Iodine glycerin is prepared from iodine, potassium iodide and glycerin. It has the function of disinfection and antisepsis. Iodine has a strong killing effect on fungi, viruses, amoebas and gemmule cells. Glycerin, as a solvent and lubricant, has strong hygroscopicity and has a lubricating and astringent effect on the mucosa. Therefore, iodine glycerin has many uses in clinical practice.
Apical periodontitis caused by devitalizer
In the treatment of oral diseases, it is often seen that after arsenic devitalizer is sealed in, due to the patient’s reasons, the follow-up visit is not on time, causing arsenic apical periodontitis.
In practice, it is found that injecting 20% iodine glycerin into the periapical tissue has a good curative effect on arsenic apical periodontitis. It is better than using iodine glycerin cotton twist in 10 patients.
Typical case
Wang, female, 38 years old, came to the hospital for pulpotomy due to acute pulpitis of the second premolar on the left side of the mandible. After sealing in the devitalizer, she felt pain and returned for follow-up visit after 8 days. The devitalizer was removed and arsenic apical periodontitis was found. Treated by this method, there was no percussion pain and root filling. After follow-up observation, it was good.
- Treatment method
The devitalizer should be removed immediately, the pulp should be extracted, the root canal should be expanded and flushed, and the root canal should be dried. Then, under local anesthesia, insert the syringe needle of 20g/L iodine glycerin 0.5 that has been drawn into the root canal to the narrow place near the apical foramen and slowly inject it so that the iodine glycerin slowly infiltrates into the periapical tissue damaged by arsenic. The injection volume can be determined according to the resistance of pressure injection. Generally, injection for 15-30 seconds is sufficient. Then remove the syringe and seal 30G/L iodine glycerin cotton twist in the root canal. The patient should return for follow-up visit after 3 days. After 1-2 times of root canal dressing change with iodine glycerin cotton twist, there is no percussion pain, and root canal filling can be performed. - Precautions
Before injecting iodine glycerin, the root canal must be expanded.
This method should be carried out under local anesthesia to avoid severe pain during and after injecting iodine glycerin.
After injecting iodine glycerin, iodine glycerin cotton twist should also be sealed in the root canal. First, it can prevent the liquid injected into the periapical area from flowing back into the root canal. Second, a small amount of iodine glycerin on the cotton twist can infiltrate into the periapical tissue to increase the curative effect. - Effect
Among 10 patients with arsenic apical periodontitis within five years, 8 cases had good curative effect after treatment with this method. After follow-up observation, there was no abnormality. The other 2 cases failed twice with this method because the root canal was curved and small and could not be expanded.
Fistulous chronic apical periodontitis
Iodine glycerin has strong anti-inflammatory ability, little irritation to tissues, and is not easy to damage normal mucosa. At the same time, it has the characteristics of soothing, analgesic and promoting epithelial repair for inflamed and ulcerated mucosa. Zeng Xiaojuan reported that among 485 patients with fistulous chronic apical periodontitis, 0.5ml of iodine glycerin was inhaled with a syringe. The syringe was connected with a curved needle for flushing No. 7. It was inserted from the outer orifice of the gingival duct and iodine glycerin was injected into the fistula or abscess under pressure. The patient returned for follow-up visit after 1 week.
Result: After 486 teeth were medicated, 98% of the dental fistulas basically disappeared. After follow-up for 1 to 2 years after treatment, there was no recurrence of fistulas. A large number of studies have confirmed that the flora in the deep dentin of infected root canals and periapical lesions mainly consists of anaerobic bacteria and G+ bacilli and cocci. The iodine released by iodine glycerin has a strong lethality to these bacteria, which is important for the successful treatment of apical periodontitis clinically. This method is simple, safe and has a short course of treatment.
Burn of oral mucosa
Burns of oral mucosa often involve the pharynx and larynx. Coupled with the rich blood vessels and loose tissues around, the edema after burns is severe. If the burn wound on the perioral skin is deep, within 48 hours, the edema is easy to transfer to the soft tissues of the neck and throat, and it is extremely easy to cause asphyxia.
Iodine glycerin has a strong antibacterial and anti-inflammatory effect, can reduce local edema, promote the proliferation of capillaries, improve local microcirculation, and accelerate wound healing.
Li Shimin reported 12 patients, including 2 cases of simple oral mucosa burns, and 10 cases with esophageal and gastric mucosa burns and/or facial and neck burns. Among them, there were 7 cases of liquid scalds, 4 cases of injury caused by accidentally taking strong acid, and 1 case of injury caused by mistakenly using potassium permanganate solution.
Rinse with 0.02% furanilin solution for 5 minutes, rinse the oral cavity with 3% hydrogen peroxide and 0.9% sodium chloride solution in turn, gently wipe dry with dry gauze, and apply 2% iodine glycerin every 4 hours. 1.6 million u of penicillin sodium and 250ml of metronidazole injection were intravenously dripped once a day; the course of treatment was 3 to 7 days. All were fed through a nasogastric tube for 5 to 7 days. Patients with facial and neck burns were treated with 1% sulfadiazine silver paste on the wound surface by exposure therapy.
Result: The necrotic oral mucosa of 12 cases healed within 7 to 14 days after injury. In 3 cases of free oral recruitment, there was microstomia deformity due to deep burns of perioral skin. The rest 9 cases had good function and appearance.
Treatment of acute pericoronitis
Acute pericoronitis is most common in clinical practice as pericoronitis of the third mandibular molar. It is a mixed infection mainly caused by anaerobic bacteria. Iodine glycerin has the curative effect of sterilization and antisepsis.
Hu Yuming reported that there were 60 patients with acute pericoronitis, including 38 cases of 前倾 impacted mandibular third molar and 22 cases of buccal impacted mandibular third molar. Give oral cefalexin 0.5g, four times a day. Flush the pericoronal pocket with 3% hydrogen peroxide. Place the gelatin sponge strip soaked in iodine glycerin in the pericoronal pocket.
The longer retention time of iodine glycerin in the pericoronal pocket increases the curative effect, reduces the number of patient follow-up visits, and shortens the course of treatment.
At the same time, placing the gelatin sponge strip expands the closed pericoronal pocket opening, which is conducive to the drainage of inflammatory secretions and relieves pain symptoms. The gelatin sponge strip does not need to be removed and is dissolved and absorbed by itself. It is an effective method for treating acute pericoronitis.
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