Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis

Meza‐Mauricio, Jonathan; Soto-Peñaloza, David; Peñarrocha‐Oltra, David; Montiel-Company, José María; Peruzzo, Daiane Cristina

doi:10.1007/s00784-018-2507-x

Cited by 17 publications

(14 citation statements)

References 62 publications

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“…(A) Evidence‐based clinical relevance scale for interpreting MBL values. Format adapted from Meza‐Mauricio et al (2018) . (B) MBL in crestal‐positioned implants.…”

Section: Resultsmentioning

confidence: 99%

Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta‐analysis

Díaz‐Sánchez

Soto-Peñaloza

Peñarrocha‐Oltra

et al. 2019

J of Periodontal Research

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The present systematic review and meta‐analysis was carried out to determine the extent to which supracrestal tissue attachment (STA) thickness affects marginal bone loss (MBL) around dental implants. An electronic search was conducted in PubMed (MEDLINE), EMBASE, and complementary sources covering the period up to June 2018. The studies were meta‐analyzed based on implant position with respect to the alveolar bone crest (crestal/supracrestal). The MBL values were categorized according to STA width (thick/thin). Of the 1062 eligible titles, nine articles were included in the review. The implants were positioned crestal or supracrestal with respect to the alveolar ridge. The difference between (thin/thick) STA was statistically significant among analytical subsets in terms of lesser MBL (crestal‐positioned: weighted mean difference [WMD] = 0.52, 95% CI [0.03‐1.01]; P = 0.036; supracrestal‐positioned: WMD = 1.26; 95% CI [1.12‐1.39]; P = 0.00; pooled analysis: WMD = 0.73; 95% CI [0.033‐1.13]; P < 0.01). Implant positioning and patient age showed statistical significance in the meta‐regression analysis. The heterogeneity explained by age was R2 = 39.8%. Despite its limitations, the present study demonstrates that implants with thin STA result in greater MBL. There is moderate certainty of the evidence for a large effect of MBL prevention “in favor” of a thick STA environment in crestal‐positioned implants and the pooled analysis, but lesser certainty when only supracrestal‐positioned implants are considered. No trials studying this topic in subcrestal‐positioned implants were found.

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“…(A) Evidence‐based clinical relevance scale for interpreting MBL values. Format adapted from Meza‐Mauricio et al (2018) . (B) MBL in crestal‐positioned implants.…”

Section: Resultsmentioning

confidence: 99%

Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta‐analysis

Díaz‐Sánchez

Soto-Peñaloza

Peñarrocha‐Oltra

et al. 2019

J of Periodontal Research

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“…However, clinical trials investigating the effects of different statins on adjuvant treatment of CP are limited. To our knowledge, there are six meta-analyses comparing statins adjunctive to scaling and root planing (SRP) with SRP alone, however, they fail to measure the relative effects of various statins on CP without other systemic diseases [4, 17–21]. Therefore, a network meta-analysis which compares and ranks different statins should be beneficial to clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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

Cao

Chen

et al. 2019

BMC Oral Health

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Background Studies indicate locally-delivered statins offer additional benefits to scaling and root planning (SRP), however, it is still hard to say which type of statins is better. This network meta-analysis aimed to assess the effect of locally-delivered statins and rank the most efficacious statin for treating chronic periodontitis (CP) in combination with SRP. Methods We screened four literature databases (Pubmed, Embase, Cochrane Library, and Web of Science) for randomized controlled clinical trials (RCTs) published up to June 2018 that compared different statins in the treatment of chronic periodontitis. The outcomes analyzed were changes in intrabony defect depth (IBD), pocket depth (PD), and clinical attachment level (CAL). We carried out Bayesian network meta-analysis of CP without systemic diseases. Traditional and Bayesian network meta-analyses were conducted using random-effects models. Results Greater filling of IBD, reduction in PD, and gain in CAL were observed for SRP treated in combination with statins when compared to SRP alone for treating CP without systemic diseases. Specifically, SRP+ Atorvastatin (ATV) (mean difference [MD]: 1.5 mm, 1.4 mm, 1.8 mm, respectively), SRP + Rosuvastatin (RSV) (MD: 1.8 mm, 2.0 mm, 2.1 mm, respectively), and SRP + Simvastatin (SMV) (MD: 1.1 mm, 2.2 mm, 2.1 mm, respectively) were identified. However, no difference was found among the statins tested. In CP patients with type 2 diabetic (T2DM) or in smokers, additional benefits were observed from locally delivered statins. Conclusion Local statin use adjunctive to SRP confers additional benefits in treating CP by SRP, even in T2DM and smokers. RSV may be the best one to fill in IBD. However, considering the limitations of this study, clinicians must use cautious when applying the results and further studies are required to explore the efficacy of statins in CP with or without the risk factors (T2DM comorbidity or smoking history). Electronic supplementary material The online version of this article (10.1186/s12903-019-0789-2) contains supplementary material, which is available to authorized users.

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“…Regarding patient‐related endpoints, all patients reported a significant improvement in all outcomes. The pain measured by VAS was improved at seven and 10 days, and the seven‐day OHrQoL also showed improvement (Cosola et al, 2018), allowing us to conclude that the benefits of the domestic oral care instructions and the patients' motivation did not only result in an improved anti‐plaque effect, but also in their increased well‐being (Meza‐Mauricio et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of the information‐motivation model and domestic brushing with a hypochlorite‐based formula on peri‐implant mucositis: A randomized clinical study

Cosola

Oldoini²,

Giammarinaro³

et al. 2021

Clinical & Exp Dental Res

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Objective Management of mucositis is essential for the long‐term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non‐surgical periodontal therapy (NSPT) for patients with peri‐implant mucositis. Materials and methods Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite‐based formula brushing solution (test) after diagnosis of peri‐implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient‐related outcomes were recorded during a 90‐day follow‐up period. Results Forty patients completed the three‐month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh‐day evaluation (T1) in the gingival index (0–3) and FMBS (%). Favorable outcomes were maintained during the entire follow‐up period. Conclusion The present study showed that the modified NSPT paired with the domestic use of nitradine‐based formula helps resolve peri‐implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases. Clinical relevance The gold standard for nonsurgical maintenance is full‐mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross‐infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.

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Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis

Abstract: Clinicians might consider the use of SRP + statins as an adjunct over other alternative approaches, based on the results of the present review. The informed decision should be taken, considering the patient's values and preferences, and the intervention to be implemented by the clinician.

Cited by 17 publications

References 62 publications

Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta‐analysis

Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta‐analysis

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

The effectiveness of the information‐motivation model and domestic brushing with a hypochlorite‐based formula on peri‐implant mucositis: A randomized clinical study

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