Using Povidone Iodine After Wisdom Teeth Removal

The article titled “Effect of Low-Concentration Povidone Iodine on Postoperative Complications After Third Molar Surgery: A Pilot Split-Mouth Study” written by Hamid Mahmoud Hashemi and et. al. appears in the January 2015 issue of the Journal of Oral and Maxillofacial Surgery (vol. 73, issue 1). The article discusses polyvinylpyrrolidone iodine which is a highly potent antiseptic solution known for its bactericidal activity. The authors performed a prospective randomized split mouth study of patients undergoing surgical removal of impacted mandibular wisdom teeth to evaluate whether diluted povidone iodine can be used as an irrigant and coolant and if it has any effect on common postoperative sequelae, including swelling, pain, and trismus.

A total of 30 healthy patients (18 to 25 yr old) with bilateral impacted mandibular wisdom with similar position and degree of impaction were recruited at Tehran University in Iran between March 2012 and September 2012. One impacted mandibular wisdom teeth in the first patient was randomly allocated to the study side by using a coin and the other side served as the control. In the subsequent patient, the opposite sides were allocated to the study and control groups. The teeth were removed under local anesthesia with 2% lidocaine and 1:80,000 epinephrine.

Ten percent povidone iodine 1 mL was diluted in normal saline 20 mL to obtain a 0.5% concentration of povidone iodine. Ten milliliters of this solution was diluted in normal saline 1,000 mL to obtain the povidone iodine concentration of 0.5 mg/mL. This solution was used as a coolant and irrigant during bone removal and tooth sectioning with burs in the study side, whereas sodium chloride 0.9% was used in the control side.

The average orotragus distance and mentotragus distance (indicator of swelling) was significantly shorter in the study group on postoperative days 2 and 7 than in the control group. The mean maximum interincisal opening was significantly larger on the povidone iodine side at the 2 postoperative visits. Nineteen patients (63.3%) claimed that they were more satisfied with the povidone iodine side, whereas 5 patients (16.6%) were more comfortable with the normal saline side. Six patients (20%) found no subjective difference between the 2 sides.

The authors state in the conclusion

“In summary, according to the present study results, it might be concluded that using povidone iodine at a low concentration is an inexpensive, safe, and effective method to decrease unavoidable edema and trismus after third molar surgery. It is advisable to compare the effect of different concentrations of povidone solution on postoperative sequelae in future studies.”

The end result is that treating the wisdom teeth sites with povidone iodine after surgery reduced the average amount of trismus and edema during the postoperative course when compared with normal saline.

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