The effect of low-frequency ultrasound in combination with ozonated water on subgingival microbiocenosis in chronic generalized periodontitis of moderate severity

   In our work, we evaluated the effect of low-frequency ultrasound therapy (LF ultrasound) in combination with ozonated water on the quantitative and qualitative composition of subgingival microbiocenosis in patients with chronic generalized periodontitis (CGP) of moderate severity compared with monotherapy with ozonated water.

   Materials and methods. The study included 100 patients with a diagnosis of chronic generalized periodontitis of moderate severity. After the basic therapy, the patients were randomly divided into two groups of 50 people. In the main group, after basic therapy, a course of low-frequency ultrasound was performed through sterile gauze wipes soaked in ozonated distilled water. In the control group, 10 static applications of similar wipes with ozonated water were performed without ultrasonic exposure. Subgingival material was removed with sterile paper pins from periodontal pockets at three time points: before the start of treatment (T0), 2 weeks after completion of the course (T1) and 3 months after treatment (T2).

   Results. In the main group by T1, the total microbial number (PMF) decreased to 4.8 ± 0.5 lg CFU/ml (reduction ≈ 3.8 lg; p < 0.001). By T2, there was a moderate increase in these indicators compared to T1, but they remained significantly lower than the initial ones.

   Conclusion. The combination of low-frequency ultrasound with ozonated water provides deeper and more stable sanitation of subgingival biofilms compared with monotherapy with ozonated water, which is accompanied by a pronounced reduction of periodontal pathogens and Candida spp. while simultaneously restoring the resident and stabilizing microflora. The data obtained indicate the transition of the subgingival biocenosis from severe dysbiosis to a state of relative eubiosis and substantiate the use of a combination of low-frequency ultrasound and ozonated water as an eubiotic-oriented antibiotic-film approach in the treatment of chronic generalized periodontitis of moderate severity.

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