Statins: A new era in local drug delivery

Abstract

Periodontitis is an inflammatory disease of the supporting tissues of the teeth, caused by a group of specific microorganisms. Aggressive forms of periodontitis can be localized or generalized. The concept that localized problem sites may be treated by local drug delivery appears attractive as the antimicrobial agent is delivered within periodontal pockets and the therapy is targeted on specific pathogenic microorganisms. Periodontitis can result in bone resorption creating bony defects, which may cause tooth loss. Various drugs have been studied using local delivery to improve the periodontal health and to achieve periodontal regeneration. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. Pharmacological agents offer great promise in this direction. Simvastatin, used for the treatment of hypercholesterolemia, is a universally accepted and relatively inexpensive drug. Local application of simvastatin has been shown to stimulate bone formation in rodents both in vitro and in vivo and in human periodontal ligament cells in vitro. This article reviews the effects of simvastatin as a local delivery and examines its potential role in periodontal regenerative therapy.

Potential mechanisms and applications of statins on osteogenesis: Current modalities, conflicts and future directions

“…Moreover, systemic administration of statins is associated with systemic side effects [45][46][47][48][49][50]. Local delivery of statins may be the alternative option which increases the bioavailability of the drugs and reduces the dose and dosage required for bone healing and the need for repeated administrations [6,118,119]. Table S1 shows the advantages and disadvantages of local and systemic therapy of statins.…”

Platelet‐Rich Fibrin With 1.2% Rosuvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial

“…Statins (hydroxymethylglutaryl coenzyme‐A reductase inhibitor drugs), such as rosuvastatin (RSV), are an important class of bone‐modulating agents, commonly used in medicine to improve lipid profile owing to their anti‐inflammatory and antioxidant properties 12 . Their osteostimulative action has led to their use in periodontal regenerative procedures 13 . RSV has already been found to enhance the clinicoradiographic condition of the periodontium, in combination with PRF and porous hydroxyapatite (HA) bone graft 14 .…”

“…12 Their osteostimulative action has led to their use in periodontal regenerative procedures. 13 RSV has already been found to enhance the clinicoradiographic condition of the periodontium, in combination with PRF and porous hydroxyapatite (HA) bone graft. 14 It has also been found to provide significant mean defect depth reduction (DDR) (48.58%) with greater clinical benefits when delivered locally into IBD sites.…”

Sistemas de administración de estatinas en el tratamiento de la periodontitis: una revisión de literatura

“…En la actualidad, los sistemas de administración local se utilizan para eliminar los efectos sistémicos de la SMV. Este tipo de aplicación se recomienda para el tratamiento de la periodontitis crónica como suplemento en la terapia periodontal, para eliminar cualquier componente inflamatorio residual en el tejido periodontal 32 . Sus diferentes efectos se han demostrado tanto in vitro como in vivo 26,33 .…”