Patient-reported outcome measures comparing povidone iodine rinse and chlorhexidine rinse for dental implant therapy: a randomized controlled trial.

Abstract

Objectives: To evaluate patient-reported outcome measures (PROMs) of povidone-iodine rinse and chlorhexidine rinse for patients undergoing dental implant treatments, as well as their bacteriostatic efficacy.

Materials and methods: Patients needing implant or bone augmentation surgery were randomized into two groups: povidone-iodine(PVP-I) and chlorhexidine(CHX). On the first day after surgery, pain levels were assessed by Numerical Rating Scale (NRS) to compare the two mouthwashes. At two weeks post-surgery, wound healing was evaluated using the early wound healing index. Finally, patient-reported outcome measures (PROMs) were employed to compare each mouthwash's flavor, texture, and whether it caused irritation or mucosal staining. The significance of intergroup differences was tested using both an intention to treat and a per-protocol analysis.

Results: A total of 83 patients(with a median age of 43, 49 females) were enrolled and randomized. In general, both rinses were similarly favorable in terms of patient comfort. Notably, the postoperative pain NRS was significantly lower in the PVP-I group (1.68 ± 0.82) than in the control group (2.55 ± 1.38, p < 0.01). Regarding to wound healing, there was no significant difference in the Early Healing Index (EHI) between the two groups (Z = 0.351, p = 0.725). Regarding PROMs, at day 7, the swelling reduction was significantly greater in the PVP-I group (p = 0.031). Additionally, fewer participants in the PVP-I group (7%) reported mucosal irritation compared to the CHX group (29%) (p < 0.05), while other PROMs showed no significant differences in both groups.

Conclusions: Within the scope of this trial, PVP-I rinse demonstrated superior patient comfort (significantly lower postoperative pain intensity, less mucosal irritation, and greater swelling reduction at day 7) compared to CHX rinse, though both rinses showed comparable wound healing outcomes. PVP-I may serve as an alternative for dental implant therapy, but all mouthrinses should be used judiciously under clinical guidance.

Trial registration: The study protocol was registered at Chinese Clinical Trial Registry ( www.chictr.org.cn ) under registration number ChiCTR2500098491 on 10/03/2025 (retrospectively registered).