Efficacy of Povidone-Iodine in Reducing Pain and Swelling After Lower Third Molar Surgery: A Randomized Controlled Trial
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1050Abstract
Background: Postoperative pain and swelling are common complications after mandibular third molar extraction. Povidone-iodine, due to its antimicrobial and anti-inflammatory properties, may help reduce these symptoms.
Objective: To compare the efficacy of povidone-iodine and normal saline irrigation in minimizing postoperative pain and swelling following surgical removal of impacted lower third molars.
Methodology: This randomized controlled trial included 90 patients aged 18–45 years, divided equally into two groups: Group A received 0.5% povidone-iodine irrigation, and Group B received 0.9% sterile normal saline. Pain and swelling were assessed on postoperative Days 1, 3, and 7 using the Wong-Baker Faces Pain Rating Scale and linear facial measurements. Data were analyzed using SPSS v22, with repeated measures ANOVA and Chi-square tests (p<0.05 considered significant).
Results: Among 90 participants, 42 (46.7%) were male and 48 (53.3%) female. Both groups showed significant reduction in mean pain and swelling from Day 1 to Day 7 (p<0.001). Povidone-iodine showed slightly better early outcomes, but the overall difference between groups was statistically non-significant.
Conclusion: Both povidone-iodine and normal saline effectively reduced postoperative pain and swelling. Povidone-iodine offered minor early benefits and may be used as a safe, low-cost alternative for third molar surgery.
Keywords: Irrigation, Mandibular third molar, Povidone-iodine, Postoperative pain, Swelling.
References
Sharma Lamichhane N, Sigdel B, Lamichhane S, Tripathi R, Koirala U, Bajgain DP. Mandibular Third Molar Impaction among Patients Visiting Outpatient Dental Department of a Tertiary Care Centre. JNMA J Nepal Med Assoc. 2023;61(266):769-774. http://doi.org/10.31729/jnma.8295
Ishaque E, Punjabi SK, Qazi M, Hasan F, Memon ZA, Hassan S, et al. Comparison of Pain Determination Between Celecoxib Tramadol in Third Molar Surgery: Comparative Pain Management. PJHS-Lahore 2024 Jun. 30; 5(06):151-5. https://doi.org/10.54393/pjhs.v5i06.1532
Ahmed F, Baliga SD, Baliga SS, Rathi P, Jha G. Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial. Cureus. 2024;16(2):e53370. http://doi.org/10.7759/cureus.53370
Beuelman CJ, Van den Berg AJ, Hoekstra MJ, Reimer K, Mueller S. Anti inflammatory properties of a liposomal hydrogel with povidone iodine for wound healing in vitro. Burns. 2008;34(1):845-55. http://doi.org/10.1016/j.burns.2007.11.014
Hashemi HM, Mohammadi F, Hasheminasab M, Hashemi AM, Zahraei S, Hashemi TM. Effect of low concentration povidone iodine on posoperative complication after third molar surgery. J Oral Maxifac Surg. 2015;73(1):18-21. http://doi.org/10.1016/j.joms.2014.06.454
Otake H, Sato Y, Nakatani E. Oxytetracycline-hydrocortisone ointment reduces the occurrence of both dry socket and post-extraction pain after third molar extraction: An observational study. PLoS One. 2021;16(7):e0254221. Published 2021 Jul 2. http://doi.org/10.1371/journal.pone.0254221
Basha NA, Karkoutly M, Bshara N. Comparative efficacy of topical povidone-iodine and chlorhexidine gel on dental plaque regrowth in toddlers: A randomized controlled trial. Clin Exp Dent Res. 2023;9(5):764-771. http://doi.org/10.1002/cre2.755
Chorney SR, Rizzi MD, Dedhia K. Considerations for povidone-iodine antisepsis in pediatric nasal and pharyngeal surgery during the COVID-19 pandemic. Am J Otolaryngol. 2020;41(6):102737. http://doi.org/10.1016/j.amjoto.2020.102737
Zhang M, Jin J, Liu Y. Analysis of povidone iodine, chlorhexidine acetate and polyhexamethylene biguanide as wound disinfectants: in vitro cytotoxicity and antibacterial activity. BMJ Nutr Prev Health. 2023;6(1):21-27. http://doi.org/10.1136/bmjnph-2022-000431
Ghosh D, Bhardwaj S, Koyalada S. Comparison of efficacy of ozonated water, normal saline, and povidone-iodine after surgical removal of impacted mandibular third molars: A cross-sectional study. J Family Med Prim Care. 2020;9(8):4139-4144. http://doi.org/10.4103/jfmpc.jfmpc_534_20
Sabe-Alarab M, Al-Essa H, Jaber F, Saleh H. Role of povidone-iodine (PV-I) in surgical extraction of impacted lower third molars.: hemostyptic and anti-edema. Int J Appl Dent Sci. 2019;5:306-9.
Chappi DM, Suresh KV, Patil MR, Desai R, Tauro DP, Bharani SKNS, et al. Comparison of clinical efficacy of methylprednisolone, and serratiopeptidase for reduction of postoperative sequelea after third molar surgery. J Clin Exp Dent. 2015;7(2):197-202. http://doi.org/10.4317/jced.51868
Sruthy TV, Roshni A, Aslam S, Cherian MP, Soman S, Akhila K. Low-concentration povidone-iodine and normal saline as irrigant on reducing postoperative complications after the third-molar surgery: a comparative study. J Contemp Dent Pract. 2022 Jul 1;23(7):733-8. https://europepmc.org/article/med/36440521
Arakeri G, Brennan PA. Povidone-iodine: an anti-edematous agent?. International journal of oral and maxillofacial surgery. 2011 Feb 1;40(2):173-6. http://doi.org/10.4103/jioh.jioh_89_20
Argel S, Castaño M, Jimenez DE. Assessment of Bacterial Nanocellulose Loaded with Acetylsalicylic Acid or Povidone-Iodine as Bioactive Dressings for Skin and Soft Tissue Infections. Pharmaceutics. 2022;14(8):1661. http://doi.org/10.3390/pharmaceutics14081661
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 The authors retain the copyrights. Authors are permitted and encouraged to post their work online (e.g. in institutional repositories or on their website), as it can lead to productive exchanges, as well as greater citation of published work.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Readers may “Share-copy and redistribute the material in any medium or format” and “Adapt-remix, transform, and build upon the material”. The readers must give appropriate credit to the source of the material and indicate if changes were made to the material. Readers may not use the material for commercial purpose. The readers may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
