Ozonated oils as functional dermatological matrices: effects on the wound healing process using SKH1 mice

Enhancing the Antimicrobial Effect of Ozone with Mentha piperita Essential Oil

This study aimed to obtain and analyse Mentha piperita essential oil (MpEO) for the prospect of being used as an enhancement agent for the antimicrobial potential of ozone against gram-positive and gram-negative bacteria and fungi. The research was done for different exposure times, and it gained time-dose relationships and time-effect correlations. Mentha piperita (Mp) essential oil (MpEO) was obtained via hydrodistillation and further analysed by using GC-MS. The broth microdilution assay was used to determine the strain inhibition/strain mass growth by using spectrophotometric optical density reading (OD). The bacterial/mycelium growth rates (BGR/MGR) and the bacterial/mycelium inhibition rates (BIR/MIR) after ozone treatment in the presence and absence of MpEO on the ATTC strains were calculated; the minimum inhibition concentration (MIC) and statistical interpretations of the time-dose relationship and specific t-test correlations were determined. The effect of ozone on the following tested strains at maximum efficiency was observed after 55 s of single ozone exposure, in order of effect strength: S. aureus > P. aeruginosa > E. coli > C. albicans > S. mutans. For ozone with the addition of 2% MpEO (MIC), maximum efficacy was recorded at 5 s for these strains, in order of effect strength: C. albicans > E. coli > P. aeruginosa > S. aureus > S. mutans. The results suggest a new development and affinity regarding the cell membrane of the different microorganisms tested. In conclusion, the use of ozone, combined with MpEO, is sustained as an alternative therapy in plaque biofilm and suggested as helpful in controlling oral disease-causing microorganisms in medicine.

A Comparative Study of Pain and Healing in Post-Dental Extraction Sockets Treated with Ozonated Water/Oil and Normal Saline

Aim

A comparative study of pain and healing in post-dental extraction sockets treated with ozonated water/oil and normal saline.

Purpose

The present study was conducted to evaluate the efficacy of ozonated water/oil in reducing pain and enhancing healing and swelling following dental extractions and surgical removal of impacted mandibular third molars.

Patients and Methods

Clinical trial was conducted involving 50 individuals requiring two-stage bilateral removal of tooth of which 25 patients were for asymptomatic bilateral extractions and 25 patients for surgical removal of asymptomatic bilaterally similar impacted mandibular third molars. The patients were divided into two groups following a split-mouth design: In group I, sterile ozonated water was irrigated in the sockets after extraction for 2 min on study side and normal saline on the control side following extraction. In group II, transalveolar extractions/surgical extraction of impacted mandibular III molars were carried out under copious irrigation with sterile ozonated water on study side and normal saline irrigation on control side evaluated by independent observer on 2nd, 4th and 7th day for the efficacy of ozonated water/oil in reducing pain and enhancing healing in post-dental extraction sockets.

Results

The use of ozonated water/oil increased the healing rate in all extraction cases, except in 4% of cases in which they did not show any effect of healing in extraction sockets on 7th postoperative day. The use of ozonated water/oil did not show any effects on the healing rate in impaction cases in all postoperative days. The use of ozonated water/oil showed decreased incidence of pain in subjects of both extraction and impaction cases.

Effect of topical ozonated sunflower oil on second intention wound healing in turtles: a randomised experimental study

Background

Ozone is an antimicrobial agent that in experimental and case-control studies has been found to exert a positive effect on wound healing. Wild and pet chelonians frequently present insidious wounds exhibiting secondary infections and/or delayed healing.

Objectives

Evaluate the effects of topical ozonated sunflower oil on second-intention healing of acute experimental skin wounds in red-eared sliders (Trachemys scripta elegans).

Methods

Randomised within-subject controlled study; Group 1 (n = 24) was used to assess clinical healing features; Group 2 (n = 12) was used for histological evaluation in which two sets of wounds were biopsied at 2, 7, 14, 21, 28 and 42 days over the course of the cicatrisation process. A single 6 mm diameter wound was made on each rear limb and topical ozonated (950 peroxide value) and non-ozonated sunflower oil were applied daily for one week on treated and contralateral control wounds, respectively.

Results

Mean wound size was significantly lower in the ozone-treated group at day 28 (p < 0.0001) with differences of clinical relevance (74.04% vs. 93.05% reduction of initial wound size). Histologically, the acute inflammatory reaction was enhanced in treated wounds, with significantly higher numbers of heterophils (p = 0.0016), lymphocytes (p < 0.001) and fibroblasts (p < 0.001).

Conclusions

Daily topical application of ozonated sunflower oil over the course of one week improved the healing of acute, full-thickness skin wounds in chelonians. This clinical outcome was histologically correlated with an enhanced acute inflammatory reaction, as well as the production and remodelling of collagen fibres.

Ozone and its derivatives in veterinary medicine: A careful appraisal

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In the Vet field, there are lot of scientific publications with missing or incomplete data, poor case reports and papers without a control group or unrepresentative sample.

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Differences between animal and human blood composition, anatomy and physiology must be taken into consideration, especially in therapies not yet fully approved.

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Some practitioners produce their own ozonated solution or autohemotherapy, in the absence of information regarding the compatibility of the material used.

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Other than the properties of the commercial preparations, the standardization of both treatment methods and times influence the results obtained with ozone therapy.

The therapeutic use of ozone and its derivatives in the veterinary medicine it is still in an emergent stage. Gaseous ozone chemical instability makes necessary its extemporaneous preparation and the accordance about ozone treatments with the highest quality standards in publications is of paramount importance. Moreover, the numerous method of administration in different animal species, the prevalence of case reports, the deficiency of consistent evaluation of the outcomes, as well as the lack of standardization of the treatment operating procedures represents an open question for its spreading and official approval. The keywords “ozone”, “ozonated”, “ozonation” “ozonized”, “ozonization”, “oxygen-ozone therapy”, “veterinary”, “pets”, “animal” were used to perform a literature review using PubMed, Cochrane, Google Scholar, Zotero databases with the temporal restriction for published manuscripts starting from 2010. All the researches were critically evaluated, regardless of the impact factor, if any, of the journals in which they were presented. The deepening of the mechanisms of action of this bio-oxidative therapy can open new horizons on its use. The distinctive condition to achieve such a scenario is an improved knowledge of the qualitative/quantitative characteristics of ozone and its derivatives. All with the aim of taking nothing away to the cited original research papers, but of improving the promising therapeutic implications of ozone therapy in veterinary medicine as a standardization stimulus about this therapeutic resource with multiple application specificities.

Ozonated oil in wound healing: what has already been proven?

Acute or chronic inflammatory reactions aim to control lesions, resist to pathogens attack and repair damaged tissue. The therapeutic administration of ozone known as ozone therapy appears as a possible treatment for tissue repair, as it promotes the healing of wounds. It has bactericidal, antiviral and antifungal properties and has been used as a therapeutic resource to treat inflammation. The objective was to carry out an integrative review regarding the use of ozonated oil in acute and chronic inflammations. The keywords “ozone therapy,” “inflammation” and “ozone” were used in the Portuguese, Spanish and English languages. The paper selection was based on inclusion and exclusion criteria. In total, 28 articles were selected. It has been seen that ozonated oil is effective in healing cutaneous wounds. The beneficial effects are due to the healing of wounds, due to the reduction of microbial infection, debridement effect, modulation of the inflammatory phase, stimulation to angiogenesis as well as biological and enzymatic reactions that favor the oxygen metabolism, improving the wound cicatrization. In addition to promoting healing, ozonated oil reduces symptoms related to skin burns, prevents post-lesion hyperpigmentation, and reduces the pain of aphthous ulcers. Therefore, ozonated oil represents an effective and inexpensive therapeutic alternative that must be implanted in the public health system.

Ozonated oil effect for prevention of medication-related osteonecrosis of the jaw (MRONJ) in rats undergoing zoledronic acid therapy

OBJECTIVES

The aim of this study was to evaluate the preventive effect of ozonated oil on the development of MRONJ-like lesions at tooth extraction sites in rats submitted to zoledronic acid treatment.

MATERIALS AND METHODS

Twelve rats were divided into two groups. Each rat received an injection of zoledronic acid solution once a week for 5 weeks before having its upper first molar extracted. In group 1, the clotted socket was maintained, while in the group 2, the socket was treated with ozonated oil for 10 min/day during 3 days. After euthanasia, block resection was performed for histological analysis. Necrotic bone was defined as the area of the bone with empty osteocyte lacunae and vital bone as the area with osteocyte-occupied lacunae.

RESULTS

There was no statistically significant difference between the groups in the average area of vital bone (p = 0.2248) and the average area of necrotic bone (p = 0.1208). However, the average area of vital bone in group 1 was smaller (24.1 ± 2.9 cells/cm²) than in group 2 (26.8 ± 4.2 cells/cm²), and the average area of necrotic bone in group 1 was higher (7.0 ± 2.5 cells/cm²) than in group 2 (4.0 ± 1.1 cells/cm²), indicating that ozonated oil may reduce the development of osteonecrosis.

CONCLUSIONS

Our findings suggest that ozonated oil might prevent MRONJ-like lesions at tooth extraction sites in rats submitted to a disease induction protocol. Further research should be conducted to confirm this hypothesis.

CLINICAL RELEVANCE

MRONJ has been reported as a complication of surgical dental procedures, and there are currently no predictable preventive therapies.

Ozonated Oils as Antimicrobial Systems in Topical Applications. Their Characterization, Current Applications, and Advances in Improved Delivery Techniques

The search for a wide spectrum of antimicrobial agents that can avoid resistance while maintaining reasonable side effects has led to ozonated oils experiencing an increase in scientific interest and clinical applications. The treatment of vegetable oils with ozone leads to the creation of a reservoir of ozone that slowly releases into the skin thanks to the fact that ozone can be held as ozonides of unsaturated fatty acids. Interest in the use of ozonated oils has meant that several ozonated-vegetable-oil-containing products have been commercialized as cosmetic and pharmaceutical agents, and in innovative textile products with antibacterial activity. New approaches to the delivery of ozonated oils have very recently appeared in an attempt to improve their characteristics and reduce drawbacks, such as an unpleasant odor, high viscosity and undesired effects on skin, including irritation and rashes. The present review focuses on the current status of delivery agents that use ozonated oils as antimicrobial agents in topical (dermal, skin, and soft tissues) treatments. Challenges and future opportunities for these delivery systems will also be discussed.

ES2 as a Novel Verbascoside-Derived Compound in the Treatment of Cutaneous Wound Healing

Several pathologies are characterized by chronic wounds and often resistant to many of the common therapies, leading to chronic infections that can become even life-threatening for patients. For this reason, the identification of new products able to ameliorate the healing process is still an on-going research. Natural compounds have been used to improve skin conditions due to their dermo-cosmetic and therapeutic activities including anti-inflammatory, antioxidant and cell-migratory properties. Among these compounds, it has been recently demonstrated that Verbascoside, a phenyl propanoid glycoside widely used in the cosmetic field, can improve keratinocytes proliferation. Because of its high hydrophilic character, Verbascoside has a limited range of possible topical applications and the synthesis of ES2, a semi-synthetic derivative of Verbascoside was performed to bypass some of the drawback aspects of this molecule. In the present study, the wound healing properties of Verbascoside and ES2 were compared in both keratinocytes “in vitro” wound scratch and in wounded SKH1 mice. The results showed that both compounds were not cytotoxic and ES2 showed an efficient ability to promote the proliferation of human keratinocytes compared to Verbascoside. The findings were also confirmed in vivo but only at early time points (2/3 days). Taken together, these data suggest that the Verbascoside-derivative ES2 could be considered a novel and promising candidate for the topical treatment of wounds.

The antibacterial effect of topical ozone on the treatment of MRSA skin infection

Skin can be infected by many types of microorganisms, most commonly by gram‑positive strains of Staphylococcus and Streptococcus spp. Treatment of Staphylococcus aureus (S. aureus) infections, particularly that of methicillin resistant Staphylococcus aureus (MRSA), is a challenge in clinical practice. Ozone therapy has proven to be one of the strongest antiseptics against the majority of microorganisms involved in skin infections. The purpose of the present study was to evaluate the microbicidal effects of topical ozone therapy on S. aureus and MRSA, and determine the clinical efficacy of ozone therapy on patients with MRSA skin infection. Microbicidal effects of ozonated oil and ozonated water were determined by plating and Kirby Bauer methods. Clinical efficacy and safety of topical ozone were evaluated in two cases with skin MRSA infection. The killing rates of ozonated oil for S. aureus and MRSA were greater when compared with the control oil group. Almost 100% of S. aureus were eliminated by ozonated oil following 5 min. Almost 100% MRSA were eliminated by ozonated oil following 15 min. In addition, 100% S. aureus and 100% MRSA were eliminated by ozonated water in 1 min. The inhibition zone diameters of ozonated oil for S. aureus and MRSA were 17 and 13 mm, respectively, which were significantly larger than the control group. Both cases of skin MRSA infection were completely healed with ozone therapy. In conclusion, ozone therapy is a potential treatment for S. aureus and MRSA skin infection as it has great efficacy, few side effects and low‑costs.

Nanostructured lipid systems modified with waste material of propolis for wound healing: Design, in vitro and in vivo evaluation

Propolis, a natural compound that can accelerate the wound healing process, is mainly used as ethanolic extract. The extractive solution may also be obtained from the propolis by-product (BP), transforming this waste material into a pharmaceutical active ingredient. Even if propolis does not show toxicity, when used as an extract over harmed skin or mucosa, the present ethanol content may be harmful to the tissue recovering, besides hindering the drug release. This study describes the development of solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) as topical propolis delivery systems and the investigation of their in vitro and in vivo activities. The extracts were evaluated to guarantee their quality, and the lipid dispersions were characterized with respect to morphology (cryo-TEM), size and diffractometry (X-ray) properties. The occlusive capacity of formulations was also evaluated by an in vitro technique, which determines the occlusion factor. The drug entrapment efficiency (EE), as well as the in vitro drug release profile from the nanoparticulate systems was investigated as well. The size analysis performed through 90days was favorable to a topical administration and the polydispersity index, though not ideal in all cases due to the high content of resins and gums from the extracts, were relatively stable for the SLN. The propolis extract contributes to the occlusive potential of the formulations. The human immortalized keratinocytes presented good cell viability when tested with both extracts (propolis and BP) freely or entrapped in the systems. SLN modified with propolis material provided an acceleration of the in vivo wound healing process.

Use of Ozone to Treat Ileostomy Dermatitis in an Experimental Rat Model

Background

Dermatitis associated with ileostomy is an important problem that affects many people, especially children. The aim of this study was to investigate the therapeutic effects of ozone on dermatitis due to ileostomy, and to develop an alternative treatment option.

Material/Methods

A total of 28 rats were divided into 4 groups: control, ileostomy, ozone, and zinc oxide. Ileostomy was performed in all rats except the control group. After a 1-week waiting time, the ozone group was administered ozone therapy and the zinc oxide group was administered zinc oxide cream locally once a day for a total of 7 days. All rats were sacrificed at the end of this period. The efficacy of treatment was examined by biochemical, histopathological, and immunohistochemical parameters. The levels of malondialdehyde (MDA), total glutathione (tGSH), total antioxidant capacity (TAC), and total oxidant status (TOS) were measured from tissue. Vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) were examined immunohistochemically.

Results

Dermatitis occurred pathologically in all rats that underwent ileostomy surgery. The lowest dermatitis score was in the ozone treatment group (p<0.05). Ileostomy dermatitis caused increased levels of MDA and TOS. Ozone treatment resulted in reduced MDA and TOS levels, while the levels of tGSH and TAC were increased (p<0.05). Both VEGF and PCNA immunostaining were augmented in the ozone treatment group (p<0.05).

Conclusions

Local ozone application may be a good alternative compared to the conventional treatment methods for the prevention of skin lesions that develop after ileostomy.

Synthesis, characterization, thermal behavior, and biological activity of ozonides from vegetable oils

This study involved detailed characterization of ozonated oils, including thermal analysis and investigation of antimicrobial activity and cytotoxicity.