The Use of Ozone Therapy or Blue®M Gel as an Adjunctive Therapy in Patients With Periodontal Disease: A Systematic Review

Abstract

Background: Conventional treatment of periodontal disease is based on subgingival instrumentation, but its limited effectiveness in eliminating certain pathogens has led to the need for adjuvant approaches such as ozone therapy (OT) or Blue®m gel. Methods: A systematic review was carried out between October 2024 and June 2025, using four databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen articles that met the in-clusion criteria were selected from a total of 727. Results: Although most articles reported an improvement in periodontal parameters after treatment, significant differences between groups were found in only one article. Furthermore, two articles showed that the use of OT reduced anaerobic bacterial colonisation between 28.5% and 55.0%. Regarding Blue®m, two articles argued that there was a clinical im-provement in periodontal parameters within 14 days to three months. However, an article reported that no significant differences were found between groups. OT and Blue®m oral gel are used as a viable alternative, as they favour wound healing by increasing oxygen levels in periodontal pockets and allowing high concentrations of active oxygen directly in the pocket depth. Oxygen participates in various biological processes, such as bacterial elimination by oxidation, re-epithelialisation, angiogenesis, and collagen synthesis, which appear to be promising new alternatives to conventional approaches. Conclusions: Despite promising results, significant intragroup differences were observed, but not intergroup differences, demonstrating that the use of these therapies does not have a negative effect as a complement to conventional treatment.