Objective To explore the effects of povidone-iodine (PVP-I) mouthwash on the α diversity of oral flora and the occurrence of gingivitis in adolescent orthodontic patients, and to compare it with chlorhexidine (CHX) mouthwash and sodium chloride (NaCl) mouthwash, and to evaluate its clinical feasibility and advantages in the oral hygiene management of orthodontic patients. Methods A total of 174 adolescent patients undergoing orthodontic treatment at the department of stomatology of Yingshan Hospital, West China Hospital of Sichuan University, from January 2020 to January 2025, were enrolled and divided into three groups according to the type of mouthwash used: NaCl group (n=76), CHX group (n=52), and PVP-I group (n=46). All patients received standardized oral hygiene education and used the assigned mouthwash for four consecutive weeks. Plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), simplified oral hygiene index (OHI-S), subjective scores, and gingival crevicular fluid inflammatory markers (TNF-α, IL-1β, IL-6, IL-17) were evaluated at baseline and 1, 4, and 12 weeks post-treatment, along with changes in oral microbiota α-diversity. Results At baseline, no significant differences were found among the three groups. After 1 and 4 weeks of treatment, PLI, GI, SBI, and OHI-S were significantly lower in the CHX and PVP-I groups than in the NaCl group. Microbiota diversity analysis showed significantly lower Shannon and Simpson indices in the CHX and PVP-I groups. Inflammatory factor analysis revealed that at week 4, TNF-α, IL-1β, IL-6, and IL-17 levels were significantly lower in the PVP-I group than in the NaCl group. Moreover, PVP-I group patients had the highest subjective scores for taste, freshness, mucosal comfort, and overall satisfaction, outperforming the CHX group. Conclusion PVP-I mouthwash has comparable efficacy to CHX in controlling plaque, alleviating gingivitis and reducing inflammatory responses, and has better patient tolerance. It can be used as an ideal clinical alternative.
Key words
orthodontics /
povidone-iodine /
chlorhexidine /
gingivitis
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