Effect of application of a PVP-iodine solution before and during subgingival ultrasonic instrumentation on post-treatment bacteraemia: a randomized single-centre placebo-controlled clinical trial

J Clin Periodontol. 2015 Jul;42(7):632-9. doi: 10.1111/jcpe.12416. Epub 2015 Jun 11.

Abstract

Background: To assess the effect of concomitant subgingival rinsing with 10% PVP-iodine during subgingival instrumentation on the prevalence and magnitude of bacteraemia of oral origin.

Materials and methods: Subgingival instrumentation was performed with water or PVP-iodine rinse in patients with periodontitis. Prior to instrumentation, subjects gargled for 1 min with the allocated liquid. Pockets were then rinsed for 1 min and subgingivally instrumented with liquid-cooled (water/PVP-iodine) ultrasonic scalers (1 min). Two minutes later, a blood sample from the arm vein was drawn using a lysis centrifugation blood culture system for quantitative microbiological analysis. Non-parametric statistical tests were performed to assess differences in the prevalence and extent of bacteraemia between groups.

Results: Of the 19 samples in each group, oral-borne bacteraemia was detected in 10 of the control and 2 of the test samples. With an average of 3.0 [1; 5] colony forming units, significantly less bacteria and bacteraemia were found in the test group compared to the controls (12.2 [1; 46]) (p = 0.003). Anaerobic bacteria were not found in the test group.

Conclusions: Bacteraemia after subgingival instrumentation with concomitant PVP-iodine rinsing is reduced but not eliminated. Therefore, it might be recommended for patients at a high risk of endocarditis or infection of endoprostheses. However, preventive antibiotic treatment should not be omitted.

Keywords: RCT; antiseptics; bacteraemia; periodontitis; ultrasonic debridement.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacteremia / microbiology
  • Bacteremia / prevention & control*
  • Bacterial Load
  • Cross-Over Studies
  • Dental Scaling / instrumentation
  • Female
  • Gram-Negative Bacteria / classification
  • Gram-Positive Bacteria / classification
  • Humans
  • Male
  • Middle Aged
  • Mouth / microbiology
  • Mouthwashes / therapeutic use
  • Periodontal Attachment Loss / microbiology
  • Periodontal Attachment Loss / therapy
  • Periodontal Debridement / instrumentation
  • Periodontal Debridement / methods*
  • Periodontal Pocket / drug therapy
  • Periodontal Pocket / microbiology
  • Periodontal Pocket / therapy
  • Periodontitis / microbiology
  • Periodontitis / therapy*
  • Placebos
  • Povidone-Iodine / therapeutic use*
  • Ultrasonic Therapy / instrumentation
  • Ultrasonic Therapy / methods*

Substances

  • Anti-Infective Agents, Local
  • Mouthwashes
  • Placebos
  • Povidone-Iodine