# Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial
###### Abstract  
Peri-implant mucositis represents an inflammatory lesion of the mucosa surrounding an endosseous implant, without the loss of the supporting peri-implant bone. Considering its reversible nature, every effort should be made to contrast it, thus avoiding the eventual progression towards peri-implantitis. The aim of the present randomized clinical trial is to evaluate the efficacy of the ozonized water against peri-implant mucositis. A total of 26 patients diagnosed for this latter clinical condition were randomly divided according to the professional oral hygiene protocol performed on the pathological sites at baseline, at T1 (1 month), and T2 (2 months). Group 1 underwent an ozonized water administration (experimental treatment), whereas Group 2 underwent a pure water one (control treatment). Both administrations were performed with the same professional irrigator (Aquolab(r) professional water jet, Aquolab s.r.l. EB2C S.r.l., Milano, Italy) with no differences in color or taste between the two substances delivered. At each appointment, the following indexes were assessed: the Probing Pocket Depth (PPD), Plaque Index (PI), Bleeding on Probing (BoP), and Bleeding Score (BS). As regards intragroup differences, in Group 1 ozonized water significantly and progressively reduced all the clinical indexes tested, except for PI in the period T1-T2, whereas no significant differences occurred within the control group. Despite this, no significant intergroup differences were generally detected between the two treatments. Accordingly, the role of ozone for the management of peri-implant mucositis deserves to be further investigated. ozone; ozone therapy; ozonized water; peri-implant mucositis; peri-implantitis; implants; implant failure; periodontal therapy; oral hygiene; randomized clinical trial +
Footnote †: journal: Applied Sciences  
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Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial  
used as a functionalizing agent on implant surfaces (for both dental and orthopedic use) with the goal of improving their osseointegration [11; 12; 13; 14]. Considering the abovementioned applications, the use of ozone for the treatment of gingivitis and periodontitis appears quite promising. Gingivitis is regarded as the result of a progress accumulation on the teeth of dental plaque/calculus, which is a complex bacterial biofilm embedded into a polymeric matrix. This causes an inflammatory condition which continues in cases where proper domiciliary and professional oral hygiene procedures are not performed to remove this biofilm. Despite this condition being reversible, it may also evolve into an irreversible one (i.e., periodontitis) with the degradation of soft and hard tooth-supporting tissues and, eventually, tooth loss [15; 16]. Nowadays, the implant-prosthetic therapy represents the main possible resource to face a total or partial edentulism, achieving a high success rate for both the upper and the lower arch [17]. However, the gingival tissue around implants, the so-called peri-implant mucosa, does not come without the risk of developing either a reversible or an irreversible inflammation too. According to the latest Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) [18], the following four states might regard peri-implant tissues: 1, peri-implant health; 2, peri-implant mucositis; 3, peri-implantitis; 4, peri-implant soft and hard tissue deficiencies. Considering peri-implant mucositis, this condition is defined as 'an inflammatory lesion of the mucosa surrounding an endosseous implant without loss of supporting peri-implant bone' [19]. On this basis, a clinical case is defined in the presence of peri-implant mucosal inflammation but in the absence of peri-implant bone loss. The main clinical sign is bleeding on gentle probing, though additional features can occur, such as erythema, swelling, and/or suppuration [18; 19].