The Application of Statins in the Regeneration of Bone Defects. Systematic Review and Meta-Analysis

Abstract

This systematic review aims to analyze the effect of the local application of statins in the regeneration of non-periodontal bone defects. A systematic study was conducted with the Pubmed/Medline, Embase, Cochrane Library and Scielo databases for in vivo animal studies published up to and including February 2019. Fifteen articles were included in the analysis. The local application of the drug increased the percentage of new bone formation, bone density, bone healing, bone morphogenetic protein 2, vascular endothelial growth factor, progenitor endothelial cells and osteocalcin. Meta-analyses showed a statistically significant increase in the percentage of new bone formation when animals were treated with local statins, in contrast to the no introduction of filling material or the introduction of polylactic acid, both in an early (4–6 weeks) and in a late period (12 weeks) (mean difference 39.5%, 95% confidence interval: 22.2–56.9, p <0.001; and mean difference 43.3%, 95% confidence interval: 33.6–52.9, p < 0.001, respectively). Basing on the animal model, the local application of statins promotes the healing of critical bone size defects due to its apparent osteogenic and angiogenic effects. However, given the few studies and their heterogenicity, the results should be taken cautiously, and further pilot studies are necessary, with radiological and histological evaluations to translate these results to humans and establish statins’ effect.

Potential bioactive coating system for high-performance absorbable magnesium bone implants

“…Simvastatin cannot be metabolized by the liver, hence, reduce the risk of drug toxicity and others side effects [ 265 ]. According to a review published in 2019, the local application of statins on animal models promotes the healing of critical bone size defects due to its apparent osteogenic and angiogenic effects [ 292 ]. The delivery of simvastatin to bone defects using methylcellulose gel [ 293 , 294 ], gelatin hydrogel [ 295 ], collagen sponge [ 296 ], or gelatin sponge [ 297 ] has shown an enhanced bone healing by radiological and histological assessment.…”

Hybrid Self‐Assembled Gel Beads for Tuneable pH‐Controlled Rosuvastatin Delivery

“…[12] As one example, rosuvastatin (Figure 1) is usually administered orally as a tablet in a 5-40 mg daily dose and is mainly absorbed from the intestine (pH 8.0). [14] Statins have also been suggested to have positive effects on bone growth [15] and are being particularly explored in the field of dentistry for the treatment of periodontitis. [16] There has therefore been considerable interest in the local delivery of statins, including their formulation with simple polymer gels.…”

Effect of an “Autogenous Leukocyte Platelet-Rich Fibrin Tooth Graft” Combination around Immediately Placed Implants in Periodontally Compromised Sites: A Randomized Clinical Trial

“…The use of probiotics [ 33 ] and natural compounds can modify clinical and microbiological parameters in periodontal patients [ 34 ]. Moreover, statins and other biomaterials [ 35 , 36 ] could have an effect also in the response to the technique described in the present report. All these variables should be considered in future clinical trials.…”