Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements

Abstract

Objective: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I) used as an adjunct to non-surgical treatment of interproximal class II furcation involvements.

Material and methods: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD) ≥ 5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10%) as the cooling liquid (test group) or identical treatment using distilled water as the cooling liquid (control group). The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP), position of the gingival margin, relative attachment level (RAL), PPD and relative horizontal attachment level (RHAL). BAPNA (N-benzoyl-L-arginine-p-nitroanilide) testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation.

Results: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>0.05). These variables were, respectively, 2.20 ± 1.10 mm, 1.27 ± 1.02 mm and 1.33 ± 0.85 mm in the control group and 2.67 ± 1.21 mm, 1.50 ± 1.09 mm and 1.56 ± 0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain ≥ 2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD ≥ 5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group.

Conclusion: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits.

Figure 1

Bleeding on probing (BOP) of furcation involvements at different time intervals for control and test groups

Figure 2

Percentage of furcation involvements with probing pocket depth (PPD) ≥5 mm atdifferent time intervals for control and test groups. * Difference (p<0.05) between groups by chi-square test.

Figure 3

Percentage of furcation involvements that needed re-treatment at different time intervals for control and test groups