Reduction of MRONJ risk after exodontia by virtue of ozone infiltration: A randomized clinical trial

Introduction Exodontia is commonly considered as a risk factor for the development of medication‐related osteonecrosis of the jaw (MRONJ) in individuals exposed to bone modifying agents. This study was aimed at assessing the efficiency and safety of a gaseous oxygen–ozone mixture as an adjuvant to a standard exodontia to reduce the risk of MRONJ development. Methods A randomized, open‐label, phase II, single‐center clinical trial involving 117 patients at risk of MRONJ was conducted. The study protocol tested injections of an oxygen–ozone mixture in the post‐extraction site. Participants were randomly assigned to two groups: oxygen‐ozone therapy, and standard tooth extraction protocol. Post‐extraction wound healing was assessed using the Inflammatory Proliferative Remodeling (IPR) Wound Healing Scale. Results The oxygen‐ozone therapy group exhibited a significant improvement in wound healing post‐extraction during the inflammatory and proliferative phases, as indicated by the IPR scale scores at 3–5 days ( p = 0.006) and 14 days ( p < 0.001) respectively. Conclusion Oxygen–ozone therapy shows promise in improving post‐extraction healing in patients at risk of MRONJ. Future studies with larger sample sizes and multicenter collaborations are recommended to confirm the validity of these findings and explore the long‐term efficacy of ozone therapy.