The effect of ozone therapy in the treatment of bisphosphonate-related osteonecrosis of the jaws

Introduction: The osteonecrosis of the jaws, or bisphosphonate-related osteonecrosis of the jaws (BRONJ), is defined as the exposed jawbone (part of the jawbone) in the oral cavity that persists for more than eight weeks despite a given therapy in the patient with no history of undergoing radiotherapy, and there is no evidence of bone metastases. The influence of ozone (as ozone gas and ozone oil) is due to its antibacterial, antiviral and antifungal effect, improving the oxygenation of tissues, as well as its impact on wound epithelialization, and the stimulation of local immunity. Aim: This study aimed to determine the effect of ozone in the treatment of bisphosphonate-related osteonecrosis of the jaws after its application in the form of gas and ozone oil in the osteonecrotic area. Case report: Through the presentation of two similar cases, we presented the influence of ozone, in the form of ozone gas and ozone oil, on wounds healing in two BRONJ patients over 60. Both patients have been receiving bisphosphonate therapy for more than 2 years and experienced exposed bone following tooth extraction. The patients underwent surgical intervention (sequestrotomy) in combination with conservative treatment with antibiotics and ozone therapy, after which tissue epithelization was stimulated. Conclusion: The use of ozone gas and ozone oil in the treatment of bisphosphonate-related osteonecrosis of the jaws has a positive effect on wound healing in the area of the osteonecrotic tissue.