THE EFFICACY OF SCALING AND ROOT PLANING WITH SUBGINGIVAL APPLICATION OF POVIDONE IODINE IN THE TREATMENT OF PERIODONTAL DISEASE AMONG ADULT PATIENTS COMPARED TO SCALING AND ROOT PLANING ALONE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective: The aim of this study was to research the efficacy of Povidone (PVP) Iodine as an adjunct to scaling and root planing (SRP) in reducing periodontal pocket depth (PPD) compared to scaling and root planing with water, saline, or no rinse in the treatment of chronic periodontitis among adult patients. Material and methods: An electronic search of the databases PubMed, EMBASE, Cochrane Library, Medline, and Dentistry & Oral Sciences Source (DOSS) were performed from 2010 up to January 2022. A single reviewer identified and selected screened abstracts and titles for possible inclusion, and assessed randomized, controlled clinical trials comparing the additional benefit of PVP-Iodine in the treatment of chronic periodontitis in adult patients. A meta-analysis was conducted to analyze the eight studies included. Results: The pool effects for split mouth design and randomized control trials was significant in favoring the control group. A mean reduction of periodontal pocket depth (PPD) favoring the control group was observed, this reduction was 0.93 mm, (95% CI: 0.66–1.2) (p = 0.00, fig. 2a) for split mouth design studies and a reduction of 0.61 mm, (95% CI: 0.2-1.02) (p=0.004, fig. 2b) for randomized controlled trials (RCTs). There was significant heterogeneity between the split mouth studies and RCTs, i2 = 89.7 and i2 = 83.9, respectively. The studies included administered different concentrations and irrigation frequencies of PVP-iodine, presented with different baseline pocket depths, and evaluated different teeth. Based on the studies included, there was no additional benefit of adjunct use of PVP-iodine with SRP in improving PPD reduction. Conclusion: The adjunctive use of PVP-iodine during scaling and root planing does not improvement pocket depth reduction. However, due to the high heterogeneity between studies more clinical trials should be conducted to evaluate PVP-iodine efficacy in deeper pockets.