Non-Cochrane · umbrella · PM42346828
Effectiveness and Safety of Ozone Therapy in Humans: An Umbrella Review of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials.
Cacciatore Stefano, Abbatecola Gabriele, Calvani Riccardo, et al. · Medical sciences (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/medsci14020289
Findings
21 findings
| Population | ||||
|---|---|---|---|---|
| Patients with chronic periodontitis undergoing scaling and root planing | Ozone therapy as adjunct to scaling and root planing | Scaling and root planing without ozone (control) | Clinical attachment level | MD -0.27 [-0.56, 0.01] Very low Downgraded: risk of bias, imprecision, inconsistency 9 studies · 439 participants |
| Patients with chronic periodontitis undergoing scaling and root planing | Ozone therapy as adjunct to scaling and root planing | Scaling and root planing without ozone (control) | Plaque index | MD -0.05 [-0.15, 0.04] Low Downgraded: risk of bias, imprecision 7 studies · 254 participants |
| Patients with chronic periodontitis undergoing scaling and root planing | Ozone therapy as adjunct to scaling and root planing | Scaling and root planing without ozone (control) | Probing pocket depth | MD -0.26 [-0.48, -0.05] Very low Downgraded: risk of bias, imprecision, inconsistency 12 studies · 595 participants |
| Patients with chronic periodontitis undergoing scaling and root planing | Ozone therapy as adjunct to scaling and root planing | Scaling and root planing without ozone (control) | Bleeding on probing | MD -3.29 [-8.65, 2.06] Low Downgraded: risk of bias, imprecision 6 studies · 316 participants |
| Patients with chronic periodontitis undergoing scaling and root planing | Ozone therapy as adjunct to scaling and root planing | Scaling and root planing without ozone (control) | Gingival index | MD -0.15 [-0.24, -0.07] Low Downgraded: risk of bias, imprecision 7 studies · 294 participants |
| Patients hospitalized for COVID-19 | Ozone therapy | Control treatment (non-active) | Intensive care unit admission | RR 0.44 [0.15, 1.33] -64 [-97, 38] per 1000 Low Downgraded: imprecision 3 studies · 180 participants |
| Patients hospitalized for COVID-19 | Ozone therapy | Control treatment (non-active) | Length of hospital stay | MD -0.7 [-4.1, 2.7] Very low Downgraded: imprecision, inconsistency 2 studies · 122 participants |
| Patients hospitalized for COVID-19 | Ozone therapy | Control treatment (non-active) | PCR positivity at follow-up | RR 0.07 [0.01, 0.34] -434 [-462, -308] per 1000 Low Downgraded: imprecision 2 studies · 90 participants |
| Patients hospitalized for COVID-19 | Ozone therapy | Control treatment (non-active) | Mortality | OR 0.73 [0.32, 1.68] -15 [-38, 35] per 1000 Low Downgraded: imprecision 3 studies · 180 participants |
| Patients with diabetic foot ulcers | Ozone therapy | Control treatment (non-active) | Adverse events | RR 2.27 [0.48, 10.79] GRADE not reported Studies not reported |
| Patients with diabetic foot ulcers | Ozone therapy | Control treatment (non-active) | Reduction in ulcer area | MD -2.11 [-5.29, 1.07] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 111 participants |
| Patients with diabetic foot ulcers | Ozone therapy | Control treatment (non-active) | Ulcers healed | RR 1.69 [0.9, 3.17] 138 [-20, 434] per 1000 Low Downgraded: risk of bias, imprecision 2 studies · 111 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Quality of life at 24 h | MD -11.24 [-12.73, -9.75] Very low Downgraded: risk of bias, imprecision 2 studies · 160 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Quality of life at 7 days | MD -6.85 [-7.68, -6.02] Very low Downgraded: risk of bias, imprecision 2 studies · 160 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Mouth opening at 72 h | MD 2.77 [-0.63, 6.17] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 266 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Swelling at 7 days | SMD -0.87 [-2.31, 0.56] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 266 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Mouth opening at 24 h | MD 2.74 [-1.93, 7.41] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 266 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Number of analgesics used | MD -3.8 [-4.38, -3.22] Very low Downgraded: risk of bias, imprecision 3 studies · 226 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Mouth opening at 7 days | MD 1.42 [-1.34, 4.18] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 266 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Quality of life at 72 h | MD -11.08 [-12.08, -10.08] Very low Downgraded: risk of bias, imprecision 2 studies · 160 participants |
| Patients undergoing surgery for impacted mandibular third molar | Ozone therapy | Control treatment (non-active) | Swelling at 72 h | SMD 0.63 [-1.42, 2.69] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 266 participants |
Included primary studies 7
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chaudhry 2021 Efficacy of adjuvant ozone therapy in reducing postsurgical complications following impacted mandibular third-molar surgery: A systematic… PMID:34579810 | 2021 | this review only | not stated | not extracted yet |
| Filho 2024 Ozone therapy as a treatment for diabetic foot ulcers: a systematic review and meta-analysis. PMID:39630555 | 2024 | this review only | not stated | not extracted yet |
| Jafari-Oori 2022 Efficacy of ozone adjuvant therapy in COVID-19 patients: A meta-analysis study. PMID:36438064 | 2022 | this review only | not stated | not extracted yet |
| Liu 2015 Ozone therapy for treating foot ulcers in people with diabetes. PMID:26505864 | 2015 | this review only | not stated | not extracted yet |
| Liu 2025 Effects of ozone therapy as an adjuvant in the treatment of periodontitis: a systematic review and meta-analysis. PMID:40038617 | 2025 | this review only | not stated | not extracted yet |
| Moraschini 2020 Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. PMID:32399735 | 2020 | this review only | not stated | not extracted yet |
| Shang 2023 Benefits of ozone on mortality in patients with COVID-19: A systematic review and meta-analysis. PMID:36513208 | 2023 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human participants with any medical condition | Four populations across 7 meta-analyses: chronic periodontitis (n=2 meta-analyses), hospitalized COVID-19 (n=2), diabetic foot ulcers (n=2), impacted mandibular third-molar surgery (n=1) |
| Intervention | Ozone therapy: medical ozone in any form (systemic administration, intra-articular injection, rectal insufflation, topical application) with therapeutic intent | Ozone therapy by local, systemic or combined routes (ozonated water or gas, autohemotherapy, rectal insufflation, nebulization, topical gel); dose not standardized |
| Comparison | Non-active controls: placebo, saline, sham treatment or standard care | Control treatment, placebo or standard care |
| Outcomes | Clinical efficacy endpoints relevant to the treated condition; safety endpoints (incidence and severity of adverse events) | Periodontal outcomes (probing pocket depth, gingival index, bleeding on probing, plaque index, clinical attachment level); COVID-19 outcomes (PCR positivity, length of hospital stay, ICU admission, mortality); diabetic foot ulcer healing, ulcer area, adverse events; third-molar outcomes (swelling, mouth opening, quality of life, analgesic use) |
| Study designs | Systematic reviews with meta-analyses of randomized clinical trials | Meta-analyses of RCTs (n=7); outcome-level GRADE synthesis from one retained meta-analysis per indication |
| Timing | Not specified | Not specified |