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

Background and Objective: 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 (I² = 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.