In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites.
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In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites.
Background and Objectives: This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone–iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy.
Materials and Methods: Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone–iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months.
Results: After three months, notable differences were found in the bacterial detection scores for
Porphyromonas gingivalis (a significant reduction in detection frequency was observed in the test compared to the control (
p = 0.021)), and there were significant reductions in detection in the test group for
Tannerella forsythia and
Treponema denticola, showing undetectable levels (
p < 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly (
p = 0.0005); similarly, bleeding on probing showed a marked decrease (
p < 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant.
Conclusions: Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations.
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