text below is an introduction from an article, does it have a Scientific background and explanation of the rationale? write some pros and nons
Over the last few years, the use of ozone in medicine has significantly raised due to its recognized properties. Several in vitro studies have shown wide antibacterial activity for ozonized vegetable oils against microorganisms, such as bacteria, virus, protozoa, and fungi [1,2]. In addition to that, ozone shows immunomodulatory, anti-hypoxic, biosynthetic, and anti-inflammatory properties which justifies its several applications, both in orthopedics and dentistry [3]. As regards the latter, ozone therapy has been used to manage wounds healing, dental caries, oral lichen planus, gingivitis and periodontitis, halitosis, osteonecrosis of the jaw, post-surgical pain, plaque and biofilms, root canal treatment, dentin hypersensitivity, temporomandibular joint disorders, and teeth whitening [3,4], and to functionalize implants surfaces for dental and orthopedic clinical uses [3]. Considering the abovementioned applications, the use of ozone for the treatment of gingivitis and periodontitis appears quite interesting for clinicians. In particular, this latter condition is not only more and more frequent among patients but, in some cases, might be refractory to the treatment. Gingivitis arises from the accumulation on the teeth of dental plaque, corresponding to a complex biofilm of bacteria dipped into a polymeric matrix. If this biofilm is not properly removed by means of oral hygiene, gingivitis might develop into periodontitis, with a destruction of tooth-supporting tissues, in presence of other predisposing factors among which smoke, diabetes, immune disorders, etc. [5].

Scaling and root planing (SRP) is a gold standard non-surgical therapy, which is aimed both to remove dental plaque and calculus as well as to smooth the root surfaces infected by bacteria [6]. In addition to mechanical therapy, local chemical treatments should be favored in comparison to systemic treatments like antibiotics which are linked to the risk of emergence of resistance. In this context, the use of ozone as an antimicrobial could be very useful considering the pathogenetic action exerted by bacteria in the development and maintaining of periodontal inflammation. Broad spectrum antiseptics such as chlorhexidine are often used, but toxicological aspects should be considered. In contrast, ozone has also a broad spectrum of activity but with low toxicity, giving an advantage to this local treatment before the development of substances with a more specific action on the micro-organisms related to periodontitis.

In vitro exposition of bacteria to ozone causes the oxidation of phospholipids and lipoproteins constituting the bacterial cell envelope; this event leads to the disruption of the cytosolic membrane integrity, thus allowing ozone to infiltrate the microorganisms and oxidize glycoproteins and glycolipids, with a final block of the bacterial enzymatic function [3].

The aim of the present study is to evaluate the efficacy of the subgingival application of an experimental ozone gel in addition to standard SRP, as well as to compare this protocol with SRP plus a conventional chlorhexidine gel. To the best of our knowledge, few studies in literature have compared, so far, the efficacy of ozone with respect to chlorhexidine in periodontal nonsurgical therapy. The null hypothesis of the study is that there are no significant intergroup and intragroup differences between the two different oral gels.