Effect of Ozone Therapy on Marginal Bone Levels Around Dental Implants

This prospective split-mouth randomized clinical trial was conducted to evaluate the effect of ozone treatment applied to fresh implant sockets on marginal bone levels and bone microarchitecture following immediate implant placement. Each participant received ozone treatment at one implant site and conventional treatment at the contralateral site according to a randomized allocation. Marginal bone levels and bone microarchitecture were evaluated using cone-beam computed tomography (CBCT) and fractal analysis over a 6-month follow-up period.

Inclusion Criteria: * Adults aged 18 years or older. * Systemically healthy individuals. * Ability to comply with the study protocol. * At least two missing teeth in symmetrical areas or different quadrants of the same jaw requiring implant placement. * Adequate alveolar bone volume for placement of standard diameter (3.5-4.0 mm) and length (8-12 mm) implants with at least 1.5 mm of surrounding bone. * Soft tissue phenotype ≥2 mm and keratinized mucosal width ≥2 mm at implant sites. * Written informed consent provided. Exclusion Criteria: * Systemic diseases contraindicating implant surgery. * Pregnancy. * Insufficient alveolar bone volume requiring advanced bone augmentation. * Active oral infection. * Previous implant failure at the intended implant site. * Incomplete healing after recent tooth extraction. * Advanced periodontal disease. * Smoking. * Any contraindication to ozone therapy.