Do adjunctive statins improve periodontal treatment outcomes in patients with chronic periodontitis

Data sources Medline-PubMed, Scopus and Embase databases. Study selection Controlled clinical trials studies with at least one month follow-up that utilised locally or systemically delivered statins as a sole adjunctive treatment to mechanical periodontal therapy in patients diagnosed with chronic or aggressive periodontitis were included. Selection was carried out independently by two reviewers. Data extraction and synthesis Data were extracted to a spreadsheet with authors being contacted for missing data. Risk of bias for randomised controlled trials was assessed using the Cochrane tool with the ROBINS-I tool being used for non-randomised studies. Weighted mean differences between baseline and six months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD) and intrabony defect (IBD) were calculated. Results Fifteen studies were incorporated in the systematic review, with ten investigations included in the meta-analysis. In the meta-regression, the additional use of simvastatin, rosuvastatin and atorvastatin decreased pocket depth in contrast with mechanical periodontal treatment and a placebo gel (p < 0.05). Simvastatin and rosuvastatin significantly reduced the development of intrabony defect in contrast with control group (p < 0.05). Statins failed to provide a statistically significant difference between the adjunct therapy for both periodontal pocket depth and intrabony defect (p < 0.05). Simvastatin provided a statistically significant improvement in clinical attachment level gain, as compared to the control group (2.02 ± 0.79 mm; p = 0.043). Conclusions Improvements in periodontal parameters were observed with the use of statins as adjunct to mechanical periodontal therapy. Simvastatin was the main medication that demonstrated additional advantages in all assessed parameters. The use of statins in relationship with non-surgical scaling and root planing provided better clinical periodontal outcomes.