The effect of local and systemic statin use as an adjunct to non-surgical and surgical periodontal therapy—A systematic review and meta-analysis
Abstract
Objectives
To evaluate the effect of local and/or systemic statin use as an adjunct to non-surgical and/or surgical periodontal therapy.
Data
Literature
search according to PRISMA guidelines with the following eligibility
criteria: (a) English or German language; (b) interventional studies;
(c) statins as monotherapy or as an adjunct to non-surgical and/or
surgical treatment of periodontitis; (d) clinical and/or radiographic
treatment effect size of statin intake reported.
Sources
Medline (PubMed), Embase (Ovid), CENTRAL (Ovid).
Study
selection
Thirteen clinical studies regarding local application and 2 with
systemic administration of statins as an adjunct to non-surgical
treatment (SRP) and 4 studies regarding intrasurgical statin application
with a maximum follow-up of 9 months could be included; simvastatin,
atorvastatin, and rosuvastatin were used. Local but not systemic statin
application as an adjunct to SRP yielded significantly larger probing
pocket depth (PD), radiographic defect depth (RDD), and bleeding index
reduction, and larger clinical attachment level gain, and less residual
PD and RDD (p ≤ 0.016); rosuvastatin appeared as the most efficacious.
Three of 4 studies reported a significant positive effect of
intrasurgical statin application. No adverse events were reported after
statin use. The vast majority of the included studies were from the same
research group.
Conclusions
Significant
additional clinical and radiographic improvements are obtained after
local, but not systemic, statin use as an adjunct to SRP in deep pockets
associated with intrabony defects and seemingly with furcation defects;
intrasurgical statin application seems similarly beneficial.
Confirmation of these results, and especially of the effect size, from
other research groups is warranted.
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