Evaluation of Post-surgical Bacteremia with Use of Povidone-Iodine and Chlorhexidine During Mandibular Third Molar Surgery.

BACKGROUND: Microorganisms may invade the blood stream by oral routes through surgical procedures like extractions, fractured teeth and periodontal pockets. The incidence of bacteremia is 70-80 % following tooth extraction, sub gingival scaling and intra ligament injection.

AIMS AND OBJECTIVES: Aim of study was to evaluate and compare the efficacy of two topical antimicrobial agents for the prevention of post-surgical bacteremia during mandibular third molar surgery. And objectives were to suggest need of proper topical antimicrobial agents and select proper antibiotics before oral surgical procedures in high risk cardiac patients.

MATERIALS AND METHODS: Thirty patients with Class 1, Position B mesioangular impacted mandibular third molar were randomly included in study and divided into 3 groups, each group containing 10 patients. Group I; sterile water group, Group II: povidone-iodine (5 %) group, Group III: chlorhexidine (Q, 2 %) group, pre and post-surgical blood samples were collected and Microbiological analyses of the blood samples were done. The organisms were identified by standard method on grams staining and identification of bacterial species by biochemical tests.

RESULTS: The clinical parameters like oral hygiene index simplified and periodontal index of Russel showed that all patients in three groups had fair oral hygiene with simple gingivitis on mean. In some individuals with slightly higher OHIS and PI scores, bacteremia was noted. All the pre surgical blood samples were negative for the growth of bacteria after 7 days of culture. In total 30 patients, 12 subjects had postoperative bacteremia. Out of those 12 patients 6 cases (60 %) of group I showed positive bacterial growth in the post surgical blood sample, while 4 cases in group III and 2 cases (20 %) in group II showed the same.

CONCLUSION: Use of povidone-iodine and chlorhexidine prior to the oral surgical procedures decreases the incidence of bacteremia as compared to sterile water irrigation. Povidone-iodine significantly reduces the incidence bacteremia and number of organisms compared to chlorhexidine and sterile water.