povidone-iodine and Dental-Plaque

Little has been written about mouth hygiene measures during the immediate postoperative phase in patients with oral cancer. Mouth hygiene not only involves the care and maintenance of the dentition and its related structures, but also the maintenance of surgical sites, reconstructive techniques such as free flaps and generally keeping the mouth clean, which may optimize healing potential and patient comfort. Ward conditions and novel methods of reconstruction require innovation and improvisation of routine methods of mouth and oral hygiene.. A review of techniques of mouth hygiene used during the immediate post-operative phase by our unit over the last nine years and a review of the literature.. Various methods gained from our experience in treating patients with oral cancer at the Austin and Repatriation Medical Centre are documented. Most methods involve a combination of either chlorhexidine or normal saline mouth rinses and mechanical cleaning.. There are many different methods of mouth care in patients who have had resection for oral tumours. It is important for dental practitioners, hygienists and allied health professionals, who may be involved with care of such patients to have an understanding of the methods that are available and appropriate for such patients.

Topics: Anesthetics, Local; Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Humans; Hydrogen Peroxide; Mouth Neoplasms; Mouthwashes; Oral Hygiene; Oxidants; Patient Care Planning; Postoperative Care; Povidone-Iodine; Sodium Chloride; Surgical Flaps; Toothbrushing; Wound Healing

Plaque control can be achieved by mechanical means. Since plaque removal can be laborious and difficult, chemical agents became important adjuncts to traditional oral hygiene procedures. Chlorhexidine is one of the synthetic antiseptics that has a unique antiplaque effect and 0.2% chlorhexidine can achieve a practically complete plaque control. It has one negative effect namely an extrinsic brown-yellow staining. Listerine has proven its ability to reduce plaque and gingivitis in a moderate way. Hexetidine has a greater antiplaque effect in combination with zinc and can be compared with a 0.1% chlorhexidine. Povidone-iodine can not be used to keep plaque at low levels. Sanguinarine can reduce plaque accumulation when the toothpaste and mouthrinse are used together. H2O2 is an antiplaque agent but has some negative effects such as ulcerations... One can conclude that the use of a chemical agent cannot replace a good mechanical plaque control but is rather an adjunct to oral hygiene under certain conditions.

Topics: Alkaloids; Anti-Infective Agents; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Hexetidine; Isoquinolines; Mouthwashes; Povidone-Iodine; Salicylates; Terpenes

A number of mouthrinse formulations containing antimicrobials have been evaluated to determine their effectiveness as antiplaque and/or antigingivitis agents. These have included the bis-biguanides, phenols, quaternary ammonium compounds, oxygenating compounds, plant extracts, fluorides, antibiotics and antimicrobial combinations. These mouthrinses have often been tested as adjuncts to normal oral hygiene procedures as well as in the experimental gingivitis model. 2 agents in particularly, chlorhexidine gluconate and listerine, have been shown to both inhibit or reduce plaque accumulation and the severity of gingivitis. Chlorhexidine has been reported to reduce the accumulation of plaque by approximately 60% and the severity of gingivitis by 50-80% as determined by improvements in clinical indices. A 0.12% chlorhexidine gluconate rinse resulted in significant reductions after both 3 and 6 months use in the numbers of total anaerobes, total aerobes, streptococci, and actinomyces recovered from supragingival plaque. Listerine has been reported to retard the development of plaque by 45 to 56% and to reduce existing plaque by 39 to 48%. Gingivitis scores were reduced as much as 59%. Microbial studies have shown that the effect of listerine is exerted against the total microbial mass and results in an overall decrease in both the biomass and the activity. Long-term use of neither mouthrinse, chlorhexidine or listerine, resulted in the emergence of opportunistic or oral pathogens. Preliminary data obtained following the use of a novel mouthrinse consisting of a combination of povidone-iodine and hydrogen peroxide appears promising. This combination was more effective than was more effective than either single component alone in reducing gingivitis scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Hydrogen Peroxide; Mouthwashes; Povidone-Iodine; Salicylates; Terpenes

This study aimed to compare and evaluate the efficacy of topical use of povidone-iodine (PVP-I) solution and chlorhexidine (CHX) gel on dental plaque regrowth after 3 and 7 days in toddlers aged 24-36 months.. A randomized controlled trial that included 45 healthy toddlers aged 24-36 months, who were randomly assigned to three groups. The first group received a placebo (distilled water (DW)) (negative control). The second group received topical CHX gel (0.2% w/v) (positive control). The third group received topical PVP-I solution (10% w/v). Plaque accumulation was measured at the baseline (t. In the DW group, the mean of the TMQHPI score was 1.89 ± 0.67 at t. CHX and PVP-I efficacy lasted only for 3 days, and PVP-I was not superior to CHX in terms of plaque control in toddlers. However, further studies are needed to determine the long-term efficacy of these antiplaque agents in toddlers.

Topics: Anti-Infective Agents, Local; Child, Preschool; Chlorhexidine; Dental Plaque; Humans; Mouthwashes; Povidone; Povidone-Iodine

The aim of this study is to determine in a randomized trial the impact on treatment outcome after 12 months of different subgingival irrigation solutions during scaling and root planing (SRP).. Fifty-one adult volunteers with generalized chronic periodontitis were treated by full-mouth SRP using 0.9% sodium chloride, 0.12% chlorhexidine digluconate, or 7.5% povidone-iodine for subgingival irrigation during SRP. Before SRP and after 3 and 12 months, probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded. Subgingival plaque samples were analyzed for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola.. PD, CAL, and BOP were significantly improved in all groups after 12 months (P <0.001 to P = 0.044). No significant differences were seen among the groups for all sites and sites with 4 to 6 mm PD at baseline. The povidone-iodine group had the highest clinical improvements. The counts of A. actinomycetemcomitans and P. gingivalis were significantly reduced after 12 months (P = 0.045 and P = 0.002) using povidone-iodine. Significant differences between the groups were seen after 3 months for A. actinomycetemcomitans and P. gingivalis, and after 12 months for T. forsythia.. No differences were seen among the groups in the clinical results after 12 months. Regarding the microbiologic results, a slight benefit seemed to derive from the use of povidone-iodine.

Topics: Adult; Aged; Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacterial Load; Bacteroides; Biofilms; Chlorhexidine; Chronic Periodontitis; Dental Plaque; Dental Scaling; Female; Follow-Up Studies; Gingival Hemorrhage; Humans; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Pocket; Pilot Projects; Porphyromonas gingivalis; Povidone-Iodine; Root Planing; Sodium Chloride; Therapeutic Irrigation; Treatment Outcome; Treponema denticola

Treating a carious tooth in children with high caries experience by providing a restoration does not cure the disease. If the unfavorable oral environment that caused the cavity persists so will the disease and more restorations will be required in future. Treating the oral infection by reducing the number of cariogenic microorganisms and establishing a favorable oral environment to promote predominantly remineralization of tooth structure over time will stop the caries process. The present study was conducted: (1) To evaluate the efficacy of povidone-iodine and chlorhexidine mouth rinses on plaque Streptococcus mutans when used as an adjunct to restoration. (2) To compare the anti-microbial effect of 1% povidone-iodine and 0.2% chlorhexidine mouth rinses on plaque S. mutans count.. Forty-five study participants in the age group of 6-12 years with dmft (decay component) of three or four were selected from one government school in Bangalore city. They were divided into three groups after the restorative treatment. Group-A, Group-B, and Group-C received 1% povidone-iodine mouth rinse, 0.2% chlorhexidine mouth rinse and placebo mouth rinse, respectively, twice daily for 14 days. The plaque sample was collected and S. mutans count was estimated at six phases: (1) Baseline, (2) 3 weeks after restoration, (3) First day after mouth rinse therapy, (4) 15 days after mouth rinse therapy, (5) 1 month and (6) 3 months after mouth rinse therapy. After the restoration the percentage change in S. mutans count was 28.4%. Immediately after mouth rinse therapy there was significant reduction in S. mutans count in all the three groups. After which the count started to increase gradually and after 3 months the bacterial counts in the povidone-iodine group and placebo group were almost near the postrestorative count.. Mouth rinses can be used as adjunct to restoration for short duration as temporary measure in reduction of S. mutans count and restorations provide longer effect. In case a mouth rinse has to be used, chlorhexidine can be recommended as it has shown to have better effect than Povidone-iodine and placebo.

Topics: Child; Chlorhexidine; Colony Count, Microbial; Combined Modality Therapy; Dental Caries; Dental Plaque; Dental Restoration, Permanent; DMF Index; Humans; Mouthwashes; Povidone-Iodine; Streptococcus mutans

The aim of this double blind study was to evaluate the effect of various mouthwashes: Chlorhexidine, Essential oil, Azadirachta indica (Neem) extract, and Povidone iodine on gingival tissue interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) levels in patients with chronic gingivitis. A total of 8O patients (42 boys, 38 girls; mean age 16.0 +/- 1.8 years) were included in this study. Patients were randomly assigned into four groups of 20 each: Group I--Azadirachta indica (Neem) extract, Group II--Essential oil, Group III--Povidone iodine, and Group IV--Chlorhexidine. They were instructed to use these mouthwashes for two weeks. Plaque and gingival indices scores, and IL-2 and IFN-gamma levels in the gingival tissues were measured at baseline and after two weeks of mouthwash use. Results showed the reduction of plaque and gingival indices, and IL-2 and IFN-gamma level with Chlorhexidine, Essential oil, and Povidone iodine, which were found to be statistically significant. Although Neem reduced the level of plaque and gingival indices, and IL-2 and IFN-gamma to a certain level, it was not statistically significant. Therefore, Chlorhexidine, Essential oil, and Povidone iodine mouthwashes can be used as an adjunct to oral prophylaxis in reducing pro-inflammatory cytokines, IL-2 and IFN-gamma in patients with chronic gingivitis.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Child; Chlorhexidine; Chronic Disease; Dental Care for Children; Dental Plaque; Dental Plaque Index; Double-Blind Method; Female; Gingiva; Gingivitis; Glycerides; Humans; Interferon-gamma; Interleukin-2; Male; Mouthwashes; Oils, Volatile; Periodontal Index; Plant Oils; Povidone-Iodine; Statistics, Nonparametric; Terpenes; Treatment Outcome

The aim of the present study was to evaluate the clinical effects of one-stage periodontal debridement with an ultrasonic instrument, associated with 0.5% povidone (pvp)-iodine irrigation in patients with chronic periodontitis.. Forty-five patients were randomly assigned into three groups: the control group (CG) received quadrant root planing at 1-week intervals over four consecutive sessions; the periodontal debridement plus pvp-iodine group (PD-PIG) received a 45-minute full-mouth debridement with an ultrasonic instrument, associated with 0.5% pvp-iodine irrigation; and the periodontal debridement group (PDG) received a 45-minute full-mouth periodontal debridement with an ultrasonic instrument, associated with NaCl irrigation.. At the 3-month evaluation, the mean probing depth (PD) reduction in CG was 2.51+/-0.52 mm, 2.53+/-0.50 mm in PD-PIG, and 2.58+/-0.60 mm in PDG (P<0.05). The clinical attachment level (CAL) analysis showed a statistically significant gain in all groups compared to baseline (1.87+/-0.56 mm [CG], 1.94+/-0.70 mm [PD-PIG], and 1.99+/-0.92 mm [PDG]). Intergroup analysis of PD and CAL at 1 and 3 months showed no differences (P>0.05). The N-benzoyl-L-arginine-p-nitroanilide (BAPNA) test showed a significant reduction in trypsin activity only during the first month (P<0.05); at 3 months there were no differences compared to baseline (P=0.80).. This study provides no evidence that pvp-iodine is effective as an adjunct for one-stage periodontal debridement.

Topics: Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Benzoylarginine Nitroanilide; Chronic Disease; Dental Plaque; Dental Scaling; Female; Humans; Male; Middle Aged; Periodontal Index; Periodontitis; Povidone-Iodine; Prospective Studies; Single-Blind Method; Statistics, Nonparametric; Treatment Outcome; Ultrasonic Therapy

The aim of this study was to compare serum antibody responses to periodontal pathogens after single-visit full-mouth ultrasonic debridement and quadrant-wise therapy.. Thirty-six subjects with chronic periodontitis were randomized into three groups: quadrant-wise debridement in four visits, one-visit full-mouth debridement with water and with povidone iodine. Blood samples were collected before and immediately after treatment and 1, 3 and 6 months post-therapy. Serum antibody titres and avidity to Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia and Treponema denticola were determined by enzyme-linked immunosorbent assay (ELISA) and thiocyanate ELISA, respectively.. IgG titres to P. gingivalis significantly decreased at 1, 3 and 6 months in full-mouth debridement with water group, while significant reductions were seen only at 3 and 6 months after quadrant-wise debridement. Both full-mouth groups showed significant reduction in IgG titres to A. actinomycetemcomitans at 3 and 6 months. Significant increases in antibody avidity to P. gingivalis and A. actinomycetemcomitans were noted 3 months following full-mouth debridement with povidone.. Both full-mouth and quadrant treatments generally resulted in a decrease in antibody titres and increase in antibody avidity. Full-mouth debridement induced an earlier reduction of IgG titre to P. gingivalis and A. actinomycetemcomitans, than quadrant-wise therapy.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Antibodies, Bacterial; Antibody Affinity; Chronic Disease; Dental Plaque; Follow-Up Studies; Humans; Immunoglobulin G; Periodontitis; Porphyromonas gingivalis; Povidone-Iodine; Prevotella intermedia; Saliva; Single-Blind Method; Subgingival Curettage; Treponema denticola; Ultrasonic Therapy

The purpose of the present study was to assess the effects of Nd:YAG laser irradiation into periodontal pockets with or without the combination of local antibiotic application on clinical parameters and microbiological prevalence. Sixteen patients, each of whom had 4 or more sites with probing depth e x 4mm were included in this study. They were monitored clinically and microbiologically at baseline, 1 and 3 months after the treatment. Subgingival plaque samples were taken from periodontally involved sites with a probing depth of e x 4mm. A total of 135 sites were randomly assigned to the following treatments; Nd:YAG laser alone (Group L: 10 pps, 200 mJ for 90 sec, n = 37), local minocycline administration following laser treatment (Group LP, n = 33), povidone-iodine irrigation following laser treatment (Group LI, n = 33), and control group (Group C: sham procedure, n = 32). The prevalence of 18 subgingival taxa were determined using the checkerboard technique. The mean value of the pocket probing depth (PPD) significantly decreased in Group L, Group LP and Group LI, and the mean clinical attachment loss (CAL) decreased in all three treatment groups. Multivariate logistic regression analysis showed that Group LP showed the most improvement in PPD or CAL at 3 months. The proportions of Porphyromonas gingivalis, Tannerella forsythia (formerly Bacteroides forsythus) and Prevotella intermedia were significantly lower in Group LP than in Group L after 3 months. These results showed that Nd:YAG laser irradiation plus local minocycline provides a much greater reduction in PPD, CAL and the amount of periodontopathogenic bacteria than laser irradiation alone in periodontitis patients.

Topics: Anti-Infective Agents, Local; Bacteria, Anaerobic; Bacterial Typing Techniques; Colony Count, Microbial; Dental Plaque; DNA, Bacterial; Humans; Laser Therapy; Logistic Models; Middle Aged; Minocycline; Neodymium; Nucleic Acid Hybridization; Periodontal Index; Periodontal Pocket; Povidone-Iodine; Statistics, Nonparametric

The aim of this randomized controlled clinical trial was to determine the effects of single-visit full-mouth ultrasonic debridement versus quadrant-wise therapy.. Thirty-six subjects with chronic periodontitis, were randomly allocated to three groups--quadrant-wise ultrasonic debridement, single-visit full-mouth ultrasonic debridement with povidone iodine and single-visit full-mouth ultrasonic debridement with water. Whole-mouth plaque, bleeding on probing (BOP), pocket depth and attachment level were recorded before treatment and 1, 3 and 6 months post-treatment. Plaque and saliva samples were collected for microbiological analysis.. After treatment, all groups showed significant improvement in clinical parameters. Full-mouth treatments resulted in similar improvements in full-mouth mean plaque percentage, probing pocket depth and probing attachment level as conventional therapy. When data were analysed based on pocket depth and tooth type, there was no difference between groups in probing depth reduction or attachment gains. The full-mouth groups demonstrated greater reduction in BOP% and number of pockets > or =5 mm and the total treatment time was significantly shorter. The detection frequencies of periodontal pathogens in plaque and saliva showed slight changes with no difference between groups.. Single-visit full-mouth mechanical debridement may have limited additional benefits over quadrant-wise therapy in the treatment of periodontitis, but can be completed in a shorter time.

Topics: Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Chronic Disease; Dental Plaque; Dental Scaling; DNA, Bacterial; Episode of Care; Female; Humans; Male; Middle Aged; Patient Satisfaction; Periodontal Index; Periodontitis; Povidone-Iodine; Saliva; Statistics, Nonparametric; Time Factors; Treatment Outcome; Ultrasonic Therapy

Povidone-iodine [polyvinylpyrrolidone-iodine complex (PVP-iodine)] might constitute a valuable adjunct to current periodontal therapy because of its broad-spectrum antimicrobial activity, low potential for developing resistance and adverse reactions, wide availability, ease of use, and low financial cost. This investigation employed a randomized, split-mouth study design to determine the microbiological and clinical effects of 10% PVP-iodine subgingival irrigation in periodontitis lesions showing radiographic evidence of subgingival calculus.. Sixteen adults having at least one periodontal pocket of 6 mm or more in each quadrant of the dentition and harboring one or more periodontopathic bacteria participated in the study. In each subject, a study site in each quadrant was randomly chosen to receive either subgingival irrigation with 10% PVP-iodine together with scaling and root planing, scaling and root planing alone, subgingival irrigation with 10% PVP-iodine, or subgingival irrigation with sterile saline. Prior to therapy and at 5 weeks post-treatment, microbiological culture was carried out without knowledge of the clinical status or the type of treatment rendered. A blinded clinical examiner determined presence of dental plaque, probing pocket depth, and gingival bleeding on probing. Microbiological and clinical data were analyzed using a repeated measures analysis of variance and Kruskal-Wallis rank test with the Tukey and Mann-Whitney post hoc tests.. At 5 weeks post-treatment, subgingival irrigation with PVP-iodine together with scaling and root planing caused a 95% or greater reduction in total pathogen counts in 44% of pockets having >/= 6 mm depth whereas scaling and root planing alone, povidone-iodine irrigation alone and water irrigation alone caused 95% reduction of total pathogens only in 6-13% of similar study sites (P = 0.02). Reduction in mean pocket depth was 1.8 mm for the PVP-iodine/scaling and root planing group, 1.6 mm for the scaling and root planing group, and 0.9 mm for the PVP-iodine and the saline monotherapy groups, with statistical significance reached for the scaling and root planing group vs. the PVP-iodine group (P = 0.04) and for the scaling and root planing group vs. the saline group (P = 0.02). Reduction in visible dental plaque, which ranged from 38% to 62%, showed no significant differences among treatment groups.. The addition of subgingival PVP-iodine irrigation to conventional mechanical therapy may be a cost-effective means of reducing total counts of periodontal pathogens and helping control periodontal disease. However, subgingival irrigation with PVP-iodine without concomitant mechanical debridement might not improve microbiological and clinical variables in comparison with saline irrigation, at least not in sites with radiographic evidence of subgingival calculus.

Topics: Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Colony Count, Microbial; Dental Calculus; Dental Plaque; Dental Scaling; Female; Humans; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Povidone-Iodine; Root Planing; Single-Blind Method; Statistics, Nonparametric; Therapeutic Irrigation

The dramatic increase in the number of dependent elderly in developed countries has created a great need for their improved oral care. However, optimal oral care by caregivers is not possible because of time constraints, difficulty involved in brushing other individuals' teeth, lack of co-operation, and the lack of perceived need. Therefore, the development of an effective instrument simplifying and supporting oral care to relieve the strain on caregivers is a matter of some urgency.. In order to clean the mouths of elderly dependent patients, we have developed a new oral care support instrument (an electric toothbrush in combination with an antibacterial-agent supply and suction system). The purpose of the present study was to develop and evaluate a new oral care support instrument.. a) Plaque removal study: The plaque- removing ability of this new instrument in 70 outpatients was compared with the Plak Control D9011 (Braun Gillette Japan Inc.) as a control by means of the Turesky modification of the Quigley and Hein plaque index. b) Clinical study: The subjects were 10 dependent elderly who received oral care using the new oral care support instrument for two weeks. The plaque and gingival indices were used for clinical evaluations.. a) Plaque removal study: Brushing with the new oral care support instrument removed significantly more plaque than with the Plak Control D9011. b) Clinical study: The new oral care support instrument allows a more effective removal of dental plaque and shows a significant improvement in the gingival indices in dependent elderly.. It is concluded that the new oral care support instrument is effective and can be recommended for oral care in the dependent elderly.

Topics: Administration, Topical; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Dental Care for Aged; Dental Care for Chronically Ill; Dental Care for Disabled; Dental Devices, Home Care; Dental Plaque; Equipment Design; Female; Health Education, Dental; Humans; Male; Middle Aged; Oral Hygiene; Periodontal Index; Povidone-Iodine; Toothbrushing

The present study was performed to assess the effect of topically-applied PVP-iodine, used as an adjunct both during basic non-surgical therapy and at re-treatment during the long-term maintenance of patients with advanced periodontal disease.. 223 patients with advanced destructive periodontitis were recruited. The participants met the following inclusion criteria: (i) a minimum of 8 non-molar teeth, (ii) probing pocket depth of > or = 6 mm at > or = 2 teeth in each dentate quadrant, and radiographic bone loss exceeding 40% at the same teeth. A baseline I examination included assessment of plaque, gingivitis, probing pocket depth (PPD), probing attachment level (PAL) and radiographic bone height (RxBL). Following baseline I, the patients were stratified into 2 treatment groups; 2 subjects out of 3 were included in a control group and 1 in a test group. All participants, on an individual basis, received a case presentation and were instructed in proper self-performed plaque control measures. Non-surgical therapy was performed by the use of an ultrasonic device. The instrumentation in the test group was combined with the administration of 0.1% PVP-iodine. All subjects were recalled for comprehensive examinations 3, 6 and 12 months (baseline II) after baseline I and then after 3, 5 and 13 years of maintenance therapy. PAL determinations were performed annually. Subjects (losers) who at the re-examinations after 1, 2 and 3 years of maintenance demonstrated an annual further loss of PAL > or = 2 mm at > or = 4 teeth were exited from the study and referred for re-treatment. There were 9 losers in the test and 31 in the control group. In addition, 8 subjects in the test and 25 subjects in the control group withdrew from the trial for reasons unrelated to the study. These 73 subjects were not included in the data presentation from the various examinations.. It was demonstrated that non-surgical periodontal therapy resulted in (i) improved gingival conditions, (ii) reduced PPD, (iii) gain in PAL. It was also documented that the topical application of 0.1% PVP-iodine in conjunction with the mechanical root debridement established conditions which further improved the outcome of therapy. This was evidenced by the fact that at the 3, 6, and 12 months re-examinations after baseline I, the test group had significantly lower mean PPD values and significantly more gain of PAL than the control group. During the 12 years of SPT, it was possible for most subjects in both groups to maintain shallow pockets and to avoid marked further loss of PAL. There were, however, a larger number of losers in the control than in the test group.. PVP-iodine, topically applied during subgingival instrumentation, may improve the outcome of non-surgical periodontal therapy.

Topics: Administration, Topical; Adult; Alveolar Bone Loss; Analysis of Variance; Anti-Infective Agents, Local; Chronic Disease; Dental Plaque; Dental Plaque Index; Dental Scaling; Female; Follow-Up Studies; Gingivitis; Humans; Iodophors; Longitudinal Studies; Male; Oral Hygiene; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Periodontitis; Povidone-Iodine; Statistics as Topic; Treatment Outcome; Ultrasonic Therapy

Periodontal disease is a common infection-induced inflammatory disease among individuals suffering from diabetes mellitus. The purpose of this study was to assess the effects of treatment of periodontal disease on the level of metabolic control of diabetes. A total of 113 Native Americans (81 females and 32 males) suffering from periodontal disease and non-insulin dependent diabetes mellitus (NIDDM) were randomized into 5 treatment groups. Periodontal treatment included ultrasonic scaling and curettage combined with one of the following antimicrobial regimens: 1) topical water and systemic doxycycline, 100 mg for 2 weeks; 2) topical 0.12% chlorhexidine (CHX) and systemic doxycycline, 100 mg for 2 weeks; 3) topical povidone-iodine and systemic doxycycline, 100 mg for 2 weeks; 4) topical 0.12% CHX and placebo; and 5) topical water and placebo (control group). Assessments were performed prior to and at 3 and 6 months after treatment and included probing depth (PD), clinical attachment level (CAL), detection of Porphyromonas gingivalis in subgingival plaque and determination of serum glucose and glycated hemoglobin (HbA1c). After treatment all study groups showed clinical and microbial improvement. The doxycycline-treated groups showed the greatest reduction in probing depth and subgingival Porphyromonas gingivalis compared to the control group. In addition, all 3 groups receiving systemic doxycycline showed, at 3 months, significant reductions (P < or = 0.04) in mean HbA1c reaching nearly 10% from the pretreatment value. Effective treatment of periodontal infection and reduction of periodontal inflammation is associated with a reduction in level of glycated hemoglobin. Control of periodontal infections should thus be an important part of the overall management of diabetes mellitus patients.

Topics: Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Arizona; Blood Glucose; Chlorhexidine; Dental Plaque; Dental Scaling; Diabetes Mellitus, Type 2; Doxycycline; Female; Glycated Hemoglobin; Humans; Indians, North American; Iodophors; Male; Middle Aged; Mouthwashes; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Pocket; Periodontitis; Placebos; Porphyromonas gingivalis; Povidone-Iodine; Subgingival Curettage; Ultrasonic Therapy

A trial was made comparing the effects of efficient and thorough removal of plaque and debris alone, and with a daily antiseptic mouthwash. The results showed considerable variation but no significant difference in gingival inflammation between hygienic treatment and a daily mouthwash with chlorhexidine-gluconate or povidone-iodine. Povidone-iodine caused less staining of the teeth than chlorhexidine-gluconate.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Clinical Trials as Topic; Combined Modality Therapy; Dental Care; Dental Plaque; Gingivitis; Humans; Mouthwashes; Oral Hygiene; Povidone; Povidone-Iodine; Random Allocation

A double blind crossover trial was carried out to assess the effect of povidone iodine on plaque accumulation in vivo and to measure the total salivary aerobes and anaerobes throughout the study. When compared to the placebo preparation, povidone iodine was without effect on plaque accumulation in all the subjects and there was a progressive increase in plaque throughout the 10-day periods. A 30 to 40 % overall reduction in aerobes and anaerobes occurred with the active preparation which was significant. There appears to be no indication for the use of povidone iodine as an adjunct to oral hygiene or in the treatment of chronic gingivitis.

Topics: Bacteria; Cell Count; Clinical Trials as Topic; Dental Plaque; Double-Blind Method; Humans; Mouthwashes; Placebos; Povidone; Povidone-Iodine; Saliva

Topics: Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Humans; Mouthwashes; Povidone-Iodine

The objective of this study is to evaluate the effect of short-term changes in the oral microbial ecology of dental plaque and plaque levels after topical treatment of a combination of 10% povidone iodine (PI) and 5% sodium fluoride varnish (FV).. A single group design intervention study on 12 pediatric patients, who underwent two baseline plaques samplings before the intervention, were enrolled in the study. A modified mixed dentition Silness-Löe plaque index score was used to assess plaque accumulation and microbial composition was assessed by amplicon sequencing analysis of the 16S rRNA V4 region.. Dental plaque accumulation (P = 0.0424) was reduced after 1 week using PI/FV application. This reduction was not observed between the two double-baseline visits. 16S rRNA analysis showed that the single PI/FV therapy did not have dramatic shifts in the plaque microbiome community depicted by hierarchical cluster and principle component analysis. More subtle changes were found when analyzing the Shannon diversity index after the application of PI/FV vs two baselines prior to combination therapy.. The bacteria within the dental biofilms showed resilience in maintaining the overall community diversity but reduced biofilm accumulation following PI/FV therapy. Repeated uses of PI/FV may augment plaque control during dental rehabilitation in children.

Topics: Anti-Infective Agents, Local; Biofilms; Cariostatic Agents; Child; Dental Plaque; Dental Plaque Index; Drug Combinations; Humans; Microbiota; Povidone-Iodine; Sodium Fluoride

Dental plaque is a biofilm that forms naturally on the surfaces of exposed teeth and other areas of the oral cavity. It is the primary etiological factor for the most frequently occurring oral diseases, such as dental caries and periodontal diseases. Specific, nonspecific, and ecologic plaque hypothesis explains the causation of dental and associated diseases. Adequate control of biofilm accumulation on teeth has been the cornerstone of prevention of periodontitis and dental caries. Mechanical plaque control is the mainstay for prevention of oral diseases, but it requires patient cooperation and motivation; therefore, chemical plaque control agents act as useful adjuvants for achieving the desired results. Hence, it is imperative for the clinicians to update their knowledge in chemical antiplaque agents and other developments for the effective management of plaque biofilm-associated diseases. This article explores the critical analysis of various chemical plaque control strategies and the current trends in the control and prevention of dental plaque biofilm.

Topics: Aloe; Benzhydryl Compounds; Biofilms; Cetylpyridinium; Chlorhexidine; Dental Plaque; Dextranase; Drug Combinations; Humans; Lippia; Morpholines; Periodontal Diseases; Phenols; Plant Extracts; Povidone-Iodine; Propolis; Salicylates; Terpenes

This paper reports on a mechanism to manage caries as a disease and to medically intervene in the disease process to halt progression. The goal of this paper is to provide this alternative to a surgical-only approach. The management of caries begins with assessing lesion activity and the potential for arrest. This requires a clinical and radiological assessment and evaluation of risk. Hopeless teeth are extracted and large cavities filled to reduce infection. Risk reduction strategies are employed so efforts to arrest lesions can be successful. Teeth with lesions in the enamel or outer third of the dentin should be sealed, not restored, as restorations can weaken teeth and can be traumatic to pulps.

Topics: Anti-Infective Agents, Local; Biofilms; Chewing Gum; Dental Caries; Dental Cavity Preparation; Dental Enamel; Dental Plaque; Dental Restoration, Permanent; Dentin; Disease Progression; Humans; Minimally Invasive Surgical Procedures; Physical Examination; Pit and Fissure Sealants; Povidone-Iodine; Radiography, Bitewing; Risk Assessment; Risk Reduction Behavior; Sweetening Agents; Tooth Extraction; Tooth Remineralization

The development of therapeutic agents inhibiting the activity of glucosyltransferases (GTF) and their production of glucans is a potential strategy to reduce dental decay. The aim of this study was first to characterize a GTF preparation from Streptococcus sobrinus ATCC 33478 and then to evaluate the effects of select compounds and mouthrinses on insoluble glucan (ISG) formation by combined GTFs.. The purity of the crude GTF mixture was assessed by electrophoresis. The effects of pH, temperature, sucrose, and dextran T10 concentrations on GTF activity were analyzed and the chemical structure of the products was investigated. Finally, the inhibition of GTF by commercial mouthrinses used in oral hygiene and their active components (chlorhexidine, polyphenolic compounds, fluoride derivatives, polyols, cetylpyridinium chloride, and povidone iodine) was analyzed through the reductions in the overall reaction rate and the quantity of ISG synthesized.. The S. sobrinus ATCC 33478 crude GTF preparation obtained contains a mixture of four different GTFs known for this species. For optimal adherent ISG formation, the reaction parameters were 37 degrees C, pH 6.5, sucrose 50 g/l, and dextran T10 2 g/l. Under these conditions, the most effective agents were chlorhexidine, cetylpyridinium chloride, and tannic acid. Eludril, Elmex, and Betadine were the most effective inhibitors of all the mouthrinses tested.. As the formulation of commercial products considerably influences the efficiency of active components, the fast representative ISG inhibition test developed in this study should be of great interest.

Topics: Anti-Infective Agents, Local; Cariostatic Agents; Cetylpyridinium; Chlorhexidine; Dental Plaque; Dextrans; Enzyme Inhibitors; Flavonoids; Fluorides; Glucans; Glucosyltransferases; Humans; Hydrogen-Ion Concentration; Materials Testing; Mouthwashes; Pharmaceutical Preparations, Dental; Phenols; Polymers; Polyphenols; Polysaccharides, Bacterial; Povidone-Iodine; Solubility; Streptococcus sobrinus; Sucrose; Tannins; Temperature

In the present study, we examined the effect of ozonated water on oral microorganisms and dental plaque. Almost no microorganisms were detected after being treated with ozonated water (4 mg/l) for 10 s. To estimate the ozonated water-treated Streptococcus mutans, bacterial cells were stained with LIVE/DEAD BacLight Bacterial Viability Kit. Fluorescence microscopic analysis revealed that S. mutans cells were killed instantaneously in ozonated water. Some breakage of ozonated water-treated S. mutans was found by electron microscopy. When the experimental dental plaque was exposed to ozonated water, the number of viable S. mutans remarkably decreased. Ozonated water strongly inhibited the accumulation of experimental dental plaque in vitro. After the dental plaque samples from human subjects were exposed to ozonated water in vitro, almost no viable bacterial cells were detected. These results suggest that ozonated water should be useful in reducing the infections caused by oral microorganisms in dental plaque.

Topics: Aggregatibacter actinomycetemcomitans; Biofilms; Cell Membrane Permeability; Chlorhexidine; Dental Plaque; Disinfectants; Humans; Mouth; Ozone; Porphyromonas; Povidone-Iodine; Sterilization; Streptococcus mutans

Non-surgical therapy, including scaling, root planing, and personal plaque control continues to be a powerful effective treatment modality for treating chronic periodontal diseases. Reports in the literature have suggested that adjunctive procedures such as systemic antibiotics and topical antiseptics may enhance the clinical outcomes of non-surgical treatment.. Three retrospective case reports spanning an evaluation period of 9-36 months are presented. The patients were treated in a private periodontal practice and had advanced periodontal disease. A significant positive clinical and radiographic response was achieved with non-surgical and adjunctive therapy.. The teeth that were treated initially had deep angular bony defects with probing depths ranging 5-8 mm. Following non-surgical and adjunctive therapy, probing depths were considerably reduced and ranged 3-5 mm. As well, a significant degree of radiographic osseous fill of the angular defects was observed.. In light of the dramatic healing responses observed in these cases, the healing potential of deep periodontal defects with non-surgical and adjunctive therapy requires further investigation. Once the critical elements contributing to the positive responses noted can be identified, then perhaps a more predictable outcome may be achieved in future cases.

Topics: Alveolar Bone Loss; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bone Regeneration; Combined Modality Therapy; Dental Plaque; Dental Scaling; Doxycycline; Female; Follow-Up Studies; Humans; Male; Middle Aged; Periodontal Pocket; Povidone-Iodine; Radiography; Retrospective Studies; Root Planing; Subgingival Curettage; Treatment Outcome

Topics: Anti-Infective Agents, Local; Bacteria; Bacterial Infections; Candida; Candidiasis; Child, Preschool; Dental Plaque; Humans; Opportunistic Infections; Povidone-Iodine; Saliva

New products and treatment modalities for the management of periodontal disease continue to offer the clinician a large number of choices, many of which involve antimicrobials. Specific pathogenic bacteria play a central role in the etiology and pathogenesis of destructive periodontal disease. Under suitable conditions, periodontal pathogens colonize the subgingival environment and are incorporated into a tenacious biofilm. Successful prevention and treatment of periodontitis is contingent upon effective control of the periodontopathic bacteria. This is accomplished by professional treatment of diseased periodontal sites and patient-performed plaque control. Attention to community factors, such as water contamination and bacterial transmission among family members, facilitates preventive measures and early treatment for the entire family. Subgingival mechanical debridement, with or without surgery, constitutes the basic means of disrupting the subgingival biofilm and controlling pathogens. Appropriate antimicrobial agents that can be administered systemically (antibiotics) or via local delivery (povidone-iodine) may enhance eradication or marked suppression of subgingival pathogens. Microbiological testing may aid the clinician in the selection of the most effective antimicrobial agent or combination of agents. Understanding the benefits and limitations of antibiotics and antiseptics will optimize their usefulness in combating periodontal infections.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacteria; Bacterial Infections; Biofilms; Child; Dental Plaque; Drug Combinations; Humans; Periodontal Diseases; Periodontitis; Povidone-Iodine; Subgingival Curettage

The object of this study was to monitor the proportion of vital bacteria (microbial vitality: VF in %) present in subgingival dental plaque following one single subgingival irrigation with saline (S), chlorhexidine (CHX) or povidone iodine (I2), but without any subgingival instrumentation. Its effect on the main composition of the microflora was also assessed. Seventeen patients with adult periodontitis took part in this investigation. In each patient four initially untreated pockets (pocket depth 5-11 mm) associated with bleeding were selected for the standardised pocket irrigation and plaque sampling at baseline (0 h) and after the following 1 h, 24 h, 7 days and 31 days. The subgingival irrigation was only performed once (0 h). One pocket per quadrant was irrigated using 0.9% prereduced S, 0.2% CHX or 0.05% I2 (Iso-Betadine Buccale). The remaining untreated pocket without any irrigation served as an additional control (C). Using an acrylic splint as a guide, paperpoints were inserted into the pocket precisely at the same site to collect subgingival plaque. The bleeding on sampling (BOS) was thereafter noted. The proportions of bacterial morphotypes were examined by darkfield microscopy. VF was evaluated using a vital fluorescence staining. The undisturbed subgingival dental plaque was composed of 86% (median value) vital bacteria. The sampling procedure alone and the saline irrigation led to a decrease in the number of spirochetes but had no influence on the vitality of the flora. Large variations in VF could be observed in the short-term (1 h, 24 h) irrigation effect of CHX and I2. The reduction of VF was still significant after 7 days (VF(CHX) 30-80%, VF(I2) 35-80%) but persisted up to 31 days only after I2 irrigation (VF(I2) 12-90%). The findings indicated that all single subgingival irrigations resulted in a temporary change of the subgingival microflora while povidone iodine produced the longest lasting antimicrobial effect. Any clinical advantage of this situation should be further investigated.

Topics: Adult; Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Coloring Agents; Dental Plaque; Female; Fluorescence; Follow-Up Studies; Gingival Hemorrhage; Humans; Male; Middle Aged; Periodontal Pocket; Periodontitis; Povidone-Iodine; Sodium Chloride; Spirochaetales; Therapeutic Irrigation; Treatment Outcome

12 patients (7 men and 5 women) with advanced periodontitis and probing depths of 4mm or more were selected to assess the effectiveness of an antiseptic: betadine used in situ, as a subgingival irrigation in periodontal pockets. Although widely used in other fields of medicine such as gynecology and dermatology, betadine has not been used in periodontology. However, betadine is an excellent antiseptic with a wide range of action. The slow release of iodine explains why this antiseptic is well tolerated by mucosae. The oral cavity was divided in 2 parts: the left side was irrigated with betadine while the right side was irrigated with saline which was used as a control. Irrigations were performed once a day during a period of 15 days. Patients were able to carry out the irrigations themselves after careful, instruction. Thc practitioner carried out the irrigation on day 0 and day 8. The comparison of clinical and histological data showed a decrease in gingival inflammation after 15 days of treatment. By means of the Student "t" test significant decreases in the plaque index, the gingival, index and the bleeding index were observed between day 0 and day 15 as well as a significant increase in recession. These clinical results were correlated with histological findings. Significant decreases in the volumetric density of the infiltrated connective tissue, the non collagenous structures and the number of plasma cells were observed as well as significant increases in the volumetric density of the non-infiltrated connective tissue of the collagenous structures and the number of fibroblasts.

Topics: Administration, Topical; Adult; Connective Tissue; Dental Plaque; Dental Plaque Index; Epithelium; Female; Gingivitis; Humans; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Periodontitis; Povidone-Iodine; Therapeutic Irrigation; Time Factors

The effects of ultrasonic scaling in combination with povidone-iodine solution were examined clinically. The results obtained were as follows: 1. Three days after instrumentation, significant improvement was found in all experimental groups. Thereafter the improvement was at the same level and backing in each group. 2. Clinical findings, with exception of plaque index, showed improvement with ultrasonic scaling in combination with povidone-iodine solution in comparison with ultrasonic scaling alone and root planing.

Topics: Combined Modality Therapy; Dental Plaque; Dental Plaque Index; Dental Scaling; Humans; Povidone-Iodine; Root Planing; Ultrasonic Therapy

Topics: Adult; Dental Plaque; Female; Gingiva; Humans; Male; Middle Aged; Periodontal Pocket; Periodontitis; Povidone; Povidone-Iodine; Therapeutic Irrigation; Water

Topics: Adult; Dental Plaque; Female; Humans; Male; Mouthwashes; Povidone; Povidone-Iodine; Thyroid Gland

The antibacterial activity of three iodine-containing compounds was determined for strains of four dental plaque-forming microorganisms, using an in vitro preclinical plaque model system. Solutions of inorganic iodine, povidone-iodine, and Wescodyne were tested for antiplaque activity against preformed plaques of a number of strains of Streptococcus mutans, Streptococcus sanguis, Actinomyces viscosus, and Actinomyces naeslundii. Solutions of inorganic iodine were more effective as antiplaque agents, with respect to minimal bactericidal concentration and time and frequency of treatments, than solutions of Wescodyne and povidone-iodine. Inorganic iodine appeared to be particularly effective against the most cariogenic (S. mutans) and periodontopathic (A. viscosus) organisms while allowing survival of the least orally pathogenic plaque-forming microorganism (S. sanguis). It is suggested that topical application of solutions of inorganic iodine may be useful in controlling dental caries and actinomyces-associated periodontal disease.

Topics: Actinomyces; Dental Plaque; Iodine; Microbial Sensitivity Tests; Polyethylene Glycols; Povidone-Iodine; Streptococcus; Streptococcus mutans; Streptococcus sanguis; Time Factors