Chronic periodontitis is a widespread condition, often managed through non-surgical procedures like scaling and root planing (SRP). But even with careful mechanical cleaning, outcomes can vary. Researchers have long looked for adjuncts to boost results, and one low-cost, readily available antiseptic—povidone-iodine (PVP-I)—is drawing renewed attention.
A systematic review published in the Journal of Periodontal Research evaluated the impact of PVP-I when used during SRP. The key question: does it offer a meaningful clinical advantage?
What the Review Looked At
The review included seven randomized controlled trials involving a total of 424 patients with chronic periodontitis. Each study compared traditional SRP with and without the addition of PVP-I, typically used as a rinse or irrigant during the procedure.
The primary outcome measured was probing pocket depth (PPD)—a critical marker of gum disease severity and treatment success. Secondary outcomes included clinical attachment level (CAL), bleeding on probing (BoP), and plaque index.
What the Evidence Showed
Across studies, PVP-I use resulted in a modest but statistically significant improvement in PPD, with an average additional reduction of 0.28 mm compared to SRP alone. While this may seem small, it represents a consistent clinical gain, especially in the context of chronic disease management.
The benefit was most pronounced in single-rooted teeth—such as incisors—where access during cleaning is easier. Re-treatment cases, where patients underwent SRP more than once, also saw greater improvement with PVP-I.
Importantly, the review found that higher concentrations or extended rinsing times did not enhance outcomes, suggesting that even low-dose, brief PVP-I application is effective. No adverse effects or complications were reported across any of the included trials.
Should Clinicians Use It?
The review's findings suggest that PVP-I is a safe and inexpensive adjunct to conventional periodontal care. While it doesn't dramatically change treatment outcomes, it provides a measurable benefit without increasing risk or cost. Compared to antibiotics, which carry concerns about resistance and side effects, PVP-I stands out as a low-impact, evidence-supported option.
Clinicians might consider using it particularly for:
- Single-rooted teeth with moderate to deep pockets
- Re-treatment cases or recurring periodontitis
- Patients who prefer non-antibiotic therapies
- Settings where cost or simplicity is a factor
Final Thoughts
Povidone-iodine may not be a breakthrough solution, but its consistent benefits—combined with safety, affordability, and ease of use—make it a valuable addition to the periodontal toolkit. For dental professionals seeking to improve SRP outcomes, especially in targeted cases, PVP-I offers a practical and research-backed adjunctive therapy.
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