Madrid Declaration on Ozone Therapy

  (ISCO3, 4th edition, 2025)

English & Spanish

Available now in the following two languages:
English, digital: 196 pages. 150€. For viewing only; cannot be copied, printed, or downloaded.

Spanish, printed: 189 pages. 150€ + shipping costs

* The digital version in English is for viewing only; cannot be copied, printed, or downloaded.

Very soon it will be available digital in Portuguese and Spanish.

Later in digital version: Italian, Spanish. Within the following months: In other different languages. The 3^rd. edition (2020) was translated into 10 different languages.

Its very high number of translations into different languages ​​makes it a unique reference document for the scientific practice of ozone therapy worldwide.

The importance of the “Madrid Declaration on Ozone Therapy”

“For the Unification of Criteria in the Practice of Ozone Therapy”

The 4th edition (2025) is a comprehensively expanded and fully updated version that covers:
– Human Medicine
– Dentistry
– Veterinary Medicine (for small and large animals)

This edition compiles scientific research from around the world, the result of years of experience and clinical practice.

Ozone therapists from many different countries contributed to this edition, fostering a global dialogue to improve clinical outcomes and scientific standards.

The Madrid Declaration on Ozone Therapy is the only truly global reference document on ozone therapy.

Its numerous translations into different languages ​​make it a unique reference document for the study, dissemination, and scientific practice of ozone therapy worldwide.

The Declaration serves as a reference and guide for healthcare professionals. The application of its recommendations depends on the clinical judgment of each health professional

It is a living document, which has been in effect for 15 years, being reviewed by ISCO3 every five years (2010, 2015, 2020, 2025). The 4^th edition was approved by ISCO3 on April 18, 2025.

1st Edition (2010). English: 24 pages. Spanish: 25 pages.
2nd Edition (2015). English: 50 pages. Spanish: 50 pages.
3rd Edition (2020). English: 102 pages. Spanish: 106 pages.

4th Edition (2025). English (digital): 195 pages. Spanish (printed): 189 pages

Officially presented at the “4th International Congress of the Madrid Declaration on Ozone Therapy, 4th ed.” at the ICOMEM (Illustrious Official College of Physicians of Madrid, similar to a State Medical Board of the USA) on June 5, 2025

Expansions and updates of the Declaration

With each new edition, the Declaration grows in scientific topics and content, bibliographic references, and pages. The 4th edition includes the addenda for Dentistry and Veterinary Medicine (the latter contains sections on “small animals” and, for the first time, “large animals”).

ISCO3 carries out very important research to ensure that each edition of the Declaration helps to realize the publication’s logo: “Towards the Unification of Criteria in the practice of ozone therapy.” True to this logo, the 4th edition is a comprehensively expanded and fully updated version reflecting the very important scientific advances that ozone therapy has had in recent years.

* The digital version in English is for viewing only; cannot be copied, printed, or downloaded.

Index of the Declaration

MADRID DECLARATION ON OZONE THERAPY

ISCO3,4^th, ed., 2025

 

“For the Unification of Criteria in the Practice of Ozone Therapy”

Official ISCO3 Document

 

INDEX

 

• EDITIONS OF THE DECLARATION

1^st Edition (2010, 19 pages)

2^nd Edition (2015, 50 pages)

3^rd Edition (2020, 102 pages)

4^th Edition (2025, 196 pages)

• AUTHORS
• ISCO3 members that approved the Declaration on April 18, 2025
• WHO IS ISCO3?
• Main Objectives of ISCO3
• DISCLAIMER
• Why is a 4^th Edition of the Madrid Declaration Necessary?
• CONCLUSIONS
• RECOMMENDATION
• ACKNOWLEDGEMENTS

———–

 

HUMAN MEDICINE

 

THERAPEUTIC RANGES FOR THE USE OF OZONE

 

INDEX

1. THERAPEUTIC BASES
2. Growth of Scientific Publications on Ozone Therapy

1.2 Costs and Economic Benefits of Ozone Therapy

1.3 Ozone therapy, a Complementary Technique, not an Alternative

1.4 Ozone Therapist

1.5. Medical Ozone Generators (MOG)

1.6. Dose-Effect Relationship

1.7. Therapeutic Window

1.8. Materials Used in Ozone Therapy

1.9. Mechanism of Ozone Action

1.10. Redox Bioregulator

1.11. Nutrient Supplementation for Patients Before Receiving Systemic Ozone Therapy

1.12. Most Common Routes of Local Ozone Application

2. OZONE THERAPY (O₃x) BASIC PRINCIPLES.

2.1. Contraindications

2.2. Warning

2.3. Interctions with Ozone

2.4. Synergistic effects with other oxidative therapies

2.5. Adverse Effects

2.5.1 Grade 1 medium

2.5.2 Grade 2 moderate

2.5.3 Grade 3 severe

2.5.4 Grade 4.

2.5.5 Grade 5.

2.6. Toxicity

2.7. Dosage in Pediatrics by Rectal Insufflation (RIO₃)

3. MAIN SYSTEMIC APPLICATION ROUTES

3.1. Major Autohemotherapy (MAH)

3.2. Minor Autohemotherapy (MiAH)

3.3. Ozonated Saline Solution Solution (O₃SS)

3.3.1. Can O₃SS Generate Toxic Compounds?

3.3.2. O₃SS Preparation Methods

3.3.3. Propeties of Microbubbling

3.3.4. Recommended Doses

3.3.5. Calculation of Concentration for O₃SS

3.3.6. Indications for use of doses

3.3.7. Adverse Effects of O₃SS

3.4. Extracorporeal Blood Oxygenation (EBOO)

3.5. Rectal Insufflation (RIO₃)

3.6. Vaginal Insufflation

4. MAIN LOCAL APPLICATION ROUTES LOCAL

4.1. Intramuscular, Paravertebral and Facet Infiltration

4.2. Intramuscular Paravertebral Infiltration

4.3. Hernias and Facet Infiltration

4.4. Intradiscal Infiltration

4.5. Infiltration of the Sacral Hiatus

4.6. Intraforaminal Infiltration

4.7. Coxofemoral Infiltration

4.8. Knee infiltration

4.9. Subcutaneous Emphysema Technique (Glove Technique)

4.10. Bagging

5. APPLICATION IN DERMATOLOGY

5.1. Facial Acne

5.2. Rosacea Acne

5.3. Atopic Dermatitis

5.4. Acute Cutaneous Abscess

5.5. Fungal Infections of the Skin, Hair, and Nails: Ringworm and Candida

5.6. Psoriasis

5.7. Fistula insufflation

6. APPLICATION IN AESTHETICS

6.1. Subcutaneous application for the treatment of cellulite

6.2. Facial Infiltration

6.3. Ozone Application with Hoods

7. VESICOURETHRAL LAVAGE
8. PROSTATE TREATMENT WITH OZONE
9. OTIC ROUTE
10. OPHTHALMOLOGICAL PATHWAY WITH OZONE
11. INTRATONSILLAR INFILTRATION
12. MICRODOSING ON TRIGGER AND ACUPUNCTURE POINTS
13. TOPICAL APPLICATION OF OZONIZED WATER: HYDROZONE THERAPY, SAUNA, OZONIZED OILS AND CREAMS

13.1 Hydrozone Therapy

13.2 Ozonation of oils and obtaining terpenes

13.3 Ozone saunas

14. INTRAOSSEOUS OZONE INFILTRATION (IOO3 T) TOPICAL AND SYSTEMIC ROUTE

14.1 Indications

14.2 Advantages

14.3 Contraindications

14.4 Type of needles

14.5 Sie of injection

14.6 Method

14.7 Complications

14.8 IOO₃ T Administration of SSO₃ under microbubling

14.9 Recommended Clinical Protocol

14.10 Protocol Used in the Treatment of Acute Infections (e.g. Osteomyelitis).

15. APPLICATION ROUTES NOT RECOMMENDED DUE TO BEING UNSAFE
16. ROUTES OF ADMINISTRATION THAT SHOULD NOT BE USED UNDER ANY CIRCUMSTANCES.

16.1. Inhalation Route

16.2. Direct Intravenous Injection (DIV)

16.3. High Dose Hyperbaric Multistep Method (OHT)

16.4. Intravenous Injection of Ozonized Glucose Solution

16.5. Autohemotherapy with Syringes

16.6. Ozonation of Saline Solution in a Plastic Bag with a Syringe by Beating the Bag

16.7. Intra-articular, Intravenous, or Fatty Tissue Injection of Ozonized Distilled Water Injection

17. APPLICATION ROUTES THAT HAVE NOT RECEIVED CONSENSUS.

17.1. Intraperitoneal route

17.2. Blood Irradiation during MAH

18. PATHOLOGIES MOST APPROPRIATE TO BE TREATED WITH OZONE.

18.1. Grades of Recommendation

18.2. Diseases in Level A

18.3. Diseases in Level B

18.4. Diseases in Level C

19. GENERAL BASES FOR OZONE TREATMENT.

19.1 Essential Requirements

19.2 Basic Rules for Ozone Therapy

———–

ADDENDUM A

APPLICATIONS OF OZONE IN DENTISTRY

THERAPEUTIC RANGES FOR THE USE OF OZONE IN DENTRISTRY

INDEX

1. INTRODUCTION
2. BASIC PRINCIPLES

2.1. Safety precautions

2.2. Ozone, Ozonized Water and Oils, and Related Factors

2.3. Oxygen Source Dilemma

2.4. Ozone-Compatible Materials

2.5. Ozonized Bidistilled Water

2.6. Ozonized Oils

2.7. The Concept of Disinfection Kinetics

2.8. Ozone Ranges and Concentrations of Ozonated Water

2.9. Introduction of Microbubbling Ozonized Saline Solution in Dentistry

3. CLASSIFICATION OF DENTAL OZONE APPLICATIONS ACCORDING TO EVIDENCE-BASED MEDICINE
4. GENERAL CLINICAL INDICATIONS

4.1. Caries

4.1.1. Low-Severity Clinical Cases: Developmental Defects; Hypocalcification; Enamel-Only Caries; Partially Erupted Posterior Teeth

4.1.2. Moderate Severity Clinical Cases: Dentin Caries Affecting the Upper Third of the Crown……………

4.1.3. Moderate-High Severity Clinical Cases: Dentin Caries Affecting the Middle Third of the Crown

4.1.4. High Severity Clinical Cases: Caries in the Apical Third of Dentin

5. HYPERSENSITIVITY: NOT ASSOCIATED WITH CARIES

5.1. Radicular Root Canal Treatment amiento de Conducto Radicular

5.2. Regular Hygiene/Prophylaxis and Root Scaling

5.3. Periodontal Conditions

5.3.1. Gingivitis

5.3.2. Periodontitis

6. ORTHODONTICS
7. ORAL SURGERY

7.1. Pre-Surgical Conditioning

7.2. Ozone Activated PRP

7.3. Dental Extractions

7.4. Implants

7.5. Mucositis

7.6. Oral-sinus communication

8. CROWNS AND BRIDGES, VENEERS
9. SOFT TISSUE INJURIES
10. DENTAL WHITENING WITH OZONE
11. MAXILLARY OSTEONECROSIS
12. TEMPOROMANDIBULAR DISORDERS (TMD)

12.1. Biological foundations of ozone action in DTM

12.2. DTM Indications for ozone therapy in TMD

12.3. Preliminary evaluation and diagnostic criteria

12.4. Main symptoms associated with TMD

12.5. Recommended therapeutic approach

12.6. Joint pain (arthralgia, synovitis, capsulitis, intra-articular post-surgery)

13. REGISTRATION AND DOCUMENTATION
14. BIOSECURITY. WATER LINES IN THE DENTAL UNIT (LAUD) – WATER HEALTH THROUGHOUT THE DENTAL OFFICE

———–

 

ADDENDUM B

APPLICATIONS OF OZONE IN VETERINARY MEDICINE

 

THERAPEUTIC RANGES FOR THE USE OF OZONE IN VETERINARY MEDICINE AND CLINICAL APPLICATIONS

Guides for Small and Large Animals

 

INDEX

1. INTRODUCTION
   2. MAIN SYSTEMIC APPLICATION ROUTES

2.1. Major Autohemotherapy (MAH)
2.2. Minor Autohemotherapy (MiAH)
2.3. Rectal Insufflation (RIO₃)
2.4. Ozonized Saline Solution (O₃SS)
2.4.1. Table 1. Relationship between Species and Circulating Blood Volume for Calculating the Volume of O₃SS to be Administered.
2.4.2. Table 2. Calculation O₃SS Doses in Veterinary.
2.4.3. Table 3. Example of Calculating Ozone Concentration in O₃SS

and Volume of O3SS to Infuse.
3. LOCAL ROUTES OF ADMINISTRATION: SUBCUTANEOUS, INTRALESIONAL, BAGGING, VESICOURETHRAL-VAGINAL, INTRAARTICULAR, PARAVERTEBRAL, TRIGGER POINTS, OTIC, OZONATED OIL.
3.1. Subcutaneous
3.2. Intralesional
3.3. Bagging
3.4. Vesicourethral-Vaginal Route
3.5. Intraarticular, Paravertebral, Trigger Point pathways
3.6. Otic Route
3.7. Topical Application of Ozonized Oil
4. ADMINISTRATION ROUTES THAT SHOULD NOT BE USED UNDER ANY CIRCUMSTANCES
4.1. Nasal Inhalation
4.2. Intra-arterial injection
4.3. Direct Intravenous Ozone Injection
4.4. Intravenous Administration of Ozonized Glucose Serum
4.5. Ozonation of Saline Solution in a Plastic Bag with a Syringe by Beating the Bag
5. PATHS THAT HAVE NOT RECEIVED CONSENSUS AND ARE NOT
RECOMMENDED

5.1. Distilled Water Injection, Double-distilled Ozonized Intra-articular or Intravenous
6. MOST COMMON ROUTES OF ADMINISTRATION IN VETERINARY MEDICINE
6.1. Table 4. Main Application Routes of Ozone in Veterinary Medicine

7. MOST FREQUENT PATHOLOGIES TREATED WITH OZONE
   7.1 Table 5. Most Frequent Pathologies Treated with Ozone in Veterinary Medicine
   Table 5.1. Digestive Diseases
   Table 5.2. Hematological Diseases
   Table 5.3. Hepatic Diseases
   Table 5.4. Nephrological Diseases
   Table 5.5. Oncology
   Table 5.6. Odontology
   Table 5.7. Endocrine Diseases
   Table 5.8. Ophthalmology
   Table 5.9. Cardiorespiratory
   Table 5.10. Genitourinary Diseases
   Table 5.11. Dermatology
   Table 5.12. Neurology
   Table 5.13. Traumatology.
   8. OZONE THERAPY IN EQUINES AND CATTLE
   8.1. Systemic Routes
   8.1.1. Major Autohemotherapy (MAH)
   8.1.2. Minor Autohemotherapy (MiAH)
   8.1.3. Rectal Insufflation (RiO₃)
   8.1.4. Vaginal Insufflation (VIO₃)
   8.1.5. Ozonized Saline Solution (O₃SS)
   8.2. Local Routes.
   8.2.1. Distilled/Double-distilled Ozonized Water
   8.2.2. Intramammary Infiltration
   8.2.3. Bagging
   8.2.4. Ozonized oil
   8.2.5. Intraarticular Infiltration
   8.2.6. Intraperitoneal
   8.2.7. Infiltration in Oncology
   8.2.8. Fistulas
   8.2.9. Subcutaneous Administration
   8.2.10. Intradiscal
   8.2.11. Paravertebral/Intramuscular
   8.2.11. Paravertebral/Intramuscular
8. VARIOUS APPLICATIONS IN EQUINES
   Table 6. Ozone application in Equines
   Table 6.1. Laminitis

Table 6.2. Navicular Syndrome
Table 6.3. Pythiosis

Table 6.4. Myositis

Table 6.5. Intraarticular Infiltration

Table 6.6. Septic Arthritis

Table 6.7. Desmitis and Tendinitis

Table 6.8. Low Back Pain and Spinal Injury

Table 6.9. Muscle Atrophy

Table 6.10. Atrial Papillomavirus

6.11. Cutaneous Papillomavirus
Table 6.12. Idiopathic Dermatitis. Allergies

Table 6.13. Various Dermatitis

Table 6.14. Kerato Conjunctivitis

Table 6.15. Neonatal Hypoxemic Syndrome

Table 6.16. Foal Pneumonia

Table 6.17. Foal Diarrhea
Table 6.18. Herpes Virus

Table 6.19. Transient Management of Acute Intra-abdominal Abdomen Syndrome

Table 6.20. Peritonitis

Table 6.21. Peritesticular

Table 6.22. Post-Sochiectomy Fistula

Table 6.23. Postorchiectomy

Table 6.24. Intravaginal

Table 6.25. Chronic Intrauterine Endometritis

Table 6.26. Subclinical or Inflammatory Intrauterine Endometritis

Table 6.27. Improvement of Oogenesis and Spermatogenesis

Table 6.28. Perineoplasty

Table 6.29. Vulvoplasty

Table 6.30. Rectovaginal Fistula

Table 6.31. Gastric and/or Duodenal Ulcer

Table 6.32. Pododermatitis

Table 6.33. Subsolar Abscess

Table 6.34. Drainage of Abscesses

Table 6.35. Extraction

Table 6.36. Dental Fistula

Table 6.37. Athletic Performance

Table 6.38. Intravesical

Table 6.39. Wounds