Skip to main content

Advertisement

SpringerLink
Log in

Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis

  • Review
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

This review aimed at evaluating the effects of chronic periodontitis (CP) treatment with local statins as adjuncts to scaling and root planing (SRP), compared with SRP alone or with placebo.

Methods

Electronic and hand searches were conducted in three databases to select randomized controlled trials (RCTs) comparing SRP + statins versus SRP alone. Random effects models were conducted to determine the clinical attachment level (CAL) gain as the primary outcome variable, and probing pocket depth (PPD) reduction, modified sulcus bleeding index (mSBI), and intrabony defect depth (IBD) as the secondary outcomes.

Results

Of the 526 papers identified, 15 articles met the criteria for inclusion in this systematic review, and 13 in the meta-analysis. The meta-analysis showed a statistically significant CAL gain (mean differences [MD] = 1.84 mm, 95% confidence interval [CI] = 1.45 to 2.23; p = 0.000), PPD reduction (MD = 1.69 mm, 95% CI = 1.37 to 2.04; p = 0.000), mSBI change (MD = 0.70, 95% CI = 0.57 to 0.84; p = 0.000), and IBD (MD = 1.48, 95% CI = 1.30 to 1.67; p = 0.000) attributed to SRP + statin treatment (6 months).

Conclusion

Within the limitations of this study, the collective evidence emerging from this systematic review and meta-analysis may support the use of locally applied statins as adjuncts to SRP in CP treatment, based on being an easy, low-cost alternative, with lesser adverse effects on bacterial resistance. These results should be interpreted with caution.

Clinical relevance

Clinicians might consider the use of SRP + statins as an adjunct over other alternative approaches, based on the results of the present review. The informed decision should be taken, considering the patient’s values and preferences, and the intervention to be implemented by the clinician.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. van der Sluijs M, van der Sluijs E, van der Weijden F, Slot DE. "The effect on clinical parameters of periodontal inflammation following non-surgical periodontal therapy with ultrasonics and chemotherapeutic cooling solutions" a systematic review =. J Clin Periodontol. 2016;

  2. Goodson JM, Haffajee AD, Socransky SS, Kent R, Teles R, Hasturk H, Bogren A, van Dyke T, Wennstrom J, Lindhe J Control of periodontal infections: a randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites. J Clin Periodontol [Internet]. 2012 [cited 2016 Apr 11];39:526–36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22512461, 536

  3. Tomasi C, Leyland AH, Wennström JL. Factors influencing the outcome of non-surgical periodontal treatment: a multilevel approach. J Clin Periodontol [Internet]. 2007 [cited 2016 Apr 11];34:682–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17635246, 690

  4. Cosgarea R, Juncar R, Heumann C, Tristiu R, Lascu L, Arweiler N, et al. Non-surgical periodontal treatment in conjunction with 3 or 7 days systemic administration of amoxicillin and metronidazole in severe chronic periodontitis patients. A placebo controlled randomized clinical study. J Clin Periodontol [Internet]. 2016;n/a-n/a. Available from: http://doi.wiley.com/10.1111/jcpe.12559

  5. Decker E-M, Bartha V, Kopunic A, von Ohle C. Antimicrobial efficiency of mouthrinses versus and in combination with different photodynamic therapies on periodontal pathogens in an experimental study. J Periodontal Res [Internet]. 2016 [cited 2016 Apr 13]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/27038101

  6. Betsy J, Prasanth CS, Baiju K V, Prasanthila J, Subhash N. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. J Clin Periodontol [Internet]. 2014 [cited 2016 Apr 13];41:573–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24617449, 581

  7. Kolbe MF, Ribeiro F V, Luchesi VH, Casarin RC, Sallum EA, Nociti FH, et al. Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immunoinflammatory, and patient-centered performance in a split-mouth randomized clinical trial. J Periodontol [Internet]. 2014 [cited 2016 Apr 13];85:e277–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24555751

  8. Horiuchi N, Maeda T. Statins and bone metabolism. Oral Dis [Internet]. 2006 [cited 2016 Apr 4];12:85–101. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16476028

  9. Maron DJ, Fazio S, Linton MF. Current perspectives on statins. Circulation [Internet]. 2000 [cited 2016 Apr 13];101:207–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10637210, 213

  10. Coxon FP, Ebetino FH, Mules EH, Seabra MC, McKenna CE, Rogers MJ. Phosphonocarboxylate inhibitors of Rab geranylgeranyl transferase disrupt the prenylation and membrane localization of Rab proteins in osteoclasts in vitro and in vivo. Bone [Internet]. 2005 [cited 2016 Nov 8];37:349–58. Available from: http://linkinghub.elsevier.com/retrieve/pii/S875632820500181X, 358

  11. Jadhav SB, Jain GK. Statins and osteoporosis: new role for old drugs. J Pharm Pharmacol [Internet]. Blackwell Publishing Ltd; 2006 [cited 2016 Nov 8];58:3–18. Available from: http://doi.wiley.com/10.1211/jpp.58.1.0002

  12. Mo H, Yeganehjoo H, Shah A, Mo WK, Soelaiman IN, Shen C-L. Mevalonate-suppressive dietary isoprenoids for bone health. J Nutr Biochem [Internet]. 2012 [cited 2016 Nov 8];23:1543–51. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0955286312002008

  13. Mundy G, Garrett R, Harris S, Chan J, Chen D, Rossini G, Boyce B, Zhao M, Gutierrez G Stimulation of bone formation in vitro and in rodents by statins. Science [Internet]. UNITED STATES; 1999 [cited 2016 Apr 13];286:1946–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10583956, 1949

  14. Liu S, Bertl K, Sun H, Liu Z-H, Andrukhov O, Rausch-Fan X. Effect of simvastatin on the osteogenetic behavior of alveolar osteoblasts and periodontal ligament cells. Hum Cell [Internet]. 2012 [cited 2016 Nov 9];25:29–35. Available from: http://link.springer.com/10.1007/s13577-011-0028-x

  15. Baigent, C., Keech, A., Kearney PM. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet [Internet]. 2005 [cited 2016 Nov 8];366:1267–78. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673605673941

  16. Poston CCJ, Pierce TCT, Li Y, Brinson CWC, Lu Z, Lauer AAW, Leite RS, Huang Y Statin intake is associated with MMP-1 level in gingival crevicular fluid of patients with periodontitis. Oral Dis [Internet]. 2016 [cited 2016 Apr 13];22:438–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26988924, 444

  17. Stein D, Lee Y, Schmid MJ, Killpack B, Genrich MA, Narayana N, et al. Local simvastatin effects on mandibular bone growth and inflammation. J Periodontol [Internet]. 2005 [cited 2018 Apr 21];76:1861–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16274305

  18. Nyan M, Sato D, Oda M, Machida T, Kobayashi H, Nakamura T, Kasugai S Bone formation with the combination of simvastatin and calcium sulfate in critical-sized rat calvarial defect. J Pharmacol Sci [Internet]. 2007 [cited 2018 Apr 21];104:384–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17721043, 386

  19. Goes P, Lima NA, Rodrigues JAG, Benevides NMB, Brito GAC, Lima V (2016) Anti-inflammatory and anti-resorptive effects of atorvastatin on alveolar bone loss in Wistar rats. Braz Dent J Brazil 27:267–272

    Article  Google Scholar 

  20. Moraschini V, Almeida DCF, Calasans-Maia JA, Diuana Calasans-Maia M. The ability of topical and systemic statins to increase osteogenesis around dental implants: a systematic review of histomorphometric outcomes in animal studies. Int J Oral Maxillofac Surg [Internet]. 2018 [cited 2018 Apr 21]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/29352637

  21. Kellesarian S, Al Amri M, Al-Kheraif A, Ghanem A, Malmstrom H, Javed F. Efficacy of local and systemic statin delivery on the osseointegration of implants: a systematic review. Int J Oral Maxillofac Implants [Internet]. 2017 [cited 2018 Apr 21];32:497–506. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28494034

  22. Sakoda K, Yamamoto M, Negishi Y, Liao JK, Node K, Izumi Y. Simvastatin decreases IL-6 and IL-8 production in epithelial cells. J Dent Res [Internet]. 2006 [cited 2016 Nov 9];85:520–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16723648

  23. Ting M, Whitaker EJ, Albandar JM. Systematic review of the in vitro effects of statins on oral and perioral microorganisms. Eur J Oral Sci [Internet]. 2016;124:4–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26718458

  24. Suresh S, Narayana S, Jayakumar P, Sudhakar U, Pramod V. Evaluation of anti-inflammatory effect of statins in chronic periodontitis. Indian J Pharmacol [Internet]. Medknow Publications and Media Pvt. Ltd.; 2013 [cited 2016 Oct 18];45:391–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24014917

  25. Cicek Ari V, Ilarslan YD, Erman B, Sarkarati B, Tezcan I, Karabulut E, Oz SG, Tanriover MD, Sengun D, Berker E Statins and IL-1β, IL-10, and MPO levels in gingival crevicular fluid: preliminary results. Inflammation [Internet]. 2016 [cited 2016 Nov 12];39:1547–57. Available from: http://link.springer.com/10.1007/s10753-016-0390-7, 1557

  26. Pradeep AR, Thorat MS. Clinical effect of subgingivally delivered simvastatin in the treatment of patients with chronic periodontitis: a randomized clinical trial. J Periodontol [Internet]. 2010 [cited 2016 Apr 12];81:214–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20151799

  27. Rath A, Mahenra J, Thomas L, Sandhu M, Namasi A, Ramakrishna T. A clinical radiological and IL-6 evaluation of subgingivally delivered simvastatin in the treatment of chronic periodontitis. Int J Drug Deliv A. Rath, Department of Periodontology and Implantology, Meenakshi Ammal Dental College and Hospital, Chennai −600 095, Tamil Nadu, India; 2012;4:70–81

  28. Pradeep AR, Karvekar S, Nagpal K, Patnaik K, Guruprasad CN, Kumaraswamy KM. Efficacy of locally delivered 1.2% rosuvastatin gel to non-surgical treatment of patients with chronic periodontitis: a randomized, placebo-controlled clinical trial. J Periodontol [Internet]. 2015 [cited 2016 Apr 12];86:738–45. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25786565

  29. Gaekwad SS, Gujjari SK, Kumar TMP, Devishree S. Effect of subgingivally delivered simvastatin in postmenopausal women with chronic periodontitis: a randomized controlled trial. J Adv Clin Res Insights [Internet]. 2015;2:253–8. Available from: http://jcri.net/eJournals/ShowText.aspx?ID=89&Type=FREE&TYP=TOP&IN=_eJournals/images/JPLOGO.gif&IID=9&Value=1&isPDF=YES

  30. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol [Internet]. 2009 [cited 2014 Jul 16];62:1006–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19631508

  31. Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol [Internet]. 2009 [cited 2016 Feb 9];62:1013–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19230606

  32. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol [Internet]. 1999 [cited 2018 Jan 26];4:1–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10863370

  33. Tonetti MS, Claffey N, European Workshop in Periodontology group C. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol [Internet]. 2005 [cited 2018 26];32 Suppl 6:210–3. Available from: http://doi.wiley.com/10.1111/j.1600-051X.2005.00822.x

  34. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources [Internet]. Br. Med. J. 2005 [cited 2017 Apr 21]. p. 1064–5. Available from: http://www.bmj.com/content/331/7524/1064

  35. Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, et al. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc [Internet]. 2015 [cited 2017 Apr 12];146:508–524.e5. Available from: http://www.sciencedirect.com/science/article/pii/S0002817715003463

  36. Michalowicz BS, Hodges JS, Pihlstrom BL. Is change in probing depth a reliable predictor of change in clinical attachment loss? J Am Dent Assoc [Internet]. 2013 [cited 2017 Apr 23];144:171–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23372133

  37. Claffey N, Egelberg J. Clinical characteristics of periodontal sites with probing attachment loss following initial periodontal treatment. J Clin Periodontol [Internet]. 1994 [cited 2017 Apr 23];21:670–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7852611, 679

  38. Badersten A, Nilvéus R, Egelberg J. Scores of plaque, bleeding, suppuration and probing depth to predict probing attachment loss. 5 years of observation following nonsurgical periodontal therapy. J Clin Periodontol [Internet]. 1990 [cited 2017 Apr 23];17:102–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2406291, 107

  39. Newbrun E. Indices to measure gingival bleeding. J Periodontol [Internet]. 1996 [cited 2018 Jan 27];67:555–61. Available from: http://doi.wiley.com/10.1902/jop.1996.67.6.555, 561

  40. Holtfreter B, Albandar JM, Dietrich T, Dye BA, Eaton KA, Eke PI, et al. Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group J Clin Periodontol [Internet]. 2015 [cited 2018 Jan 27];42:407–12. Available from: http://doi.wiley.com/10.1111/jcpe.12392

  41. Higgins A, Gotzsche J, Moher O et al (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928–d5928

    Article  PubMed  PubMed Central  Google Scholar 

  42. Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  43. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ [Internet]. 1997 [cited 2017 Jun 12];315:629–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9310563, 634

  44. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck Y, Alonso-coello P et al (2008) Rating quality of evidence and strength of recommendations : GRADE : an emerging consensus on rating quality of evidence and strength of recommendations rating quality of evidence of recommendations GRADE : of evidence an emerging and consensus of on rati. Br Med J 336:924–926

    Article  Google Scholar 

  45. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, Jaeschke R, Rind D, Meerpohl J, Dahm P, Schünemann HJ (2011) GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394

    Article  PubMed  Google Scholar 

  46. Grover H, Kapoor S, Singh A. Effect of topical simvastatin (1.2 mg) on gingival crevicular fluid interleukin-6, interleukin-8 and interleukin-10 levels in chronic periodontitis—a clinicobiochemical study. J oral Biol craniofacial [Internet]. 2016 [cited 2017 Apr 20]; Available from: http://www.sciencedirect.com/science/article/pii/S221242681500127X

  47. Suresh S, Narayana S, Jayakumar P, Sudhakar U, Pramod V (2013) Evaluation of anti-inflammatory effect of statins in chronic periodontitis. Indian J Pharmacol India 45:391–394

    Article  Google Scholar 

  48. Surve SM, Acharya AB, Thakur SL (2015) Efficacy of subgingivally delivered atorvastatin and simvastatin as an adjunct to scaling and root planing. Drug Metab Pers Ther Germany 30:263–269

    Google Scholar 

  49. Pradeep AR, Priyanka N, Kalra N, Naik SB, Singh SP, Martande S. Clinical efficacy of subgingivally delivered 1.2-mg simvastatin in the treatment of individuals with Class II furcation defects: a randomized controlled clinical trial. J Periodontol [Internet]. 2012 [cited 2016 Apr 12];83:1472–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22348696

  50. Garg S, Pradeep A. 1.2% rosuvastatin and 1.2% atorvastatin gel local drug delivery and redelivery in the treatment of class II furcation defects: a randomized controlled clinical. J Periodontol [Internet]. 2017 [cited 2017 Apr 20]; Available from: http://www.joponline.org/doi/abs/10.1902/jop.2016.160399

  51. Rao NS, Pradeep AR, Bajaj P, Kumari M, Naik SB. Simvastatin local drug delivery in smokers with chronic periodontitis: a randomized controlled clinical trial. Aust Dent J [Internet]. 2013 [cited 2016 Apr 12];58:156–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23713634, 162

  52. Kumari M, Martande SS, Pradeep AR. Subgingivally delivered 1.2% atorvastatin in the treatment of chronic periodontitis among smokers: a randomized, controlled clinical trial. J Investig Clin Dent. Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, India.; Department of Periodontics, Dr D.Y. Patil Dental College and Hospital, Pimpri, Pune, India.; Department of Periodontics, Government Dental College and : John Wiley & Sons Australia, Ltd; 2016;

  53. Pradeep AR, Rao NS, Bajaj P, Kumari M. Efficacy of subgingivally delivered simvastatin in the treatment of patients with type 2 diabetes and chronic periodontitis: a randomized double-masked controlled clinical trial. J Periodontol [Internet]. United States; 2013 [cited 2016 Apr 12];84:24–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22420871

  54. Kumari M, Martande SS, Pradeep AR, Naik SB (2016) Efficacy of subgingivally delivered 1.2% atorvastatin in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. J Periodontol United States 87:1278–1285

    Article  Google Scholar 

  55. Pradeep AR, Thorat MS. Clinical effect of subgingivally delivered simvastatin in the treatment of patients with chronic periodontitis: a randomized clinical trial. J Periodontol A R Pradeep, Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore-560002, Karnataka, India; 2010;81:214–22

  56. Pradeep AR, Rao NS, Naik SB, Kumari M. Efficacy of varying concentrations of subgingivally delivered metformin in the treatment of chronic periodontitis: a randomized controlled clinical trials J Periodontol [Internet]. 2013 [cited 2017 Apr 7];84:212–20. Available from: http://www.joponline.org/doi/10.1902/jop.2012.120025

  57. Agarwal S, Chaubey KK, Chaubey A, Agarwal V, Madan E, Agarwal MC (2016) Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients. J Indian Soc Periodontol India 20:409–416

    Article  Google Scholar 

  58. S Martande S, Kumari M, Pradeep AR, Pal Singh S, Kumar Suke D (2017) Comparative evaluation of efficacy of subgingivally delivered 1.2% atorvastatin and 1.2% simvastatin in the treatment of intrabony defects in chronic periodontitis: a randomized controlled trial. J Dent Res Dent Clin Dent Prospects Iran 11:18–25

    Article  Google Scholar 

  59. Mombelli A, van Oosten MA, Schurch E, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol [Internet]. 1987 [cited 2016 Feb 11];2:145–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3507627, 151

  60. Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck-Ytter Y, Meerpohl J, Norris S, Guyatt GH (2011) GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 64:401–406

    Article  PubMed  Google Scholar 

  61. Andrews J, Guyatt G, Oxman AD, Alderson P, Dahm P, Falck-Ytter Y, Nasser M, Meerpohl J, Post PN, Kunz R, Brozek J, Vist G, Rind D, Akl EA, Schünemann HJ (2013) GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol 66:719–725

    Article  PubMed  Google Scholar 

  62. Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, et al. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc [Internet]. Elsevier Inc; 2015;146:525–35. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0002817715003347

  63. Hopewell S, Clarke MJ, Stewart L, Tierney J. Time to publication for results of clinical trials. In: Hopewell S, editor. Cochrane Database Syst Rev [Internet]. Chichester: John Wiley & Sons, Ltd; 2007 [cited 2017 Jul 11]. p. MR000011. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17443632

  64. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials. Control Clin Trials [Internet]. 1998 [cited 2017 Jul 9];19:159–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9551280

  65. Yusuf S, Wittes J, Probstfield J, Tyroler HA. Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. JAMA [Internet]. 1991 [cited 2017 Jul 8];266:93–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2046134, 98

  66. Chambrone L, Vargas M, Arboleda S, Serna M, Guerrero M, de Sousa J, et al. Efficacy of local and systemic antimicrobials in the non-surgical treatment of smokers with chronic periodontitis: a systematic review. J Periodontol [Internet]. 2016 [cited 2016 Oct 26];87:1320–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27498712

  67. Bajaj P, Pradeep AR, Agarwal E, Kumari M, Naik SB (2012) Locally delivered 0.5% clarithromycin, as an adjunct to nonsurgical treatment in chronic periodontitis with well-controlled type 2 diabetes: a randomized controlled clinical trial. J Investig Clin Dent 3:276–283

    Article  PubMed  Google Scholar 

  68. Rovai ES, Souto MLS, Ganhito JA, Holzhausen M, Chambrone L, Pannuti CM. Efficacy of local antimicrobials in the non-surgical treatment of patients with periodontitis and diabetes: a systematic review. J Periodontol [Internet]. 2016 [cited 2017 Sep 9];87:1406–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27468792

  69. Penoni DC, Fidalgo TKS, Torres SR, Varela VM, Masterson D, Leão ATT, et al. Bone density and clinical periodontal attachment in postmenopausal women. J Dent Res [Internet]. 2017;96:261–9. Available from: http://journals.sagepub.com/doi/10.1177/0022034516682017

  70. Sinjab K, Zimmo N, Lin G-H, Chung M-P, Shaikh L, Wang H-L. The effect of locally-delivered statins on treating periodontal intrabony defects: a systematic review and meta-analysis. J Periodontol [Internet]. 2016;1–18. Available from: http://www.joponline.org/doi/10.1902/jop.2016.160384, 2017

  71. Silva MA, Swanson AC, Gandhi PJ, Tataronis GR. Statin-related adverse events: a meta-analysis. Clin Ther [Internet]. 2006 [cited 2017 Jul 10];28:26–35. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0149291806000191

  72. Armitage J. The safety of statins in clinical practice. Lancet (London, England) [Internet] 2007 [cited 2017 Jul 10];370:1781–90. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673607607168, 1790

Download references

Author information

Authors and Affiliations

  1. Department of Periodontology, Guarulhos University, Rua Nilo Peçanha, 68, Guarulhos, SP, Brazil

    Jonathan Meza-Mauricio

  2. Stomatology Department School of Medicine and Dentistry, University of Valencia, Valencia, Spain

    David Soto-Peñaloza, David Peñarrocha-Oltra & Jose Maria Montiel-Company

  3. São Leopoldo Mandic Dental Institute and Research Centre, Campinas, SP, Brazil

    Daiane Cristina Peruzzo

Authors
  1. Jonathan Meza-Mauricio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Soto-Peñaloza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Peñarrocha-Oltra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jose Maria Montiel-Company
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daiane Cristina Peruzzo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan Meza-Mauricio.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No ethical approval was required for this study, since no human participants or animals were used in this study.

Informed consent

Formal consent is not required for a systematic review and meta-analysis.

Electronic supplementary material

ESM 1

(DOCX 230 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meza-Mauricio, J., Soto-Peñaloza, D., Peñarrocha-Oltra, D. et al. Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. Clin Oral Invest 22, 2413–2430 (2018). https://doi.org/10.1007/s00784-018-2507-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-018-2507-x

Keywords

Search

Navigation