J Am Dent Assoc. 2021 Oct;152(10):842-854.e1. doi: 10.1016/j.adaj.2021.05.006.
Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis.
The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence.
Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients).
Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
几项随机对照试验的结果表明，臭氧在减少下颌阻生第三磨牙手术后的术后并发症方面具有有益的效果，但文献中缺乏系统评价和荟萃分析。
作者根据系统评价和荟萃分析的首选报告项目指南进行了这项系统评价，应用排除和纳入标准后，评估了以下结局参数：疼痛、肿胀、张口受限、生活质量、镇痛药使用量和不良反应。使用 RevMan Cochrane 协作软件，版本 5.3 进行荟萃分析，并使用推荐评估、制定和评估方法对证据的确定性进行评级。
与对照组相比，接受臭氧辅助治疗的患者在手术后 24 小时（95%CI，-3.94 至-1.56）和 7 天（95%CI，-1.67 至-0.78）时报告的疼痛评分较低。对所有 4 项纳入试验进行的汇总分析显示，在 24 小时、72 小时和术后 7 天，实验组的肿胀标准化均数差（SMD）分别为-0.44、0.63 和-0.87。在手术后 24 小时（SMD，2.74；95%CI，-1.93 至 7.41；4 项研究，133 名患者）、72 小时（SMD，2.77；95%CI，-0.63 至 6.17；4 项研究，133 名患者）和 7 天（SMD，1.42 SMD；95%CI，-1.34 至 4.18；4 项研究，133 名患者），接受臭氧治疗的患者张口幅度的平均估计值更高。
证据表明，辅助臭氧应用可以减少下颌阻生第三磨牙手术后的疼痛、改善生活质量和减少镇痛药的平均摄入量，但对减少面部肿胀和张口受限无效，为进一步研究铺平了道路。
