Charles W. Ruefenacht DDS NMD IBDM

AAOT Dallas Texas

April 11-13, 2013

Ozone for the treatment of root sensitivity

A. Symptoms

B. Anatomical base

C. Etiology

D. Treatment protocol with ozone

Symptoms

Symptoms

Sharp, immediate, transitory pain to

1. cold

2. heat

3. air

4. biting*

Anatomy and Etiology

Enamel: •98% inorganic•parallel enamel rods of HA

•crystalline•brittle•not tough

•DEJ: interphase layer• 50:50 collagen/mineral (vol)• ~ 150 microns thick• binds brittle enamel w/ tough•dentin • shock absorber• allows for toughness• prevents crack propagation

Physical properties of the dentin-enamel junction region. Urabe, Nakajima, Sano, Tagami. American Journal of Dentistry, Vol 13, No 3, June 2000, 129-135

SEM etched dentin

SEM DentinDentin:•50% mineral, 30% collagen

•25k/mm @ DEJ•48k/mm @ pulpchamer•2.8 micron diameter @ pulp

•0.8-1micron @ DEJ•peritubular dentin: more highly mineralized

•odontoblast in each tubule

Martin Brannstrom: The Hydrodynamic Theory of Dential Pain: Sensation, Preparations, Cares and the Dentinal

Crack. JOE 1986.Fluid movement through tubulestimulates the odontoblastic processes triggering pain fibers.1. cold - outward

2. heat - compression3. air - stretch, pain ends w/desiccation.

1. identify the correct tooth2. 10-15 gamma3. high speed suction about 3/4 inch away from surface4. apply ozone for about 10 seconds and re-test.5. repeat ozone application until sensitivity gone.6. collect money

Ozone Treatment

Treatment1. turn off pain fibers with ozone2. stop fluid flow with bondable resinsand probably with ‘plugs’ due to remineralization.

Now you know more than most dentists.

Thanks!