Morris Melissa S, Lee Yeonju, Lavin Mark T, Giannini Peter J, Schmid Marian J, Marx David B, Reinhardt Richard A
Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583-0740, USA.
J Periodontol. 2008 Aug;79(8):1465-73. doi: 10.1902/jop.2008.070659.
Topical injection of simvastatin in methylcellulose gel was shown to stimulate bone growth and inflammation over mouse calvaria and in rat mandible models. The purpose of these pilot studies was to evaluate the potential of locally injected simvastatin in human-sized periodontal defects.
Chronic periodontal defects were created bilaterally in seven 1-year-old beagle dogs: 3-walled intrabony defects distal of the mandibular second premolar and mesial of the fourth premolar and Class II furcation defects at the buccal furcation of the mandibular first molars. The edentulous space distal to the mandibular canine was left undisturbed. After 16 weeks of healing, defect sites were treated with scaling and root planing, and mandible sides were randomly selected to receive three weekly injections of 0.5 mg simvastatin in 30 microl methylcellulose gel and contralateral gel alone (n=3) or 2.0 mg simvastatin/methylcellulose gel and contralateral gel alone (n=4). Two months following drug application, block sections, including teeth and surrounding tissues, and submandibular lymph nodes were obtained for histomorphometric analysis.
Two trends were noted in this pilot study: buccal edentulous ridge thickness was 29% greater with simvastatin, 0.5 mg, compared to gel alone (P=0.0845), and the simvastatin groups had bone-height loss in interproximal intrabony and furcation defects, but the length of new cementum in the interproximal intrabony defects was greater with simvastatin, 0.5 mg (0.35+/-0.14 mm), compared to gel alone (0.06+/-0.15 mm; P=0.069). No new cementum was found in furcations.
Multiple injections of simvastatin are not appropriate for the treatment of intrabony or furcation defects. However, this approach shows potential to augment bone thickness in closed alveolar environments.
在小鼠颅骨和大鼠下颌骨模型中，甲基纤维素凝胶局部注射辛伐他汀可刺激骨生长和炎症反应。这些初步研究的目的是评估局部注射辛伐他汀对人类大小的牙周缺损的治疗潜力。
在7只1岁的比格犬双侧制造慢性牙周缺损：在下颌第二前磨牙远中及第四前磨牙近中制造三壁骨内缺损，在下颌第一磨牙颊侧根分叉处制造II类根分叉缺损。下颌尖牙远中的无牙间隙未作处理。愈合16周后，对缺损部位进行刮治和根面平整，随机选择下颌两侧分别接受每周3次的0.5mg辛伐他汀（溶于30微升甲基纤维素凝胶）注射及对侧单纯凝胶注射（n = 3），或2.0mg辛伐他汀/甲基纤维素凝胶及对侧单纯凝胶注射（n = 4）。给药2个月后，获取包括牙齿和周围组织的块状切片以及下颌下淋巴结进行组织形态计量分析。
在这项初步研究中观察到两个趋势：与单纯凝胶相比，0.5mg辛伐他汀组的颊侧无牙嵴厚度增加了29%（P = 0.0845）；辛伐他汀组在邻间骨内和根分叉缺损处有骨高度丧失，但在邻间骨内缺损处，0.5mg辛伐他汀组的新牙骨质长度（0.35±0.14mm）大于单纯凝胶组（0.06±0.15mm；P = 0.069）。在根分叉处未发现新牙骨质。
多次注射辛伐他汀不适用于治疗骨内或根分叉缺损。然而，这种方法在封闭的牙槽环境中显示出增加骨厚度的潜力。
