Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, The Stomatological Hospital of Chongqing Medical University, Chongqing, China.
Department of Oral and Maxillofacial Surgery, The Stomatological Hospital of Chongqing Medical University, Chongqing, China.
Clin Oral Investig. 2022 Jan;26(1):705-711. doi: 10.1007/s00784-021-04048-7. Epub 2021 Jul 1.
Absorption of iodine through skin and an increased incidence of thyroid disorders due to iodophor exposure are reported. However, the risk of oral transmucosal absorption of povidone-iodine after intraoral preparation is not clear.
To investigate the possibility of oral transmucosal absorption of povidone-iodine after intraoral preparation and its effect on thyroxine level in blood.
A randomized controlled study was carried out in the department of oral and maxillofacial surgery. Twenty- to 40-year-old healthy male adults planning to receive oral surgery under general anesthesia were enrolled. The study group received povidone-iodine irrigation of oral cavity for 3 min as intraoral preparation before operation. The control group received chlorhexidine gluconate irrigation of oral cavity for 3 min as intraoral preparation before operation. Iodine levels in blood and urine, and thyroxine levels in blood were tested and compared, before and after operation.
RESULT(S): In total, 24 patients were included and analyzed finally. We found that after intraoral preparation with povidone-iodine, serum iodine level increased significantly to 2-3 times the pre-operation level in 15-30 min, and the urinary iodine level increased to 5 times the pre-operation level on the first day after operation. Iodine levels in blood and urine decreased significantly on the third day after operation but still significantly greater than the pre-operation levels. However, thyroxine levels were not altered accordingly.
CONCLUSION(S): Oral transmucosal absorption of iodine is observed when povidone-iodine is used for intraoral preparation in healthy male adults, though the free thyroxine in blood is not affected accordingly.
Povidone-iodine is commonly used as an antiseptic in oral surgery and dental clinics. Based on our findings that iodine levels in blood and urine may elevate significantly after intraoral preparation with povidone-iodine prior to oral surgeries, care must be taken for individuals when excess iodine intakes can endanger the safety of the patient.
Name of the trial registry: The Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ). Registration number: ChiCTR2100042028.
据报道，碘通过皮肤吸收以及由于碘伏暴露而导致甲状腺疾病发病率增加。然而，口腔黏膜内的碘伏经口黏膜吸收的风险尚不清楚。
研究口腔内准备后碘伏经口黏膜内吸收的可能性及其对血液中甲状腺素水平的影响。
在口腔颌面外科进行了一项随机对照研究。纳入计划在全身麻醉下接受口腔手术的 20 至 40 岁健康成年男性。研究组在手术前用碘伏冲洗口腔 3 分钟进行口腔内准备。对照组在手术前用葡萄糖酸氯己定冲洗口腔 3 分钟进行口腔内准备。手术前后检测并比较血碘和尿碘水平以及血甲状腺素水平。
共有 24 例患者最终纳入分析。我们发现，用碘伏进行口腔内准备后，血清碘水平在 15-30 分钟内显著增加至术前水平的 2-3 倍，术后第 1 天尿碘水平增加至术前水平的 5 倍。术后第 3 天血碘和尿碘水平显著下降，但仍明显高于术前水平。然而，游离甲状腺素水平并未相应改变。
健康成年男性在口腔手术和牙科诊所中使用碘伏进行口腔内准备时，观察到碘经口腔黏膜内吸收，尽管血液中的游离甲状腺素未受影响。
碘伏常用于口腔手术和牙科诊所的消毒剂。基于我们的发现，在口腔手术前用碘伏进行口腔内准备后，血碘和尿碘水平可能会显著升高，因此对于接受过多碘摄入可能危及患者安全的个体，必须谨慎。
试验注册名称：中国临床试验注册中心（http://www.chictr.org.cn/）。注册号：ChiCTR2100042028。
