgical irrigation with ozonized water may produce inflammatory stimulus for tissue healing depending on the dose. Probably ozone's capacity to interfere in biochemistry cellular reactions, and to enhance gradient of oxygen in tissues, may be interpreted as favourable, depending on clinical condition.

research in surgery


Franscino AVM, Juliana N, Andrea M, Zindel DMC. Bone Repair of Monocortical Wounds after Ozonized Water Irrigation. IADR Abstract 1017, 2010.

Objectives: to investigate the effect of ozone diluted in water during the wound healing process of monocortical standardized bone defects in Wistar rat femurs.

Methods: 16 Wistar rats were submitted to bone defects in the left femur using a 2mm trephine bur. The animals were divided in two groups. Group I received 100ml of pure deionised water during the perforation whilst group II received 100ml of deionised water associated with 4ppms of ozone. Irrigation lasted ten minutes. After surgery and irrigation tissues were repositioned and sutured. The animals were sacrificed after 7 and 14 days in a CO2 chamber. Surgical samples of bone lesions were fixed and processed for histological analysis that was carried out by three different blinded observers.

Results: At 7 days, Group I bone healing was delayed compared to Group II, with less inflammatory infiltrate, more organized trabecular bone and periosteum with more cellularity. At 14 days, group I showed more mineralization and increased numbers of bone marrow cells while group II revealed massive numbers of osteoblasts, osteoclasts and blood vessels similar to bone granulation tissue. No signs of tissue necrosis were seeing in any group at any experimental time.

Conclusions: Ozone diluted in water has a positive effect on bone healing. No toxic effect or necrosis was seen in bone wound using 4ppm of ozone diluted in water.

research in surgery



Dental Materials as Pollutants

- Time-Bomb No2! –

- Bisphenol (pseudo-estrogen)


• Bisphenol (pseudo-estrogen) in dental composite and bonding liquids; control.

• Olea N, Pulgar R, Pérez P, Olea-Serrano F, Rivas A, Novillo-Fertrell A, Pedraza V,

Soto AM, Sonnenschein C. Estrogenicity of resin-based composites and sealants

used in dentistry. Environ Health Perspect. 1996;104:298-305.

• Arenholt-Bindslev D, Breinholt V, Preiss A, Schmalz G. Timerelated bisphenol-A

content and estrogenic activity in saliva samples collected in relation to placement

of fissure sealants. Clin Oral Investig. 1999;3:120-125.

• Fung EY, Ewoldsen NO, St Germain HA Jr, Marx DB, Miaw CL, Siew C, Chou

HN, Gruninger SE, Meyer DM. Pharmacokinetics of bisphenol A released from a

dental sealant. J Am Dent Assoc. 2000;131:51-58.

• Schuurs AH, Moorer WR. Hormone dysregulators. Pseudo-estrogens in dental

composite resins and sealants? Ned Tijdschr Tandheelkd. 2000 Dec;107(12):490-4.



• Bisphenol (pseudo-estrogen) in composite and bonding liquids; control.

• Deborde M, Rabouan S, Duguet JP, Legube B. Kinetics of aqueous ozone-

induced oxidation of some endocrine disrupters. Environmental Science

and Technology 39 (16) (2005)

• Broséusa R, Vincenta S, Aboulfadlb K, Daneshvarc A, Sauvéb S, Barbeaua

B, Prévosta M. Ozone oxidation of pharmaceuticals, endocrine disruptors

and pesticides during drinking water treatment. Water Research Volume

43, Issue 18, October 2009

suggested pseudo-regulator pollution responsible in birth rate reductions seen in ‘developed’

countries



• Bisphenol (pseudo-estrogen) in composite and bonding liquids; control.

Pre-treatment mouth rinse with ozonated water

During-treatment use ozonated water as part of treatment protocol

Post-treatment rinse

At-Home on-going care

Consider alternatives (amalgam, gold) or reduce exposure with ceramic

bonded inlays rather than in-mouth bonded composite




Ozone-Treated Liquids – Vegetable Extracts


~ ozonated vegetable extracts

Lynch E, Grootveld M, Holmes J, Silwood C, Claxson A, Prinz J, Toms H. 1H

NMR Analysis of Ozone-treated Grapeseed, Olive, and Sunflower Seed Oils,

IADR Abstract, 2002

Conclusion: Ozone treatment of commercially-available vegetable oils gives rise

to the production of ozonides, aldehydes and peroxides, agents which are likely

to account for the antimicrobial properties of ozonated oils.

ozone in dental care

mailto:[email protected]


~ the chemistry of ozonated vegetable extracts

ozone in dental care

ozonated oils are classified chemically as ‘esters’

the primary ozonide shown in Fig 4.1 decomposes (Fig 4.2) into a

carbonyl compound (aldehydes or ketone) and a zwitterion (II) in

the presence of water or cellular fluid (a).

this breaks down into a hydroxy-hydroperoxide (III) stage

this decomposes into a carbonyl compound and hydrogen

peroxide

hydrogen peroxide breaks down into oxygen and water

(a)



PLANT OIL 3% 6% 9% POI

linseed 58 14 19 221

evening primrose 0 81 11 173

sunflower 0 65 23 153

olive 0 8 76 92

avocado 90 0 0 90

POI – Potential Oxidative Index

The POI is a chemical ‘measure’ of how many potential sites ozone can

react with to form an ozonoid.

3 has 3 sites, 6 2 sites, 9 1 site. The POI is calculated as the sum of

the percentage of the omega oil x the number of sites.

EG; POI for sunflower = S 0x3, 65x2, 23x1 = 153

Holmes, J. Ozonated Oils, the POI & Uses. 2007



Used with Permission by Dr Eric Zaremski 2011

© Eric Zaremski 2011



PLANT OIL 3% 6% 9% POI

linseed 58 14 19 221

evening primrose 0 81 11 173

sunflower 0 65 23 153

olive 0 8 76 92

avocado 90 0 0 90

© Eric Zaremski 2011


• The POI is the theoretical MAXIMUM degree of ozonation chemically possible due to the available C=C bonds to attack and form the ozonoid.

• Other measurements of ozonoid content are;

Peroxide Index (IP), which indicates the quantity of peroxide within the ozonated oil. It is defined as the quantity of active oxygen per kilogram of the ozonated oil (mmol / kg (Molerio et al. 1999. The best antimicrobial activity is seen with an IP of 650 mmol/kg.

Acidity Index; indicates the free fatty acid in the ozonated oil. It is defined as the number of milligrams of potassium hydroxide that are necessary to neutralize the free fatty acid in 1 milligram of the ozonated oil (Panreac 1992). For example, for ozonated sunflower, it is not above 25 units (Molerio and Diaz 1999). Also too high an AI Index makes application on raw tissue very painful.

Aldehyde Concentration.; the aldehyde concentration is measured by adding free hydroxylamine to the aldehyde carboxylic group. The results are expressed in mmol /g of ozonated oil (Molerio and Diaz1999); For example for ozonated sunflower oil, the interval must range between 0.4 and 0.9 mmol/g.

Iodine Index; is a measure of the unsaturation rate of ozonated oil expressed as the number of grams of iodine that react with 100 grams of base oil. For example, in olive oil, the value varies between 125 and 135 units (Vajdia and Saenz 1976) whereas in sunflower, the value is between 50 and 90 units (Molerio and Diaz 1999).

Viscosity; is a measure of the polymerization by condensation of the peroxides forming in the oil ozone treatment process. The values are expressed in mPa.s (centipoise or cP value). For example, to obtain an ozonated sunflower oil with an IP between 500 and 800, the viscosity must be between 100 9 and 450 mPa.s (Molerio and Diaz 1999)

• Choice of oil is a balance between POI, cost, purity, toxicity & availability

•



1H NMR Analysis of Ozone-treated Grapeseed, Olive, and Sunflower Seed Oils.

Lynch E, Grootveld M, Holmes J, Silwood C, Claxson A, Prinz J, Toms H. IADR Abstract 2003

The Use of Ozone for the Intensification and Optimization of Oral Hygiene.

Lukinikh LM, Kosjuga SY, Russia.

Experiences with Ozone Therapy in the Sutton Disease (Periadentitis Mucous Necrotica Recurrens). A Case Report.

Legrá G, Turrent J, Menéndez S, Luis M del C, Cuba.

A Comparative Study of Bactericidal Activity of Ozonised Solution During Treatment of Inflammatory Diseases of the

Paradontium.

Sorokina S, Zaslavskaja M. Russia.

Application of Ozonised Oil in the Treatment of Alveolitis.

Cruz O, Menéndez S, Martínez ME, Clavera T. Cuba.

Application of Oleozon in the Treatment of Subprosthesis Stomatitis.

Lemus L, Ordaz E, Rodríguez E. Cuba.

Sechi LA, Lezcano I, Nunez N, Espim M, Duprè I, Pinna A, Molicotti P, Fadda G, Zanetti S. Antibacterial activity of

ozonized sunflower oil (Oleozon). Journal of Applied Microbiology, Volume 90 Issue 2 Page 279 - February 2001

Total Ozone Therapy of Trophoic Ulcers of Lower Extremities in Elderly Patients.

Gorbunov S, Gorbunova L, Romashov PH, Dmitriev V, Isaev V. Russia.

Experiences of Nine Years Using Ozonised Oil in Dermatology.

Falcón L, Simón D, Menéndez S, Moya S, Garbayo E, Díaz W. Cuba.



ozone therapies in health care

body art with near lethal consequences


ozone therapies in health care

30 Jul 2008 10 Oct 2008

21 Jul 2008 – surgical tattoo removal

MRSA infection tracking sub-dermal

Antibiotic Tx ineffective

Note rigid pose c pain

10 Oct 2008 – dermal regrowth

New skin tissue

Effective, short-time treatment

No grafting required


Ozone Experimental Medicine and Medical Treatment

MRSA Infection Control & Skin Regeneration.

Dr Julian Holmes

This poster shows the use of ozone

and ozonated fluids to eliminate a

case of MRSA following tattoo

removal, and trans-dermal skin gels

to regenerate skin tissue.

A young white female contracted

MRSA infection following an

extensive surgical removal.

Ozone and ozonated fluids were

used to eliminate the infection and

control pain, and then regenerate

new dermal tissue with minimal scar

formation.

Treatment & Research carried out in

South Africa.

Before surgical removal

Treatment Protocol Wash and Debridement;

- wash with ozonated water.

- debris debridement if possible

- 20 minutes

Wash with ozone gas

- infection control & elimination

- pain control

- 30 minutes

Ozone Bagging

- infection control & elimination

- pain control

- super-oxygenation of tissues

- support regeneration & healing

- ozone treat for 30 minutes

Ozone treatment eliminates skin tissue

infection, controls pain, and supports the

immune system. Ozone accelerates the healing

potential, and the use of trans-dermal gels and

ozone-treated plant oils supports tissue

regeneration and healing. The final result is a

pain-free new dermal layer with slight photo-

sensitivity and minimal scarring without the use

of skin transplant treatments. It is cost effective

and does not require conventional antibiotic

pharmacology or pain control. References;

Wentworth P, McDunn JE, Wentworth AD, Takeuchi C, Nieva J, Jones T, Bautista C, Ruedi JM,

Gutierrez A, Janda KD, Babior BM, Eschenmoser A, Lerner RA. Evidence for Antibody-Catalyzed

Ozone Formation in Bacterial Killing and Inflammation. 2001: Science 298, 2195-2199.

Marx J. Immunology. Antibodies kill by producing ozone. Science. 2002 Nov 15;298(5597):1319.

Babior BM, Takeuchi C, Ruedi J, Gutierrez A, Wentworth P Jr. Investigating antibody-catalyzed

ozone generation by human neutrophils. Proc Natl Acad Sci U S A. 2003 Mar 18;100(6):3031-4. Epub

2003 Feb 24.

Kettle AJ, Clark BM, Winterbourn CC. Superoxide converts indigo carmine to isatin sulfonic acid:

implications for the hypothesis that neutrophils produce ozone. J Biol Chem. 2004 Apr

30;279(18):18521-5. Epub 2004 Feb 20.

The series of pictures show the infection

control and healing process.

New dermal skin growth in 3 months

30 Jul 2008

02 Aug 2008

15 Aug 2008

10 Oct 2008


~ treatment with ozone oils – pressure sores

3 months Tx

19-03-2003

28-06-2003

~ treatment with ozone oils



~ fungal infections are very

susceptible to ozone and

ozonoids (ozone+oil by-products)

day

one

day

five

day ten



Farrell M, Dunn A, Marchevsky A. Surgical Reconstruction of Canine Footpads

Burned by Sodium Hypochlorite Drain Cleaner.

Vetlearn.com. July 2011. Compendium: Continuing Education for Veterinarians

ozone in veterinary care

1; Surgical debridement

2; Maggot Debridement Therapy

3; Ozonated Water Irrigation

4; Surgical Reconstruction

To our knowledge, this is the first clinical veterinary report of

wound management using ozone (O3) therapy. The beneficial

effects of ozone on wound healing are a consequence of its

potent bactericidal and antifungal effects and increased wound

oxygen tension via O2 donation.23 In experimental animals,

ozone application has been associated with enhanced

cutaneous wound repair and increased expression of platelet-

derived growth factor, transforming growth factor β, and

vascular endothelial growth factor.

The most practical benefit for our patient was a considerably

shorter application time (20 seconds to 2 minutes) compared

with the time required for the high-pressure saline irrigation

systems most commonly employed for open wound

management in small animals. We noted a remarkable

cleansing and deodorizing effect, coupled with a consistent

change in granulation tissue color from pale pink to deep pink.



full-thickness scalp flap injury, 2-week healing

solid-stick linseed-oil in bees-wax base

applied 3-times each day

soft tissue healing; full-thickness scalp flap injury



(Dental) Implant Studies

(essentially a bio-film problem)


~ treatment for peri-implantitis

ozone in routine dental care


McKenna D, Lynch E, Cunningham JL, Grootveld MC. Management of Peri-implant Mucositis using Ozone. IADR Abstract 0534, 2007

Objectives: The aim of this study was to assess if ozone could manage experimentally produced peri-implant mucositis.

Conclusion: Ozone treatment of tissue around implants significantly reduced inflammation and infection during this 21 day experimentally induced peri-implant mucositis study.



Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia.

Hauser-Gerspach I, Vadaszan J, Deronjic I, Gass C, Meyer J, Dard M, Waltimo T, Stübinger S, Mauth C.

Clin Oral Investig. 2012 Aug;16(4):1049-59. Epub 2011 Aug 13.

Abstract ; Dental implants are prone to bacterial colonization which may result in bone destruction and implant loss. Treatments of peri-implant disease aim to reduce bacterial adherence while leaving the implant surface intact for attachment of bone-regenerating host cells. The aims of this study were to investigate the antimicrobial efficacy of gaseous ozone on bacteria adhered to various titanium and zirconia surfaces and to evaluate adhesion of osteoblast-like MG-63 cells to ozone-treated surfaces.

Methods; Saliva-coated titanium (SLA and polished) and zirconia (acid etched and polished) disks served as substrates for the adherence of Streptococcus sanguinis DSM20068 and Porphyromonas gingivalis ATCC33277. The test specimens were treated with gaseous ozone (140 ppm; 33 mL/s) for 6 and 24 s. Bacteria were resuspended using ultrasonication, serially diluted and cultured. MG-63 cell adhesion was analyzed with reference to cell attachment, morphology, spreading, and proliferation. Surface topography as well as cell morphology of the test specimens were inspected by SEM.

Results; The highest bacterial adherence was found on titanium SLA whereas the other surfaces revealed 50-75% less adherent bacteria. P. gingivalis was eliminated by ozone from all surfaces within 24 s to below the detection limit (=99.94% reduction). S. sanguinis was more resistant and showed the highest reduction on zirconia substrates (>90% reduction). Ozone treatment did not affect the surface structures of the test specimens and did not influence osteoblastic cell adhesion and proliferation negatively. Titanium (polished) and zirconia (acid etched and polished) had a lower colonization potential and may be suitable material for implant abutments.

Conclusion; Gaseous ozone showed selective efficacy to reduce adherent bacteria on titanium and zirconia without affecting. adhesion and proliferation of osteoblastic cells This in vitro study may provide a solid basis for clinical studies on gaseous ozone treatment of peri-implantitis and revealed an essential base for sufficient tissue regeneration.



Chemical treatment of machined titanium surfaces. An in vitro study.

Krozer A, Hall J, Ericsson I.

Clin Oral Implants Res. 1999 Jun;10(3):204-11.

Abstract; Microbial plaque accumulation on titanium dental implant surfaces can result in an inflammatory condition of the surrounding tissues. Cleaning of such a contaminated surface, in vivo, by means of a solution of amino-alcohol, following surgical exposure, has been proposed. However, the tissue healing following treatment resulted in formation of a fibrous capsule at the tissue-implant interface, i.e. improper implant re-integration. The present experiment was designed to investigate the possible influence of an amino-alcohol solution on machined titanium surface properties. Titanium samples with topography and chemical composition similar to the clinically used Brånemark implant surfaces were used in this experimental in-vitro study to investigate the adsorption of amino-alcohol to such surfaces, and the possibilities to chemically remove the adsorbed alcohols in order to recover a pristine titanium surface. The amino-alcohol solution was supplied to the sample surfaces and four different methods were subsequently used in order to remove the adsorbed alcohol molecules.

Results; It was shown that rinsing in water, saline solution, and 5% H2O2 did not remove the amino-alcohol from the surface. However, exposure to ozone produced by using a commercial mercury lamp in ambient air resulted in complete removal of the adsorbed amino-alcohol.

Conclusion; The results show that the amino-alcohol used forms a stable and dense film at the implant surface in vitro. Presence of such a film most likely prevents re-integration to occur at the implant-tissue interface in vivo.

In this bio-film model, ozone removed the bio-film, an important agent in implant failure



~ accelerated bone & soft tissue healing

ozone in routine dental care


El Hadary A, Yassin H, Mekhemer S, Holmes J, Grootveld M. Evaluation of Ozonated

Oils on Osseointegration of Dental Implants under the Influence of Cyclosporine A:

An In Vivo Study. J Oral Implantol. 2010 Jun 14.

Conclusion; Within the limits of this study, the results suggest that topical ozonated oil

influences bone density and the quality of dental implant osseointegration

Therefore, topically applied ozonated oil may influence bone density and the quality

of osseointegration around dental implants.


Fig 7. Control Group - ground section reveals bone implant interphase; the bone is less mature, with cellular osteoid tissue showing fibrous connective tissue and blood vessels.

Fig 6. Ozonated Linseed Oil - ground section reveals bone implant interphase; the compact bone is mature, showing well-developed Haversian systems.


El Hadary A, Yassin H, Mekhemer S, Holmes J, Grootveld M. Evaluation of

Ozonated Oils on Osseointegration of Dental Implants under the Influence of

Cyclosporine A: An In Vivo Study. J Oral Implantol. 2010 Jun 14. CLINICAL RELEVANCE: Scientific Rationale for Study: Cyclosporine A (CsA) - are known to interfere with bone density - may lead to bone density loss and fracture. - ozone has been shown in previous studies to accelerate the healing process. - no studies to examine the role of ozonated plant oils and implant osseointegration.

Principal Findings: Ozonated plant oils applied at the implant placement stage and during the healing phase accelerate the healing of soft tissues, reduces the risk of infection and results in a more mature bone formation around the implant, resulting in accelerated osseointegration of the implant. Practical Implications: Ozonated plant oils offer a simple application and predictable end result of advanced osseo-integration. These ozonated oils are cheap, 100% organic and carry no risk of bacterial resistance or host sensitivity.




Cyclosporine A: An In Vivo Study. J Oral Implantol. 2010 Jun 14. CLINICAL RELEVANCE: Scientific Rationale for Study: Cyclosporine A (CsA) are known to interfere with bone density and may lead to bone density loss and fracture. Ozone has been shown in previous studies to accelerate the healing process. To date, no studies have examined the role of ozonated plant oils and implant osseointegration.

Principal Findings: Ozonated plant oils applied at the implant placement stage and during the healing phase - accelerate the healing of soft tissues - reduces the risk of infection - results in a more mature bone formation around the implant - resulting in accelerated osseointegration of the implant. Practical Implications: Ozonated plant oils offer a simple application and predictable end result of advanced osseo-integration. These ozonated oils are cheap, 100% organic and carry no risk of bacterial resistance or host sensitivity.




Cyclosporine A: An In Vivo Study. J Oral Implantol. 2010 Jun 14. CLINICAL RELEVANCE: Scientific Rationale for Study: Cyclosporine A (CsA) are known to interfere with bone density and may lead to bone density loss and fracture. Ozone has been shown in previous studies to accelerate the healing process. To date, no studies have examined the role of ozonated plant oils and implant osseointegration. Principal Findings: Ozonated plant oils applied at the implant placement stage and during the healing phase accelerate the healing of soft tissues, reduces the risk of infection and results in a more mature bone formation around the implant, resulting in accelerated osseointegration of the implant.

Practical Implications: -Ozonated plant oils offer simple application and predictable osseo-integration. - Ozonated oils are;

- cheap, - 100% organic - carry no risk of bacterial resistance or host sensitivity.



Dental & Other Surgery


Acta Cytologica 2012;56:277–284

Cytological Assessment of Healing Palatal Donor Site Wounds and Grafted Gingival Wounds after Application of Ozonated Oil: An Eighteen-Month Randomized Controlled Clinical Trial

Patel p, Kumar s, Patel A, Holmes J, Kumar V.

Objective: The present study was undertaken to assess the therapeutic effects of topical ozonated oil on early healing of free gingival graft surgical sites.

Study Design: Twenty subjects were entered into this triple-blinded, randomized, placebo-controlled clinical trial, designed to evaluate the efficacy ozonated oil on free gingival graft surgical wounds. Subjects were assigned to either the ozone group,in which ozonated oil was applied to the wound, or the control group, in which non-ozonated oil was used as a control. Patients were

postoperatively evaluated by cytological analysis. Cytological analysis consisted of the keratinisation and superficial cell indices measured at baseline, after 24h, on the 3rd, 7th, 14th and 21st day and 2, 3, 8 and 18 months postoperatively.

Results: Cytological results showed that there was a significant (p>0.001) improvement in epithelial healing by the 7th, 14th and 21st day and 2, 3 and 8 months postoperatively in the ozone group compared to the control group.

Conclusion: The present study showed significant improvement in epithelial healing and gingival health after topical application of ozone-treated plant oil to gingival surgical sites.



Patel PV, Kumar S, Kumar V, Vidya GD, Holmes JC.

The Therapeutic Effect of Topical Ozonated Oil on Postsurgical Epithelial Healing of Free Gingival Graft Surgical Sites – A Clinical and Exfoliative Cytological Study.

Submitted for Publishing

Background: Gingival recession is an intriguing and complex phenomenon and patients frequently present with sensitivity and aesthetic concerns following such recession. Various techniques are available to treat gingival recession, and the free gingival graft (FGG) is the classical technique that is the most predictable. However, there are disadvantages with this approach. Postoperative complications and delayed wound healing has lead to a decline in the use of the FGG in clinical practice. Recently the therapeutic effect of topical ozonated oil has been suggested to reduce postoperative complications and improve wound healing. Ozone-treated plant oils have anti-bacterial, viral and fungal therapeutic effects that are well documented in the published literature. These products also have a therapeutic effect on acute cutaneous and mucocutaneous wound healing.

Aims & Objective: To assess therapeutic effect of topical ozonated oil on early healing of free gingival graft surgical sites and to evaluate any degenerative and regenerative changes in the epithelial cells of healing tissue after application of ozonated oil. Material and methods: 10 subjects were entered into this triple-blinded, randomized, placebo controlled clinical trial, designed to evaluate the efficacy of ozonated oil on free gingival surgical wounds. Subjects were assigned to Group A where ozonated oil was applied to the surgical wound, or Group B, where non-ozonated oil was used as a control. Patients were post-operatively evaluated by clinical and cytological analysis. Plaque index, bleeding index, recession depth, recession width, width of the keratinized gingiva, probing pocket depth and clinical attachment levels were assessed. Measurements were taken at baseline, 7th day, 21st day, 2nd and 3rd month post-operatively. The percentage of root coverage was calculated at the end of the 3rd month. Cytological analysis consisted of the keratinisation index at baseline, 2nd day, 3rd day, 7th day, 21stday, 2nd and 3rd month post-operatively.

Results: Cytological results showed that there was significant (P<0.001) improvement in epithelial healing by the 7th, 21stday and 2ndmonth postoperatively in Group A compared to Group B. Clinical results showed significant (P<0.001) improvement in plaque score on the 7th day post-operatively. Gingival score was significantly (P<0.001) reduced in Group A compared to the control group on all evaluation days. There were no unwanted side effects in Group A or B, and no significant differences in other clinical parameters.

Conclusion: The present study showed significant improvement in epithelial healing and gingival health after topical ozone-treated plant oil application on gingival surgical sites




Gingivitis & Periodontal Disease

Oral Health


The antimicrobial effect of 0.1 ppm ozonated water on 24-hour plaque microorganisms in situ.

Sadatullah S, Mohamed NH, Razak FA.

Braz Oral Res. 2012 Apr;26(2):126-31.

Abstract

Objectives; Ozone is a known oxidant present in the atmosphere and is commercially produced by simple ozonizer machines. It is a powerful antimicrobial agent in its gaseous and aqueous forms. Ozone readily dissolves in water and retains its antimicrobial property even in the dissolved state.

Method; In this study, the effect of 0.1 ppm ozonated water was analyzed on 24-hour supragingival plaque (SP) samples in situ. SP was collected from the two most posterior teeth in the contra-lateral quadrants before and after a 30-second rinse with either distilled water (control group) or 0.1 ppm ozonated water (test group). The plaque was used to count the number of total bacteria, total anaerobic bacteria, Streptococcus mutans, and Candida albicans on selective agar media.

Results; The statistical analysis of the number of colony forming units (CFUs) obtained demonstrated a significant antimicrobial effect of ozonated water on the total bacteria (p = 0.01) and anaerobes (p = 0.02). A reduction in the post-rinse CFU count for Streptococcus mutans was also observed, but the effect was not statistically significant (p = 0.07). The Candida species was only grown from one sample.

Conclusion; Ozonated water at the 0.1 ppm concentration was effective in reducing the load of 24-hour plaque bacteria, but it did not eliminate them completely.



NBF Gingival Gel

• The Study On The Effect of Nanoemulsion For The Prevention And Treatment Of Gingival

Inflammation

• Chang-Hoon Chae, Jun-Woo Park

• Previous studies show reduced cellular interleukin-1β results in reduced gingival inflammation

• In this study, expression of interleukin-1β was decreased after adding nanoemulsion containing

nanovitamin C, E and propolis

• New study to examine potentiated effect with ozonated plant oils and/or ozonated water

• Yasko Fido

• NBF Gel NanoCureTech <[email protected]>


Management of gingival inflammation in orthodontic patients with ozonated water irrigation--a pilot study.

Dhingra K, Vandana KL.

Int J Dent Hyg. 2011 Nov;9(4):296-302. doi: 10.1111/j.1601-5037.2011.00506.x. Epub 2011 Apr 4.

Abstract; Ozonated water irrigation has recently been tried for its antimicrobial and anti-inflammatory effects in treatment of periodontitis. During orthodontic treatment, gingival inflammation occurs along with increased lactate dehydrogenase (LDH) enzyme levels in gingival crevicular fluid (GCF). Thus, the aim of this pilot study was to evaluate the clinical effects of a single subgingival irrigation with ozonated water on gingival inflammation in orthodontic patients and also to correlate the clinical effects with LDH enzyme activity in GCF.

Methods: Fifteen systemically healthy orthodontic patients (seven men and eight women, mean age 17.3 years) with full-mouth brackets were included in this prospective, cross-sectional, clinical and laboratory investigation. Clinical parameters, LDH enzyme activity and GCF volume were measured at baseline (0 day) followed by subgingival irrigation with 0.01 mg l(-1) ozonated water. These parameters were again assessed on 14th and 28th day.

Results: There was significant (P < 0.05) reduction in values of clinical parameters, GCF LDH activity and GCF volume after subgingival irrigation with ozonated water. Also, a significant correlation (r = 0.50, P = 0.01) was observed only between the post-treatment changes of plaque index and LDH values, among the clinical parameters assessed.

Conclusions: A single subgingival irrigation of 0.01 mg l(-1) ozonated water can effectively reduce the gingival inflammation in orthodontic patients, which is also reflected in the reduction of LDH enzyme levels. However, further randomized controlled trials are required to validate the use of ozone irrigation in orthodontic patients for plaque control measures.



Periodontal Disease & Ozone

S. Eick M. Tigan A. Sculean. Effect Of Ozone on Periodontopathogenic Species. IADR Abstract 2011 3070

Abstract; Based on the impact of pathogens, antiinfective regimen is an important component in any treatment of periodontal and peri-implant diseases. As an alternative method to chlorhexidine, application of ozone is discussed. Ozone is a powerful antimicrobial agent by destructing cell walls and cytoplasmic membranes of bacteria and fungi. The study was aimed to determine the effect of ozone on microorganisms, which play a role in pathogenesis of periodontitis and peri-implantitis.

Methods: Ozone was generated by using Prozone® device for 6 s – 2 × 24 s against 23 mainly anaerobic periodontopathic species. Agar diffusion test was used as a screening method. Then, the killing activity was tested in a serum-free environment and with 25% v/v inactivated serum. Further, the effect of ozone on bactericidal activity of native serum was analyzed against Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.

Results: Agar diffusion test showed a high efficacy of ozone against microorganisms, especially against the included P. gingivalis strains. This result was confirmed by the killing tests; most of the strains in a concentration of 105 were completely eliminated after two-fold 18 s application of ozone. Only four of the six potentially “superinfecting” species (Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae, Candida albicans) were resistant in part. Addition of inactivated serum reduced the killing rate of ozone by 78% after 6 s and by 47% after two-fold 18 s exposures; no strain was completely erradicated after any application of ozone. Bactericidal killing of native serum was enhanced after application of ozone; no effect was visible on the included A. actinomycetemcomitans strains which was found to be completely resistant to the bactericidal action of serum.

Conclusion: Ozone combined with mechanical therapy may have clinical relevance in non surgical and surgical periodontal therapy.



Patel P, Patel A, Kumar S, Holmes J.

Short-term effects of tray-applied ozonated oil-gel on gingivitis: a randomized, triple-blinded, controlled, parallel-armed clinical trial.

Submitted for Publishing 2012

Abstract; To investigate the effects of tray-applied ozonated organic oil-gel in the reduction of plaque and gingival inflammation in subjects diagnosed with plaque associated chronic generalized marginal gingivitis.

Method and materials: A triple-blinded, randomized controlled clinical trial was conducted on 64 subjects with established gingivitis. Subjects were randomly assigned to one of four Groups: Group A, Ozonated oil-gel (OZO); Group B, 25%Metronidazole benzoate gel (MTZ); Group C, 1%Chlorhexidine gluconate gel (CHX); and Group D, Placebo oil-gel. Subjects self-applied allocated gels to the affected ginigva of maxillary and mandibular arches with the use of customized dental trays, twice daily for six weeks. Subjects were asked to refrain from all other unassigned forms of oral hygiene aids for the duration of the treatment period. Gingival inflammation was assessed at baseline, 2, 4 and 6 weeks using clinical indices (plaque index, gingival index and sulcus bleeding index). In addition to clinical assessment, gingival inflammation was assessed by cytomorphometrical analysis (nucleus area:cytoplasmic area ratio of squamous epithelial cell in cytological smears) and biochemical analysis (activity of polymorphonuclear (PMN) elastase and myeloperoxidase (MPO)) in gingival crevicular fluid (CGF) samples at baseline and 6 weeks of study period. Data sets were analyzed by repeated measure ANOVA followed by Scheffe post hoc pair wise multiple comparisons for parametric variables and Kruskal-Wallis test with Wilcoxon signed-rank test for non parametric variables.

Results: There was a significant reduction in plaque and gingival inflammation after topical application of OZO over the study period and in comparison to the placebo oil-gel. The reduction in gingival inflammation and enzyme activity by OZO treatment was similar (with no differential significance) to CHX and MTZ treatment throughout the study period.

Conclusion: The efficacy of tray-applied ozonated olive oil is comparable to CHX and MTZ, but with none of the documented side effects commonly seen with CHX and MTZ. It is concluded that within the bounds of this study, ozonated olive oil is effective in improving plaque and gingival status when applied over a 6-week period in a custom dental tray.




Viral Infections

HIV


HIV Infection Rates

• Africa Prevalence (2007)

• Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world.

• Estimated 22 million people were living with HIV at the end of 2007 and approximately 1.9 million additional people were infected with HIV during that year.

• 15-20% of adults in Namibia, South Africa, Zambia and Zimbabwe are infected with HIV.

• In Botswana (23.9%), Lesotho (23.2%) and Swaziland (26.1%) the national adult HIV prevalence rate has risen and now exceeds 20%.


HIV Infection Rates

• Adult HIV prevalence in Africa between 1988 and 2003


HIV Infection Rates

• Africa

• in sub-Saharan Africa in 2007, 1.6 million people died of AIDS 4.

• 60% of deaths are adults aged between 20 and 49 years 5.

• causing population imbalances; – by removing people at their most economically productive

– during child-bearing age 6.

– References

4. UNAIDS/WHO (2007) ‘AIDS epidemic update’ December

5. UNAIDS (2006) ‘Report on the Global AIDS Epidemic, Chapter 4: the impact of AIDS on people and societies’

6. UNAIDS (2006) ‘Report on the Global AIDS Epidemic, Chapter 4: the impact of AIDS on people and societies’


HIV Infection Rates

• India.

– Prevalence • 1st reported infection 1986

• Highest Infection rates in India

– Southern India

– Far North-East India


HIV Infection Rates

• India.

- Prevalence • 1st reported infection 1986

• Southern half of the country and the far north-east

Estimated number of people living with HIV/AIDS • (2007 statistics)

• People living with HIV/AIDS: 2.31 million adults (15 years or above)

• Estimated 39% are female and 3.5% are children.

• HIV prevalence 0.34%

• Possible significant under-reporting


HIV Infection Rates

• India. Prevalence

– Estimated number of people living with HIV/AIDS • People living with HIV/AIDS: 2.31 million adults (15 years or above)

• Estimated 39% are female and 3.5% are children.

• HIV prevalence 0.34%

• Significant under-reporting

– References:

7. NACO (2007) 'HIV sentinel surveillance and HIV estimation in India 2007: A technical brief'.

8. UNAIDS (2007, 6th July) ‘Press release: 2.5 million people in India living with HIV, according to new estimates’.

9. National Family Health Survey (NFHS-3) 2005-06, September 2007

10. World Health Organization (2005, December) 'India: Summary country profile for HIV/AIDS treatment scale-up'


What markers are researchers looking for in finding effective treatment

modalities? CD4 T-Cell markers & Viral Loading

References;

37. JW Mellors, CR Rinaldo, P Gupta, et al. Prognosis in HIV-1 infection predicted by the quantity

of virus in plasma. Science 1996 272: 1167-70.

38. JW Mellors, A Munoz, JV Gorgini, et al. Plasma viral load and CD4 lymphocytes as prognostic

markers of HIV-1 infection. Annals of Internal Medicine 1997 126: 946-54.

39. MD Hughes, VA Johnson, MS Hirsch et al. Monitoring plasma HIV-1 RNA levels in addition to

CD4 lymphocyte count improves assessment of antiretroviral therapeutic response. Annals of

Internal Medicine 1997 126: 929-38. Annals of Internal Medicine 1997 126: 929-38.

40. WA O'Brien, PM Hartigan, ES Daar et al. Changes in plasma HIV RNA levels and CD4

lymphocyte counts predict both response to antiretroviral therapy and therapeutic failure. Annals

of Internal Medicine 1997 126: 939-45.




GCE offer these products as an organic plant-derived treatment for patients;

who have not started on ARV’s

where ARV’s are causing marked debilitation & unwanted side-effects

where the patient chooses to use these products instead of ARV’s.

To date, GCE-192 and GCE-221 have shown no unwanted side effects. All patients treated

have gained weight, all remain alive, and all have returned to useful work within their

communities


treatment with encapsulated ozone-gels;

‘GCE-221’ (Ls-O3) and ‘GCE-192’ (He-O3) 0.9ml Capsules

infection control



GCE-221 and GCE-192 treatment protocol

Stage 1 Treatment – 6 weeks GCE-221

Stage 2 Treatment – maintenance with GCE-221 or GCE-221

Treatment Dosage; ‘GCE-221’;

Each full ‘GCE-221’ capsule is equivalent to 0.9ml;

Day 1-14 : 2 x 0,9ml four times per day (ie 8 capsules x 0,9ml per day)

Day 15-42 : 2 x 0,9ml twice per day (ie 4 capsules x 0,9ml per day)

Day 43-98 : 1 x 0,9ml twice per day (ie 2 capsules x 0,9ml per day)

Maintaince Dosage; ‘GCE-221’ TM or ‘GCE-192’ TM

Day 99 + : 1 x 0,9ml twice per day (ie 2 capsules x 0,9ml per day)



Herpes & Viral Infections



High risk HPV types 18 and 16 are potent modulators of oral squamous cell carcinoma phenotypes in vitro.

Reddout N, Christensen T, Bunnell A, Jensen D, Johnson D, O'Malley S, Kingsley K.

Infect Agent Cancer. 2007 Nov 14;2:21.

Prevalence of human papillomavirus in squamous cell carcinoma of the tongue.

da Silva CE, da Silva ID, Cerri A, Weckx LL.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):497-500. Epub 2007 Jul

High association of human papillomavirus infection with oral cancer: a case-control study.

Anaya-Saavedra G, Ramírez-Amador V, Irigoyen-Camacho ME, García-Cuellar CM, Guido-Jiménez M, Méndez Martínez R, García-Carrancá A.

Arch Med Res. 2008 Feb;39(2):189-97. Epub 2007 Nov 8.

The Herpes Virus – A Review of HSV Infections and the Wider Implications of Treatment and Management of Patients

for the Dental Team

Holmes J, Domb W, Zaremski E, Kammer C.

E-Published 2012





Treating HSV Infections

Manufacturer; GCE, South Africa.

Products;

Ozone-treated Linseed Oil,

Presentation; 10ml dropper bottle

Ozone-treated plant oil (linseed) in a

refined and filtered bees wax suspension.

Presentation; 5ml lip-stick or 5ml lip-gloss

container



Health – it starts in the oral environment.

The research dates from the 1800’s.

In the 1890s, Willoughby Miller proposed that oral micro-organisms found in

dental cavities played a role in pulmonary diseases, gastric problems, and brain

abscesses, as well as many other medical conditions (Miller, 1890). Miller went

on to propose that the majority of systemic illnesses seen in man could be

related to the oral cavity (Miller, 1891).

Miller WD. The Micro-Organisms of the Human Mouth. The Local and General Diseases Which are Caused by Them.

SS White, Philadelphia, 1890, pp 274-342.

In 1900, British physician William Hunter claimed that poor dental health could

cause several systemic diseases (Hunter, 1900). In 1911 he expounded these

theories in a series of lectures in the USA. Hunter claimed anaemia, gastritis,

colitis, obscure fevers, nervous disturbances of all kinds from mental depression

to actual lesions of the cord, chronic rheumatic infections, and kidney diseases

had an oral origin (Hunter, 1911).




Published research is showing substantiated links between herpes and

periodontal pathogens as potential links to major degenerative diseases

such as Alzheimer’s and Dementia.

Middleton PJ, Petric M, Kozak M, Rewcastle NB, McLachlan DR. "Herpes-simplex viral genome and

senile and presenile dementias of Alzheimer and Pick". Lancet 315 (8176): 1038. 1980

Dobson CB, Itzhaki RF. "Herpes simplex virus type 1 and Alzheimer's disease". Neurobiol. Aging 20 (4):

457–65; 1999.

Hemling N, Röyttä M, Rinne J, Pöllänen P, Broberg E, Tapio V, Vahlberg T, Hukkanen V. Herpes

viruses in brains in Alzheimer's and Parkinson's diseases. Ann Neurol. 2003 Aug;54(2):267-71.

Letenneur L, Pérès K, Fleury H, Garrigue I, Barberger-Gateau P, Helmer C, Orgogozo JM, Gauthier S,

Dartigues JF. "Seropositivity to herpes simplex virus antibodies and risk of Alzheimer's disease: a

population-based cohort study.". PloS one3. 2008. (11): e3637

Hill JM, Zhao Y, Clement C, Neumann DM, Lukiw WJ. HSV-1 infection of human brain cells induces

miRNA-146a and Alzheimer-type inflammatory signaling. Neuroreport. 2009 Oct 28;20(16):1500-5.




Published research is showing substantiated links between herpes and periodontal pathogens as

potential links to major degenerative diseases such as Alzheimer’s and Dementia.

Middleton PJ, Petric M, Kozak M, Rewcastle NB, McLachlan DR. "Herpes-simplex viral genome and senile and presenile dementias of

Alzheimer and Pick". Lancet 315 (8176): 1038. 1980

Dobson CB, Itzhaki RF. "Herpes simplex virus type 1 and Alzheimer's disease". Neurobiol. Aging 20 (4): 457–65; 1999.

Hemling N, Röyttä M, Rinne J, Pöllänen P, Broberg E, Tapio V, Vahlberg T, Hukkanen V. Herpes viruses in brains in Alzheimer's and

Parkinson's diseases. Ann Neurol. 2003 Aug;54(2):267-71.

Letenneur L, Pérès K, Fleury H, Garrigue I, Barberger-Gateau P, Helmer C, Orgogozo JM, Gauthier S, Dartigues JF. "Seropositivity

to herpes simplex virus antibodies and risk of Alzheimer's disease: a population-based cohort study.". PloS one3. 2008. (11): e3637

Hill JM, Zhao Y, Clement C, Neumann DM, Lukiw WJ. HSV-1 infection of human brain cells induces miRNA-146a and Alzheimer-type

inflammatory signaling. Neuroreport. 2009 Oct 28;20(16):1500-5.

The research is not new, dating from 1980! Yet there is no single oral program devised to address this

disease process apart from ‘Gums Of Steel’ devised by Chris Kammer, Madison USA!

Routine dental care and preventative oral care programs are important for the well being of any age

group, especially an ageing and medically compromised population. These programs may be key in

maintaining a healthy, active and independent old-age. The health professions need to team up to

educate and successfully treat people.

Ozone treatment has progressed and has an important role in general health due to its unique

properties and effect on bacteria, viruses and fungi.


oral delivery systems full or partial mouth

ozone delivery

fluoride

remineralising solutions

pharmaceutical agents

routine full-mouth @ 3/12

prevention

health treatment

periodontal control

accelerated whitening

ozone in routine health care


• Vendors & Trade – please visit the stands around the Hall. These guys are here to support

IAOHD and you.

• USB drive with -research papers

-articles & previous presentations by Prof Ed Lynch, J Holmes & others

-E-Books

Ozone; The Revolution In Dentistry E Lynch, JHolmes & others

Oxygen-Ozone Therapy by V Bocci

Ozone in Medicine by R Viebahn

-this presentation

- and more!



• Thursday 7th February 2013; Day 1

• 08.00-10.00 Dr Julian Holmes; Welcome to IAOHD 2013

• 10.15-12.00 Dr Carlos Nogales, Brazil, South America

“Ozone in Endodontics”

• 12.00-13.00 Lunch

• 12.10-12.50 Lunch-time Talk Dr Kaye McArthur ‘Estro-Genomics & Inflammation’

• 13.00-16.30 Key-Note Speaker Professor Ziad Fahmy, Germany

“Ozone & the Treatment of Musculoskeletal Pain & Inflammation, & Intra-Articular Injections”

• 16.30-17.30 Vijay Sikka, USA

“Benchmarking & Practice Optimization”

• 17.30-18.30 Dr Robert Walker, USA

"Balancing the Immune Systems, TH1 vs TH2, with Ozone and Nutrition"

• 18.30-19.30 Cocktail Reception; IAOHD Sponsors

• 19.30 – late Pathfinders Dinner @ Heart Attack Café

• Carlos & Kaye please have your presentation ready to load in the interval,

• Ziad, Vijay and Robert, load your presentations in the lunch period please




• Friday 8th February 2013; Day 2

• 08.00-10.00 Professor Silvia Menendez, Cuba

“Cuban contributions to ozone therapy development during the last 27 years”

• 10.15-12.00 Professor Nabil Mawsouf, Egypt

“Ozone Therapy in Hepatitis C Patients, Healing Ulcers, & Ozone for Athletes”

• 12.00-13.00 Lunch

• 12.10-12.50 Lunch-time Talk - Michael Bianco, USA

• 13.00-15.30 Guest Lecture, Dr David Minkoff, USA

“Uses of Ozone and Amino Acid Supplementation In Clinical Practice”

• 15.45-17.45 Guest Lecture, Dr Frank Shallenberger, USA

“30-Years’ Experience Using Ozone In An Internal Medicine Practice”

• 17.45-18.15 Dennis Mihalka, DDS

“Keeping Your Water Lines Clean”

• 18.15-19.00 Table Poster Presentations

• 21.00 – Late Show; Kevin Burke, 2nd Floor. MUST HAVE BADGE

• Silvia & Nabil, load your presentations tonight,

• Michael, Friday am break, David, Frank & Dennis Friday lunch


• Saturday 9th February 2013; Day 3

• 08.00-12.00 Professor Edward Lynch, United Kingdom

“Ozone: The Revolution in Healthcare and Dentistry”

• 12.00-13.00 Lunch

• 12.10-12.50 Lunch-time Talk - Dr Chris Kammer; ‘Gums-Of-Steel’

• 13.00-15.00 Guest lecture, Dr Robert Rowen MD

“Cancer and Ozone – Oxidation In Advanced Health-Care.”

• 15.00-15.15 Comfort Break – ALL MOVE TO SIDE ROOMS FOR DINNER SET-UP

• 15.15-16.45 Master-Class Round-Table

• Prof Silvia Menendez, Prof Mawsouf, Dr Issac Juanatey, Dr Robert Rowen

• 15.15-16.45 Master-Class Round-Table

• Dr Shallenberger, Professor Fahmy, Dr Howard Robins, Dr Cedric Coucke

• 16.45-17.15 Table Poster Presentations

• 18.45-19.15 Reception; IAOHD Board

• 19.15-22.00 IAOHD Gala Dinner



• Sunday 10th February 2013; Day 4

• 08.00-08.30 Dr Julian Holmes, President IAOHD;

Closing Address; Our Future in Your Hands

• 08.30-10.00 Dr Edson Nagib, Brazil

"Laser and Ozone Usage In Atraumatic Restoration Treatment"

• 10.15-11.30 Master-Class Round-Table;

Professor Edward Lynch, Dr Julian Holmes, Dr William Domb; ‘

Practical Applications of Ozone in Healthcare’


Mrs Cris Duval, Dr Eric Zaremski, Dr Chris Kammer; ‘

Oral Links to Systemic Disease & Ozone’


Dr Tim Rainey, Dr Matt Menasco;

‘Micro-Invasive Dental Care’

• 12.30-13.30 Final Question & Answers Session, All Speakers and Board

• Hand in evaluation forms to Board Members please.

• 13.30 Congress Closes



• Quickly back to Slide5!

• Some of our presenters like questions as they go, others, for you to write

them down, and then ask them at the end. We will try to guide you who

likes what!

• What I and everyone here does not want is ‘silence’! As a researcher and

presenter, I want feed back; tell me what you think of the presentation, was

it too detailed, too vague.; did you understand it, and was it relevant!

• That is what every presenter & ‘spectator’ here at IAOHD wants too.

• When we ask for questions, we really do mean that! And remember, we

have the Master-Class Round Table discussion time, lunch times, evenings

and ‘bar-time’ to be grilled by you too!



• That is what every presenter & ‘spectator’ here at IAOHD wants too.

• When we ask for questions, we really do mean that! And remember, we

have the Master-Class Round Table discussion time, lunch times, evenings

and ‘bar-time’ to be grilled by you too!

• And from Bill Domb, to close, his favourite fortune-cookie!

‘a great pleasure in life

is doing what others say you can’t’



IAOHD Las Vegas, 2013

Congress Theme

‘Ozone in Healthcare’

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