Contribution of Statins towards Periodontal Treatment: A Review

Table 7

Clinical studies evaluating impact of systemic statin administration on periodontal wound healing.

Systemic drug delivery
Reference; Study area; Type of study	Drug; Mode of delivery; Dose	Number of patients; Periodontal status; Type of patients	Type of treatment; Study design (groups); Follow-up	Results	Periodontal considerations
[109] (USA); Retrospective cohort study	Not reported	1021; Chronic periodontal disease; All types of patients (diabetic, smokers, antibiotic users, anti-inflammatory users…)	Nonsurgical treatment; Hyperlipidemic vs healthy; Mean follow- years	Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years	Statins reduced tooth loss in chronic periodontitis
[112] (Mexico); RCT	Atorvastatin; 20 mg/day	38; Chronic periodontitis; Healthy (all types of smoking status)	Nonsurgical treatment; Group I: Group II: 3 months follow-up	↘ dental mobility; ↘ distance from the crestal alveolar bone to the cementoenamel junction	Atorvastatin reduced tooth mobility and bone loss
[110] (Turkey); No control group; Longitudinal	Atorvastatin; 10 or 20 mg	20; Chronic periodontitis; Hyperlipidemic patients (nonsmokers)	Nonsurgical treatment; SRP; 6 months follow-up	↘ median values for the PI, GI, PD, and BOP (%); ↗ median value of CAL gain; All lipid parameters decreased after the periodontal treatment; No comparison with the control group	Atorvastatin reduced periodontal breakdown; Improved periodontal health may influence metabolic control of hyperlipidemia
[113] (Turkey); Cohort study	Atorvastatin; 10 or 20 mg	80; Chronic periodontitis; Healthy or hyperlipidemic patients; (nonsmokers)	Nonsurgical treatment; Group I: healthy; Group II: hyperlipidemic diet (HD); Group III: hyperlipidemic (HS); 3 months follow-up	↗ BOP; ↘ IL-6 (serum and GCF); ↘ TNF-α (GCF) levels	Systemic atorvastatin had beneficial effects on periodontal inflammation
[111] (Germany); Cohort study	Simvastatin (), lovastatin (), pravastatin (), fluvastatin (), atorvastatin (), and cerivastatin ()	2689; All types of periodontal disease; Hyperlipidemic vs normolipidemic; All types of smoking status	All types of periodontal treatment; Group I: participants undergoing statin treatment; Group II: patients without statins; 5.3 years mean follow-up	No effect on PD and CAL; ↘ tooth loss	Statins had the beneficial effect of protecting against tooth loss
[56]; (USA); Cohort study	Simvastatin; Not reported	117; Chronic periodontitis; Diabetic vs healthy; All types of smoking status	Nonsurgical treatment; Group I: nondiabetic patients not taking statin; Group II: nondiabetic patients taking statin; Group III: diabetic patients not taking statin; Group IV: diabetic patients taking statin; 6 weeks follow-up	↘ PD in diabetic patients; ↗ CAL in nondiabetic patients; ↘ MMP-1 level in GCF of nondiabetic and diabetic patients; No difference was found for MMP-8 and MMP-9 levels in GCF	Statin intake was associated with reduced PD in diabetic patients and MMP-1 level in GCF in either nondiabetic or diabetic patients
[114]; (India); Cohort study	Atorvastatin; 20 mg/day	107; Chronic periodontitis; Hyperlipidemic vs normolipidemic; Nonsmokers	Nonsurgical periodontal treatment; Group 1: Group 2: Group 3: normolipidemic patients; 3 months follow-up	↘ GI; Mean change in PD is negatively associated with LDL-C; Mean change in GI is positively associated with HDL-C	Patients with hyperlipidemia were more prone to periodontal disease; Statin intake had beneficial effects on periodontal inflammation