A novel treatment of necrotizing ulcerative gingivitis using ozone therapy

Introduction: Necrotising ulcerative gingivitis (NUG) is a microbial disease characterized by the death and sloughing of gingival tissue. This article presents a classic case with characteristic symptoms of gingival necrosis, punched out ulcerated papillae, pseudomembrane formation and pain. Case Report: The patient was treated with the conventional treatment modalities of antimicrobial treatment, swabbing of the pseudomembrane with H2O2 followed by irrigation at home mouth rinses. A soft toothbrush was advised without any adjunctive toothpaste. Additionally, ozone therapy was done on the 3rd day since the lesion persisted. Each arch was ozonated for five minutes using custom made silicon stents with nozzle in the front to allow the ozone generator to pass through. With adjunctive ozone therapy lesions had started to resolve by the 5th day and the patient was also relieved of all associated symptoms. Conclusion: Elimination of the bacteria is a very important part of treatment of NUG. Treponema, bacteroides intermedius and fusobacterium species are the principle bacteria involved in the disease. These bacteria are essentially anaerobic. Ozone therapy creates an aerobic environment for these bacteria inhibiting their growth and disrupting the integrity of the bacterial cell wall by oxidation and inactivating the existing bacteria. Ozone therapy does not damage the other surrounding healthy cells. These healthy cells have a coating of enzymes like catalase, glutathione perioxidase, reductase and superoxide dimutase which prevents the oxygen radical from penetrating them. Hence using ozone as an adjunctive therapy helps accelerate healing and treat the basic etiology in a very targeted manner.