title: 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.
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.
  
  
  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.
authors.affiliation: Clinic of Preventive Dentistry, Cariology and Periodontology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sahrmann
authors.affiliation: Clinic of Preventive Dentistry, Cariology and Periodontology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Manz
authors.affiliation: Clinic of Preventive Dentistry, Cariology and Periodontology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Attin
authors.affiliation: Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Zbinden
authors.affiliation: Clinic of Preventive Dentistry, Cariology and Periodontology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Schmidlin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D016470:Bacteremia / Q000382:microbiology / Q000517:prevention & control*; D058491:Bacterial Load; D018592:Cross-Over Studies; D012534:Dental Scaling / Q000295:instrumentation; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification; D006094:Gram-Positive Bacteria / Q000145:classification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology; D009067:Mouthwashes / Q000627:therapeutic use; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000628:therapy; D057747:Periodontal Debridement / Q000295:instrumentation / Q000379:methods*; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy; D010518:Periodontitis / Q000382:microbiology / Q000628:therapy*; D010919:Placebos; D011206:Povidone-Iodine / Q000627:therapeutic use*; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D010919:Placebos; D011206:Povidone-Iodine
keywords: RCT; antiseptics; bacteraemia; periodontitis; ultrasonic debridement