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The effect of statins on periodontal treatment—a systematic review with meta-analyses and meta-regression

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Abstract

Objective

This study aimed to systematically review clinical trials about the effect of statins as adjunct to mechanical periodontal therapy, on probing pocket depth, clinical attachment level, and intrabony defects, in comparison to mechanical periodontal therapy alone or in association with placebo.

Material and methods

Three databases were searched for controlled clinical trials that used any locally delivered or systemically statin as a sole adjunctive therapy to mechanical periodontal treatment. Weighted mean differences between baseline and 6 months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD), and intrabony defect (IBD) were calculated. A high heterogeneity was detected. Therefore, a meta-regression adjusted for type of statin and year of publication was performed.

Results

Fifteen studies were included in the systematic review, and ten studies were included in the meta-analysis. In the meta-regression, the adjunct use of simvastatin, rosuvastatin, and atorvastatin additionally reduced PPD in comparison to mechanical periodontal therapy and a placebo gel (2.90 ± 0.35, 3.90 ± 0.77, 3.06 ± 0.71 mm, respectively; p < 0.05). Regarding the resolution of IBD, simvastatin and rosuvastatin significantly improved in comparison to control group (0.89 ± 0.35 and 1.93 ± 0.77 mm, respectively; p < 0.05). No statistically significant difference was found between the statins for both PPD and IBD (p < 0.05). Regarding CAL gain, simvastatin provided a statistically significant improvement as compared to the control group (2.02 ± 0.79 mm; p = 0.043).

Conclusions

The use of statins, used as sole adjuncts to mechanical periodontal treatment, improved the periodontal parameters. In the quantitative analyses, simvastatin was the only drug that showed additional benefits in all evaluated parameters.

Clinical relevance

Statins promote significantly clinical periodontal improvements when administered in association with non-surgical scaling and root planning (SRP), when compared to SRP alone or in association with a placebo.

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Funding

This study was self-funded by the authors.

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Authors and Affiliations

  1. Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil

    Francisco Wilker Mustafa Gomes Muniz, Keity Taminski, Juliano Cavagni, Patrícia Weidlich & Cassiano Kuchenbecker Rösing

  2. Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil

    Roger Keller Celeste

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  1. Francisco Wilker Mustafa Gomes Muniz
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  2. Keity Taminski
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  3. Juliano Cavagni
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  4. Roger Keller Celeste
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  5. Patrícia Weidlich
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Correspondence to Francisco Wilker Mustafa Gomes Muniz.

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Electronic supplementary material

Figure S1

Forest plot of PPD reduction. (GIF 25 kb)

High resolution image (TIFF 467 kb)

Figure S2

Funnel plot of the risk of bias analysis of pocket depth at 6-months follow-up. (GIF 10 kb)

High resolution image (TIFF 327 kb)

Figure S3

Cumulative meta-analysis of pocket depth at 6-months follow-up. (GIF 17 kb)

High resolution image (TIFF 257 kb)

Figure S4

Forest plot of IBD decrease. (GIF 18 kb)

High resolution image (TIFF 319 kb)

Figure S5

Funnel plot of the risk of bias analysis of intrabony defect at 6-months follow-up. (GIF 7 kb)

High resolution image (TIFF 99 kb)

Figure S6

Cumulative meta-analysis of intrabony defect at 6-months follow-up. (GIF 2 kb)

High resolution image (TIFF 29 kb)

Figure S7

Forest plot of CAL gain. (GIF 18 kb)

High resolution image (TIFF 312 kb)

Figure S8

Funnel plot of the risk of bias analysis of clinical attachment level at 6-months follow-up. (GIF 9 kb)

High resolution image (TIFF 326 kb)

Figure S9

Cumulative meta-analysis of clinical attachment level at 6-months follow-up. (GIF 17 kb)

High resolution image (TIFF 257 kb)

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Muniz, F.W.M.G., Taminski, K., Cavagni, J. et al. The effect of statins on periodontal treatment—a systematic review with meta-analyses and meta-regression. Clin Oral Invest 22, 671–687 (2018). https://doi.org/10.1007/s00784-018-2354-9

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