1%聚维酮碘漱口水联合龈下刮治与根面平整术治疗牙周炎的随机对照研究

doi:10.7518/hxkq.2025.2024326

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (3): 362-369.doi: 10.7518/hxkq.2025.2024326

1%聚维酮碘漱口水联合龈下刮治与根面平整术治疗牙周炎的随机对照研究

刘恩言¹(), 段丁瑜¹, 谢旭东¹, 李灏来², 李茂雪¹, 丁一¹()

^1.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院牙周病科，成都 610041
^2.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院国家药物/医疗器械临床试验机构，成都 610041

收稿日期:2024-09-02 修回日期:2025-02-16 出版日期:2025-06-01 发布日期:2025-06-10
通讯作者: 丁一 E-mail:liuenyanAPTX@163.com;yiding2000@126.com
作者简介:刘恩言，硕士，E-mail：liuenyanAPTX@163.com

Efficacy of 1% povidone-iodine mouthwash combined with scaling and root planing in the treatment of periodontitis: a randomized, controlled trial

Liu Enyan¹(), Duan Dingyu¹, Xie Xudong¹, Li Haolai², Li Maoxue¹, Ding Yi¹()

^1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & State Institute of Drug/Medical Device Clinical Trial, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-09-02 Revised:2025-02-16 Online:2025-06-01 Published:2025-06-10
Contact: Ding Yi E-mail:liuenyanAPTX@163.com;yiding2000@126.com

摘要/Abstract

摘要：

目的评价1%聚维酮碘（PVP-I）漱口水联合龈下刮治与根面平整术在Ⅰ/Ⅱ期A/B级牙周炎患者中的治疗效果，为PVP-I漱口水的临床应用提供依据。方法将75例受试者随机分为3组，在全口超声龈上洁治、龈下刮治与根面平整术（SRP）后，分别使用0.9%氯化钠注射液（NaCl组）、0.12%复方氯己定漱口水（CHX组）、1%PVP-I漱口水（PVP-I组）漱口1周。在SRP治疗后1、4、12周检测受试者临床指标、龈上菌斑微生物组成、龈沟液炎症标志物含量以及患者报告结局。结果 63例受试者完成随访，治疗后临床指标、微生物指标以及炎症指标均改善（P<0.05）。各组间比较，治疗后1周CHX组、PVP-I组的出血指数、菌斑指数低于NaCl组，CHX组菌斑指数低于PVP-I组（P<0.05），其余临床指标各组间差异均无统计学意义（P>0.05）。治疗后12周CHX组Shannon指数低于NaCl组（P<0.05），其余微生物指标各组间差异无统计学意义（P>0.05）。治疗后12周CHX组白细胞介素-10浓度高于NaCl组（P<0.05），其余炎症指标各组间差异均无统计学意义（P>0.05）。PVP-I组口感、口腔味道方面评分最高。3组的牙面及黏膜染色均不明显。结论 1%PVP-I漱口水联合SRP在短期内可有效减轻牙龈炎症，减少牙菌斑，改善临床症状。在疗效不明显劣于氯己定的同时，PVP-I漱口水患者接受度更高。

关键词: 牙周基础治疗, 龈下刮治与根面平整术, 聚维酮碘, 龈上菌斑, 龈沟液

Abstract:

Objective This study aimed to evaluate the therapeutic effect of 1% povidone-iodine mouthwash combined with scaling and root planing in patients with stage Ⅰ/Ⅱ class A/B periodontitis, and to provide a basis for the clinical application of povidone-iodine mouthwash. Methods Seventy-five subjects were included in this trial and randomly divided into three groups. After full-mouth ultrasonic supragingival cleansing, scaling and root planing, the placebo group was treated with sodium chloride injection (NaCl group), the control group was treated with compound chlorhexidine mouthwash (CHX group), and the experimental group was treated with 1% povidone-iodine mouthwash (PVP-I group), and rinsed their mouths for 1 week, respectively. Subjects were tested at 1, 4, and 12 weeks after dosing for clinical indicators, microbial composition of supragingival plaque, gingival crevicular fluid inflammatory marker levels, and patient-reported outcomes. Results Sixty-three subjects completed the follow-up. After treatment, the clinical indicators, microbial indicators, and inflammatory indicators were all significantly improved (P<0.05). Comparisons among the groups showed that one week after treatment, the bleeding index and plaque index of the CHX group and the PVP-I group were lower than those of the NaCl group, and the plaque index of the CHX group was lower than that of the PVP-I group (P<0.05). There were no statistically significant differences in the other clinical indicators among the groups (P>0.05). Twelve weeks after treatment, the Shannon index of the CHX group was lower than that of the NaCl group (P<0.05), and there were no statistically significant differences in the other microbial indicators among the groups (P>0.05). Twelve weeks after treatment, the interleukin-10 concentration of the CHX group was higher than that of the NaCl group (P<0.05), and there were no statistically significant differences in the other inflammatory indicators among the groups (P>0.05). The PVP-I group had the highest scores in terms of taste and oral odor. There was no obvious staining on the tooth surfaces and mucosa in all three groups. Conclusion 1% PVP-I mouthwash combined with scaling and root planing can effectively reduce gingival inflammation and dental plaque, improve clinical symptoms in the short term. While its efficacy is not significantly inferior to that of chlorhexidine, PVP-I mouthwash is more acceptable to patients than chlorhexidine.

Key words: initial periodontal therapy, scaling and root planing, povidone-iodine, supragingival plaque, gingival crevicular fluid

中图分类号:

R781.4

刘恩言, 段丁瑜, 谢旭东, 李灏来, 李茂雪, 丁一. 1%聚维酮碘漱口水联合龈下刮治与根面平整术治疗牙周炎的随机对照研究[J]. 华西口腔医学杂志, 2025, 43(3): 362-369.

Liu Enyan, Duan Dingyu, Xie Xudong, Li Haolai, Li Maoxue, Ding Yi. Efficacy of 1% povidone-iodine mouthwash combined with scaling and root planing in the treatment of periodontitis: a randomized, controlled trial[J]. West China Journal of Stomatology, 2025, 43(3): 362-369.

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项目		NaCl组	CHX组	PVP-I组
年龄/岁		35.4（24.8，48.4）	29.2（25.3，47.5）	33.6（28.5，53.0）
性别（男/女）		8/12	7/16	7/13
BI	基线	1.9±0.5	1.7±0.4	1.8±0.4
	治疗后1周	1.7±0.7	1.3±0.4*^&&	1.2±0.5*^&&
	治疗后4周	1.1±0.5^&&&▲	1.1±0.5^&&&	1.1±0.6^&&&
	治疗后12周	0.8（0.7，1.1）^&&&▲▲▲	0.9（0.4，1.1）^&&&▲▲	1.0（0.5，1.2）^&&&
PLI	基线	2.9±0.4	2.6±0.5	2.9±0.5
	治疗后1周	2.9（2.6，3.0）	1.5（1.3，2.0）**^&&&	2.1（1.7，2.4）**^##&&&
	治疗后4周	2.8（2.8，3.1）	2.7（2.5，2.8）^▲▲▲	2.8（2.4，3.2）^▲▲▲
	治疗后12周	3.0±0.5	2.7±0.4^▲▲▲	3.0±0.4^▲▲▲
SI	基线	0.2（0.0，0.3）	0.0（0.0，0.3）	0.1（0.0，0.4）
	治疗后1周	0.0（0.0，0.1）	0.1（0.0，0.2）	0.1（0.0，0.4）
	治疗后4周	0.0（0.0，0.1）	0.0（0.0，0.2）	0.1（0.0，0.2）
	治疗后12周	0.0（0.0，0.1）	0.0（0.0，0.1）	0.0（0.0，0.2）
PPD/mm	基线	2.6±0.3	2.6±0.5	2.7±0.3
	治疗后4周	2.4±0.9	2.4±0.4	2.5±0.4
	治疗后12周	2.4（2.3，2.6）	2.4（2.0，2.7）	2.5（2.3，2.7）
CAL/mm	基线	1.0（0.7，1.2）	1.1（0.7，1.6）	0.9（0.7，1.5）
	治疗后4周	0.8（0.4，1.1）	0.7（0.4，1.3）	0.7（0.4，1.3）
	治疗后12周	0.6（0.3，1.1）	0.6（0.5，1.1）	0.8（0.4，1.1）

项目		NaCl组	CHX组	PVP-I组
IL-1β/（pg/mL）	基线	46.5±3.5	46.6±23.4	45.5±3.7
	治疗后1周	44.4±5.1	45.9±4.7	45.9±5.9
	治疗后4周	44.6±2.4^#	45.2±2.5	44.4±4.3
	治疗后12周	45.1±5.7^#	41.9±4.3^##&	41.8±4.4^#&
IL-6/（pg/mL）	基线	31.5±1.5	31.2±2.3	30.3±5.8
	治疗后1周	30.6±2.3	30.9±2.0	31.1±2.3
	治疗后4周	31.0±1.8	28.5±2.5	30.4±1.5
	治疗后12周	29.7±2.6	27.1±2.2^#&	29.6±2.7
IL-10/（pg/mL）	基线	474.2±24.0	469.1±26.9	464.9±105.7
	治疗后1周	489.4±37.8	476.3±27.0	497.7±33.8
	治疗后4周	477.3±18.8	481.7±40.2	500.0±43.1
	治疗后12周	495.9±39.0	540.1±55.5*^###&▲	523.7±32.8^##
MMP-8/（ng/mL）	基线	24.2±1.9	24.6±1.7	24.3±2.0
	治疗后1周	22.9±1.4	24.2±2.1	23.0±1.8
	治疗后4周	23.4±0.9	22.7±1.0	22.1±1.7
	治疗后12周	21.8±2.0^###	20.6±2.0^###&&&	20.2±1.9^###

问卷题目	NaCl组	CHX组	PVP-I组
Q3您认为此漱口水口感怎样？	2.0（1.0，7.8）	6.0（5.0，8.0）*	8.0（8.0，8.8）**^#
Q4使用此漱口水以后，您感觉在正常进食或进饮等情况下，口腔中味道怎样？	2.5（1.0，8.0）	5.0（4.0，8.0）*	8.0（8.0，9.8）**^##
Q5使用此漱口水后，您感觉口内牙齿及黏膜的舒适度？	3.0（2.0，8.0）	7.0（5.0，10.0）*	8.0（8.0，10.0）**
Q6您认为使用此漱口水后，牙齿着色与染色情况的严重程度怎么样？	9.0（6.0，10.0）	8.0（5.0，10.0）	8.5（8.0，9.0）
Q7您认为使用此漱口水对您口腔健康的改善情况怎么样？	2.0（1.0，7.0）	8.0（5.0，10.0）**	9.0（8.0，9.0）**
Q8使用此漱口水后，您的总体满意度？	6.5（2.0，9.0）	8.0（5.0，9.0）	8.0（7.0，10.0）*

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Efficacy of 1% povidone-iodine mouthwash combined with scaling and root planing in the treatment of periodontitis: a randomized, controlled trial

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