Effekten af lokal og systemisk indgift af statiner som supplement til kirurgisk og non-kirurgisk parodontalbehandling. Systematisk oversigt og meta-analyse af praekliniske og kliniske undersögelser
Sammanfattning
The present paper presents a synopsis of 2 recently published systematic reviews (1, 2) on preclinical in vivo- and clinical studies on the use of statins as adjuncts to non-surgical and surgical periodontal treatment. Statins (e.g., simvastatin, atorvastatin, rosuvastatin) are cholesterol-lowering drugs commonly used for prevention of cardiovascular diseases in hypercholesterolemia patients. However, statins have also anti-microbial, anti-inflammatory, anti-enzymatic, and wound-healing promoting activity and thus may be beneficial in the treatment of periodontitis. In most preclinical in vivo studies, statin use appeared to exert
both a prophylactic effect and a reparative effect. In the clinical studies, local but not systemic statin application – as an adjunct to mechanical treatment – yielded significantly larger reduction of probing pocket depth, radiographic defect depth, and bleeding index, and larger clinical attachment level gain,
and less residual pocket depth and radiographic defect depth in intrabony, and seemingly furcation defects, comparing to
mechanical treatment alone. Limited evidence suggests, that intrasurgical statin application is similarly beneficial. No adverse events were reported after statin use. A limitation of the current evidence is that the vast majority of the clinical studies is from the same research group, so that confirmation of these promising results, and especially of the effect size is warranted. Not all available statins have been tested so far, and further research is needed to identify the maximum effective concentration/dose and optimal carrier, and to explore the potential synergistic effect of statins in combination with other substances in periodontal treatment.