Clinical effect of subgingivally delivered simvastatin in the treatment of patients with chronic periodontitis: a randomized clinical trial. 2010

Avani R Pradeep, and Manojkumar S Thorat
Department of Periodontics, Government Dental College and Research Institute, Karnataka, India. periodontics_gdc@rediffmail.com

BACKGROUND Periodontitis is an inflammatory disease that results 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. Simvastatin (SMV) is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. The present study was designed to investigate the effectiveness of SMV, 1.2 mg, in an indigenously prepared biodegradable controlled-release gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. METHODS Sixty patients were categorized into two treatment groups: SRP plus placebo (group 1) and SRP plus SMV, 1.2 mg (group 2). Clinical parameters were recorded at baseline before SRP and at 1, 2, 4, and 6 months; they included modified sulcus bleeding index (mSBI), probing depth (PD), and clinical attachment level (CAL). At baseline and after 6 months, radiologic assessment of intrabony defect (IBD) fill was done using computer-aided software. The mean concentration of SMV in gingival crevicular fluid was estimated by reverse-phase high-performance liquid chromatography. RESULTS All subjects tolerated the drug, without any postapplication inflammation. Both therapies resulted in significant improvements. The decrease in mSBI score at 6 months was greater in group 2 (2.3267 +/- 0.8017) compared to group 1 (0.5033 +/- 0.6815). The mean decrease in PD from baseline to 6 months was 1.20 +/- 1.24 mm and 4.26 +/- 1.59 mm in groups 1 and 2, respectively. Mean CAL gain from baseline to 6 months was 1.63 +/- 1.99 mm and 4.36 +/- 1.92 mm in groups 1 and 2, respectively. In group 2, there was greater decrease in mean IBD (1.41 +/- 0.74 mm or 32.54%) compared to group 1 (0.09 +/- 0.58 mm or 2.16%). CONCLUSIONS There was a greater decrease in gingival index and PD and more CAL gain with significant IBD fill at sites treated with SRP plus locally delivered SMV in patients with chronic periodontitis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010512 Periodontal Index A numerical rating scale for classifying the periodontal status of a person or population with a single figure which takes into consideration prevalence as well as severity of the condition. It is based upon probe measurement of periodontal pockets and on gingival tissue status. Bleeding on Probing, Gingival,CPITN,Community Periodontal Index of Treatment Needs,Gingival Bleeding on Probing,Gingival Index,Gingival Indexes,Periodontal Indexes,Gingival Indices,Index, Gingival,Index, Periodontal,Indexes, Gingival,Indexes, Periodontal,Indices, Gingival,Indices, Periodontal,Periodontal Indices
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D003692 Delayed-Action Preparations Dosage forms of a drug that act over a period of time by controlled-release processes or technology. Controlled Release Formulation,Controlled-Release Formulation,Controlled-Release Preparation,Delayed-Action Preparation,Depot Preparation,Depot Preparations,Extended Release Formulation,Extended Release Preparation,Prolonged-Action Preparation,Prolonged-Action Preparations,Sustained Release Formulation,Sustained-Release Preparation,Sustained-Release Preparations,Timed-Release Preparation,Timed-Release Preparations,Controlled-Release Formulations,Controlled-Release Preparations,Extended Release Formulations,Extended Release Preparations,Slow Release Formulation,Sustained Release Formulations,Controlled Release Formulations,Controlled Release Preparation,Controlled Release Preparations,Delayed Action Preparation,Delayed Action Preparations,Formulation, Controlled Release,Formulations, Controlled Release,Prolonged Action Preparation,Release Formulation, Controlled,Release Formulations, Controlled,Sustained Release Preparation,Timed Release Preparation,Timed Release Preparations
D005260 Female Females
D005782 Gels Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquefies; the resulting colloid is called a sol.
D005881 Gingiva Oral tissue surrounding and attached to TEETH. Gums,Interdental Papilla,Papilla, Interdental,Gum
D005888 Gingival Pocket An abnormal extension of a gingival sulcus not accompanied by the apical migration of the epithelial attachment. Pocket, Gingival,Gingival Pockets,Pockets, Gingival
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Avani R Pradeep, and Manojkumar S Thorat
January 2016, Journal of Indian Society of Periodontology,
Avani R Pradeep, and Manojkumar S Thorat
January 2017, The International journal of periodontics & restorative dentistry,
Avani R Pradeep, and Manojkumar S Thorat
May 2017, Journal of investigative and clinical dentistry,
Avani R Pradeep, and Manojkumar S Thorat
July 2017, Journal of the International Academy of Periodontology,
Avani R Pradeep, and Manojkumar S Thorat
January 2019, Journal of oral biology and craniofacial research,
Copied contents to your clipboard!