Clinical and Microbiological Study on Local Application of an Ozonated Olive Oil Gel in the Periodontal Pockets: A Randomized Double-Blind Trial

Objectives: This study aims to evaluate the clinical and microbiological efficacy of a novel Activated Ozonated Extra-Virgin Olive Oil (AOEOO) gel as a topical adjunct in the treatment of periodontal pockets. Methods: In this double-blind, randomized clinical trial, patients diagnosed with stage II–IV periodontitis received either scaling and root planing (SRP) and placebo gel or SRP combined with subgingival AOEOO gel application (test group). Periodontal indices—probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP)—were measured at baseline, 3, and 6 months. Microbiological analysis using real-time PCR quantified six key periodontal pathogens at baseline and after 6 months. Results: AOEOO-treated patients showed significantly greater improvements in PPD, CAL, PI, and BOP at both 3 and 6 months compared to the placebo group (p < 0.05). Also, microbiologically, the AOEOO group exhibited a significant reduction in total bacterial load and in all target pathogens, with reductions ranging from 63.8% to 98.7% (p < 0.05). No adverse effects were reported. Conclusions: The adjunctive use of AOEOO gel significantly improved periodontal outcomes and reduced pathogenic bacterial load, supporting its potential role as a safe and effective supportive treatment in periodontitis management. © 2025 by the authors.