Adverse reaction to irrigation with povidone-iodine after deep-impacted, lower third molar extraction.

Abstract

Povidone-iodine is most commonly used worldwide because of its germicidal activity, relatively low irritancy or toxicity and low cost. Frequently, povidone-iodine is used as a topical antiseptic for treating and preventing wound infection. In rare cases skin irritation or iododerma-like eruption could represent possible adverse effects due to the oxidative effects of iodine and allergic hypersensitivity reaction. In this report we describe a case of a massive adverse reaction to the irrigation of surgical wound dehiscence with 10 percent povidone-iodine solution after deep-impacted, lower third molar extraction. This reaction was related to a central neurotrophic reflex involving three trigeminal branches and probably due to peripheral chemical insult of mandible nerve. This adverse reaction determined a severe edema and diffuse skin lesions, involving the whole left side of the face mimicking an iododerma-like eruption. These violent symptoms were solved after 60 days. Furthermore, we report a small permanent skin scar in the zygomatic area and transient alterations of facial sensitivity on the affected side which completely disappeared in 6 months.

• Authors: G Sammartino, M Tia, S Tete, L Perillo, O Trosino
• Journal: Journal of biological regulators and homeostatic agents (J Biol Regul Homeost Agents) 2012 Jan-Mar Vol. 26 Issue 1 Pg. 145-9 ISSN: 0393-974X [Print] Italy
• PMID: 22475107 (Publication Type: Case Reports, Letter)

Chemical References

• Anti-Infective Agents, Local
• Povidone-Iodine

Topics

• Adult
• Anti-Infective Agents, Local (adverse effects)
• Humans
• Male
• Molar, Third (surgery)
• Povidone-Iodine (adverse effects)
• Surgical Wound Dehiscence (complications)
• Therapeutic Irrigation (adverse effects, methods)
• Tooth Extraction (adverse effects)
• Tooth, Impacted