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


Sahrmann, P; Manz, A; Attin, T; Zbinden, R; Schmidlin, P R (2015). Effect of application of a PVP-iodine solution before and during subgingival ultrasonic instrumentation on post-treatment bacteremia: A randomized single-center placebo-controlled clinical trial. Journal of Clinical Periodontology, 42(7):632-639.

Abstract

BACKGROUND: To assess the effect of concomitant subgingival rinsing with 10% PVP-iodine during subgingival instrumentation on the prevalence and magnitude of bacteremia 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 bacteremia between groups.
RESULTS: Of the 19 samples in each group, oral-borne bacteremia 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 bacteremia 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: Bacteremia after subgingival instrumentation with concomitant PCP-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. This article is protected by copyright. All rights reserved.

Abstract

BACKGROUND: To assess the effect of concomitant subgingival rinsing with 10% PVP-iodine during subgingival instrumentation on the prevalence and magnitude of bacteremia 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 bacteremia between groups.
RESULTS: Of the 19 samples in each group, oral-borne bacteremia 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 bacteremia 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: Bacteremia after subgingival instrumentation with concomitant PCP-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. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Preventive Dentistry, Periodontology and Cariology
04 Faculty of Medicine > Institute of Medical Microbiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:7 May 2015
Deposited On:19 Jun 2015 14:00
Last Modified:12 Jun 2016 00:00
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0303-6979
Additional Information:This is the peer reviewed version of the following article: Sahrmann P, Manz A, Attin T, Zbinden R, Schmidlin PR. 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; 42: 632–639. doi:10.1111/jcpe.12416, which has been published in final form at http://doi.org/10.1111/jcpe.12416. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Publisher DOI:https://doi.org/10.1111/jcpe.12416
PubMed ID:25950231

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