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

• Published in: Journal of clinical periodontology Vol. 42; no. 7; pp. 632 - 639
• Main Authors: Sahrmann, Philipp, Manz, Andrea, Attin, Thomas, Zbinden, Reinhard, Schmidlin, Patrick R.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.07.2015
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local - therapeutic use; antiseptics; bacteraemia; Bacteremia - microbiology; Bacteremia - prevention & control; Bacterial Load; Clinical trials; Cross-Over Studies; Dental Scaling - instrumentation; Dentistry; Female; Gram-Negative Bacteria - classification; Gram-Positive Bacteria - classification; Gum disease; 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; Periodontitis - microbiology; Periodontitis - therapy; Placebos; Povidone-Iodine - therapeutic use; RCT; ultrasonic debridement; Ultrasonic Therapy - instrumentation; Ultrasonic Therapy - methods; RCT; antiseptics; ultrasonic debridement; bacteraemia; periodontitis
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.12416

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.