The Clinical Effectiveness of Subgingival Irrigation with Povidone-Iodine and Hydrogen Peroxide in Treatment of Moderate to Severe Chronic Periodontitis

Statement of Problem: Although mechanical debridement is considered as the conventional technique in the management of chronic periodontitis, the locally delivered antiseptic agents have also been investigated as an adjunctive therapy. The purpose of this study was to investigate the clinical effectiveness of subgingival irrigation with polyvinylpyrrolidone-Iodine (PVP-I) 10%, H2O2 3%, and the combination of both in the measurement of probing depth and plaque and gingival indices of patients with moderate to severe chronic periodontitis. In this double-blind randomized clinical trial, 16 patients with moderate to severe periodontitis were selected using the simple random sampling method. They had at least one tooth with a probing depth ≥5 mm in each quadrant and had undergone phase I of periodontal therapy one month after dental scaling, The initial probing depth, plaque, and gingival indices were recorded and the selected teeth were randomly irrigated with PVP-I 10%, H2O2 3%, H2O2 3% + PVP-I 10%, or normal saline. The measurements were repeated five weeks after the procedure. The data were analyzed through running paired-samples t-test, analysis of variance (ANOVA), Wilcoxon Signed Rank Test, and Kruskal-Wallis Test. The mean differences in probing depth before and after subgingival irrigation in patients who were treated with normal saline, H2O2, PVP-I, and PVP + H2O2 were 1.29 mm, 1.35 mm, 1.47 mm, and 1.71 mm, respectively. This indi-cated a significant difference among all the groups (p <05(. Furthermore, PVP-I had a positive effect on the gingival index but it had no significant effect on the plaque index. Subgingival irrigation is an effective adjunctive therapy to mechanical debridement in treating moderate to severe chronic periodontitis.