Pleiotropic effects of statins on the treatment of chronic periodontitis – a systematic review

Abstract

AIMStatins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss. METHODSIn order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected. RESULTSStatins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts. CONCLUSIONAlthough we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis.

Antioxidant effects of melatonin in heart tissue after induction of experimental periodontitis in rats

“…In many extant studies, the effects of antioxidants such as coenzyme Q 10 , propolis and N-acetylcysteine, vitamin C, cocoa, proanthosianidine, and statins have been evaluated in experimental periodontitis (30,(43)(44)(45)(46). However, no work has been done thus far on the antioxidant activity of melatonin upon heart tissue in the presence of periodontitis.…”

Simvastatin exerts antiproliferative and differentiating effects on MG63 osteoblast‐like cells: Morphological and immunocytochemical study

“…1 Statins, particularly simvastatin and atorvastatin, are among the most frequently prescribed pharmacological groups. 2 Besides their lipid-lowering action, they have been reported to exert pleiotropic effects 3 and to possess anti-inflammatory, immunomodulatory and antimicrobial properties that may be useful against infections associated with bone healing. 4 Statins can activate the AKT1/PI3K pathway, leading to the inhibition of hydroxy-methyl-glutaryl co-enzyme A reductase, while statininduced protein prenylation can have other important downstream effects, including angiogenesis (increased vascular-endothelial growth factor) and osteogenesis (increased bone morphogenetic protein-2 (BMP-2)) and reduced receptor activator of nuclear factor κB and its ligand (RANK-RANKL).…”

The Effect of Locally Delivered Statins on Treating Periodontal Intrabony Defects: A Systematic Review and Meta‐Analysis

“…More recently, one systematic review 27 concluded that use of statins on adult patients ≥30 years of age with chronic periodontitis (CP) showed positive effect on their periodontal status, and that concomitant administration of either systemic or locally delivered statins in adjunct to non‐surgical therapy may help improve periodontal health. Results of another systematic review 28 also indicated beneficial effects of statins and their potential to improve therapeutic effect during PD treatments. However, a lack of meta‐analysis of the effect of statins on periodontal treatment has been identified.…”