Department of Stomatology, Division of Periodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil.
J Periodontal Res. 2018 Feb;53(1):12-21. doi: 10.1111/jre.12480. Epub 2017 Sep 5.
Adjunctive therapeutic agents may be used to improve the response to nonsurgical periodontal therapy. Local delivery of statins (simvastatin, artovastatin and rosuvastatin) is a promising adjunct to scaling and root planing (SRP). Thus, the aim of this review is to evaluate if adjunctive local delivery of statins is more effective than SRP alone. Randomized clinical trials that presented a test group evaluating local delivery of statins as adjuncts in healthy, diabetic and smoking patients were included. Medline and the Cochrane library database were searched up to November 2016. Random effects meta-analyses were conducted for pocket depth change and clinical attachment gain. One hundred and twenty-five studies potentially related to the aim of this review were screened, but only 10 were included. The majority of the trials reported additional clinical benefits in the groups that were treated with adjunctive local delivery of statins. Pooled calculations showed that local delivery of statins resulted in additional reduction of pocket depth and clinical attachment gain in healthy people, smokers and diabetic patients. Local statins may offer additional clinical benefits to SRP, even in smokers and diabetics.
辅助治疗药物可用于提高非手术牙周治疗的疗效。他汀类药物（辛伐他汀、阿托伐他汀和罗苏伐他汀）局部给药是牙周刮治和根面平整（SRP）的一种很有前途的辅助手段。因此，本综述的目的是评估他汀类药物局部给药是否比单独 SRP 更有效。纳入了评估健康、糖尿病和吸烟患者中他汀类药物局部给药作为辅助治疗的试验组的随机临床试验。检索了 Medline 和 Cochrane 图书馆数据库，截止日期为 2016 年 11 月。对袋深变化和临床附着增加进行了随机效应荟萃分析。对可能与本综述目的相关的 125 项研究进行了筛选，但仅纳入了 10 项研究。大多数试验报告了在接受他汀类药物局部辅助治疗的组中，有额外的临床获益。汇总计算表明，局部给予他汀类药物可使健康人群、吸烟者和糖尿病患者的袋深和临床附着进一步减少。局部使用他汀类药物可能为 SRP 提供额外的临床获益，即使在吸烟者和糖尿病患者中也是如此。
