ORIGINAL ARTICLE Efficacy of gaseous ozone in smoking and non-smoking gingivitis patients Ahmet Cemil Talmaç 1 & Metin Çalişir 2 Received: 20 February 2020 /Accepted: 27 May 2020 # Royal Academy of Medicine in Ireland 2020 Abstract Background The gingivitis treatment protocols aim to stop the progression of inflammation and prevent the affliction of deeper periodontal tissues. Current research focuses on novel methods that can be applied with handheld and ultrasonic devices to increase the effectiveness of non-surgical periodontal treatment. Ozone has been shown to have a strong antimicrobial effect against bacteria that play a role in the etiology of gingival/periodontal diseases. Research evaluating the effects of ozone gas on the treatment of gingival tissues is limited. Aim We investigated the effects of ozone application during the scaling procedure on clinical parameters of gingivitis in smokers and non-smokers and to investigate the efficacy of ozone gas in periodontal treatment. Methods A total of 40 subjects, 27 males/13 females—20 smokers/20 non-smokers—with plaque-induced gingivitis, were selected. The patients underwent a single session of full-mouth supragingival and subgingival scaling. Gaseous ozone application was performed on a randomly selected maxillary quadrant. The other maxillary quadrant was designated as the control group receiving only initial periodontal treatment. Clinical parameters, such as PI, GI, GBTI, and PPD, were measured before and 1 week after treatment. Results Our study shows that ozone therapy significantly improves clinical parameters in smokers and non-smokers when applied in addition to periodontal therapy. Conclusions Additional studies comparing the effect of ozone therapy on smokers and non-smokers to the effects of oral mouthwashes may provide valuable contributions to the field. Keywords Gingivitis . Ozone . Periodontal Indices . Periodontal Treatment . Smoking Introduction Plaque-induced gingival diseases are those that include the formation of a microbial biofilm layer on the tooth surface and show clinically observable signs of inflammation in the gingiva. If the dental plaque is not removed within days or weeks after deposition, gingivitis develops [1, 2]. Gingival inflammation in gingivitis is a very important factor for the development of periodontitis, which is characterized by severe loss of the supportive tissue around the teeth. Thus, the treat- ment of gingivitis naturally plays a key role in the prevention of periodontitis [3, 4]. Epidemiological studies have shown that plaque-induced gingivitis is a prevalent disease that can occur at any age in the population and is the most commonly observed disease among periodontal disorders [5, 6]. Smoking is an important environmental risk factor for peri- odontal disease. Plaque accumulation and disease progression have been shown to be more severe in smokers [7]. However, smoking can mask the symptoms of gingivitis and prevent the detection of its clinical manifestations. For this reason, treat- ment and prevention of gingival disease in people who smoke are more critical compared with other patient groups [8, 9]. The gingivitis treatment protocols aim to stop the progres- sion of inflammation and prevent the affliction of deeper peri- odontal tissues. Among the non-surgical periodontal treatment methods, the use of handheld and ultrasonic devices has been reported as the gold standard. Although other methods have * Ahmet Cemil Talmaç a.c.talmac@hotmail.com 1 Faculty of Dentistry, Department of Periodontology, Yüzüncü Yıl University, 65080 Van, Turkey 2 Faculty of Dentistry, Department of Periodontology, Adiyaman University, Adiyaman, Turkey Irish Journal of Medical Science (1971 -) https://doi.org/10.1007/s11845-020-02271-x