Comparative evaluation of efficacy of subgingivally delivered 1.2% Atorvastatin and 1.2% Simvastatin in the treatment of intrabony defects in chronic periodontitis: a randomized controlled trial

Abstract

Background. Statins are the recently evolved agents that aid in periodontal regeneration and ultimately in attaining periodontal health. Atorvastatin (ATV) and Simvastatin (SMV) are specific competitive inhibitors of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. The current study was conducted to compare the effectiveness of 1.2% ATV and 1.2% SMV, in addition to scaling and root planing (SRP), in the treatment of intrabony defects in subjects with chronic periodontitis.Methods. Ninety-six individuals were categorized into three treatment groups: SRP plus 1.2% ATV, SRP plus 1.2% SMV and SRP plus placebo. Clinical parameters of full-mouth plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), and relative attachment level (RAL) were recorded at baseline before SRP and at 3, 6 and 9 months. Bone fill was assessed using percentage radiographic defect depth reduction at baseline, 6 months and 9 months.Results. Both ATV and SMV showed significant PD reduction and RAL gain than placebo. ATV group showed greater mean PD reduction and mean RAL gain as compared to SMV group at 3, 6 and 9 months. Furthermore, ATV group sites exhibited a significantly greater percentage of radiographic defect depth reduction (33.23 ± 3.11%; 34.84 ± 3.07%) as compared to SMV (30.39 ± 3.36%; 32.15 ± 3.37%) at 6 and 9 months.Conclusion. ATV resulted in greater improvements in clinical parameters with higher percentage of radiographic defect depth reduction as compared to SMV in the treatment of intrabony defects in CP subjects.

The Effectiveness of Local Atorvastatin in the Treatment of Moderate Periodontitis

“…Additionally, test site showed a significant reduction in all periodontal parameters (GI, PI, PPD, BOP, CAL) versus control group. These results came in agreement with Martande el al 35 , and sinjab et al; 56 they found that there was more improvement in clinical parameters (PI, PPD, CAL) of test group after locally application of statins as adjunctive to mechanical SRP than control group. Additionally, Rosenberg et al 57 reported that one month using of 2% ATV dentifrice for periodontitis patients, showed greater significant reduction in BOP and GI.…”

“…Periodontitis is a multi-factorial disease, resulting in the destruction of periodontal tissues, bone resorption and tooth loss. 35 Non-surgical periodontal therapy in moderate periodontitis is an effective treatment, 36 where local drug delivery is one of the best adjunctives. 37 ATV inhibits the secretion of cytokines in chronic inflammatory diseases.…”

Contribution of Statins towards Periodontal Treatment: A Review

“…Only 4 studies compared the outcomes obtained with more than one statin; however, contradictory results were observed. For instance, one study did not show any significant difference between atorvastatin and simvastatin [ 100 ], whereas better results were obtained with atorvastatin in another study [ 101 ]. Nevertheless, two studies highlighted greater efficacy with rosuvastatin in comparison with atorvastatin [ 20 , 102 ].…”

Efficacy of locally-delivered statins adjunct to non-surgical periodontal therapy for chronic periodontitis: a Bayesian network analysis

“…Seven trials employed allocation concealment [31–35, 37, 38]. All studies reported whether participants or study personnel were blinded, and three studies [30, 40, 42] did not report whether these groups were blinded to outcome assessment. After considering such little incomplete outcome data, reporting bias and other bias domains, all studies had a low risk of bias.…”