Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients.
Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients.
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DOI：
10.4103/0972-124x.194270
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发表时间：
2016-07
影响因子：
--
通讯作者：
Agarwal MC
中科院分区：
文献类型：
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作者：
Agarwal S;Chaubey KK;Chaubey A;Agarwal V;Madan E;Agarwal MC
辛伐他汀（Simvastatin，SMV）是一种新型局部给药的他汀类药物，是3-羟基-2-甲基戊二酰辅酶A还原酶的特异性竞争性抑制剂。他汀类药物除了具有降脂作用外，还具有多种作用，如宿主调节和骨再生。本研究的目的是调查SMV，1.2毫克，在本土制备的可生物降解的控释凝胶作为辅助洁治和根面平整（SRP）的有效性。共有60个牙槽深度≥5 mm的部位（SRP后30例患者各2个）被分为两个治疗组，分别用于龈下放置安慰剂（Gp 1）或SMV（Gp 2）。记录基线和1、3、6个月时的临床参数，包括菌斑指数、牙龈指数、牙周袋探诊深度（PPD）和临床附着水平（CAL）。通过测量从基线到6个月的垂直增益（INFRA 1）和缺损角度（INFRA 2），通过X线片评估骨变化。所有受试者均耐受药物，无任何应用后并发症。治疗改善了两组的牙周状况，但在第2组中观察到PPD（p= 0.04）和INFRA 1（p= 0.000）显著降低，沿着CAL（p= 0.02）和INFRA 2（p= 0.000）增加。在一个部位，发现INFRA 1意外下降5 mm。SMV局部给药增强了SRP在囊袋缩小、CAL增加和骨填充方面的有益作用。
Simvastatin (SMV), a new locally delivered drug of class statins, is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins, besides having lipid-lowering abilities, also have pleiotropic effects like host modulation and bone regeneration. 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). A total of 60 sites, with pocket depth ≥5 mm, two from each of 30 patients after SRP, were categorized into two treatment groups, for subgingival placement of placebo (Gp 1) or SMV (Gp 2). Clinical parameters were recorded at baseline and at 1, 3 and 6 months comprising plaque index, gingival index, probing pocket depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical gain, INFRA 1 and angle of the defect, INFRA 2 from baseline to 6 months. All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal condition in both the groups but significant reductions in PPD (p= 0.04), and INFRA 1 (p= 0.000), along with gain in CAL (p= 0.02) and INFRA 2 (p= 0.000) were observed in Gp 2. In one site, an unexpected 5 mm decrease in INFRA 1 was found. Local drug delivery of SMV enhanced the beneficial effect of SRP, in pocket reduction, gain in CAL and bone fill.