Systematic review on the effect of rinsing with povidone-iodine during nonsurgical periodontal therapy

Abstract

The existing literature is inconsistent regarding whether there is any additional effect of povidone-iodine (PVP-iodine) as an adjunctive to scaling and root planing, and, if there is an effect, what its size is. Therefore, the aim of this study was to assess the additional effect of PVP-iodine as an adjunct to scaling and root planing compared with water, saline or no rinse in the treatment of chronic periodontitis. Material and methods: An electronic literature search of the databases PubMed, EMBASE and the Cochrane Central Library, and a handsearch, were performed (up to November 2008). Two reviewers independently identified and selected screened abstracts for possible inclusion, and assessed randomized, controlled clinical trials comparing the additional benefit of PVP-iodine with water, saline rinsing or no rinsing in the nonsurgical periodontal therapy of patients with chronic periodontitis. A fixed-effects meta-analysis was conducted in the absence of statistically significant heterogeneity. Results: A small, but statistically significant additional beneficial effect of the adjunctive use of PVP-iodine with enhanced probing pocket depth reductions of 0.28 mm (95% confidence interval: 0.08 to 0.48, p = 0.007) was found. There was no significant heterogeneity between studies (I(2) = 0%). However, most of the studies included in the meta-analysis were of low quality, and the treatment modalities showed various differences such as the use of PVP-iodine at different concentrations and application modalities. Nevertheless, single-rooted teeth, in particular, showed an additional benefit after scaling and root planing with PVP-iodine, particularly when the treatment was repeated during the healing stage. Conclusion: The adjunctive use of PVP-iodine during scaling and root planing may increase the clinical pocket depth reduction, although the clinical significance is small to moderate. were of low quality and the treatment modalities showed various differences like the use of PVP-iodine in different concentrations and application modalities.Nevertheless, especially single-rooted teeth showed an additional benefit after scaling and root planing with PVP-iodine, particularly when the treatment was repeated during the healing. Conclusion:The adjunctive use of PVP-iodine during scaling and root planing may increase the clinical pocket depth reduction, although the clinical significance is small to moderate.

Clinical and Microbiologic Results 12 Months After Scaling and Root Planing With Different Irrigation Solutions in Patients With Moderate Chronic Periodontitis: A Pilot Randomized Trial

“…Here, different baseline results for several bacterial species, such as A. actinomycetemcomitans, P. gingivalis , or T. denticola , could also mask some advantages of povidone–iodine. The findings of our study correspond with the systematic review by Sahrmann et al, 47 where a small to moderate clinical significance of the use of povidone–iodine was described. Our study also shows that SRP of high quality and under good conditions cannot be improved further by additional means during treatment.…”

Antimicrobial Advances in Treating Periodontal Diseases

“…Another systematic review found no significant benefit from supplementing full-mouth debridement with chlorhexidine irrigation [68]. A recent systematic review specifically addressed rinsing with povidone-iodine during nonsurgical periodontal therapy [69]. A small but statistically significant beneficial effect of pocket rinsing in terms of probing depth reduction was found.…”

Clearance of topically-applied PVP-iodine as a solution or gel in periodontal pockets in men

“…A recent systematic review on this topic showed evidence for an improved therapeutical effect regarding pocket depth reduction, when PVP-iodine was used during scaling and root planing [30].…”