Effect of locally applied simvastatin on clinical attachment level and alveolar bone in periodontal maintenance patients: A randomized clinical trial.

Abstract

The purpose of this double-masked, randomized, controlled trial was to determine ifthelocal application of simvastatin(SIM), combined with minimally invasive papilla reflection and root planing (PR/RP), is effective in improving clinical attachment level (CAL), probing depth(PD)reduction, and increasing interproximal bone height (IBH)in persistent 6-9mm periodontal pockets in patients receiving periodontal maintenance therapy (PMT). Fifty patientswith Stage III, Grade B periodontitis presenting with a 6-9mm interproximalPD with a history of bleeding on probing (BOP) were included in the study.Experimental [PR/RP+SIM/methylcellulose (MCL); n=27] and control (PR/RP+MCL; n=23) therapies were randomly assigned. Root surfaces were accessed via reflection of interproximal papillae, followed by RP assisted with endoscope evaluation, acid etching,andSIM/MCL or MCL application.CAL, PD, BOP, plaque presence, and IBH (using standardized vertical bitewing radiographs) were evaluated at baseline and 12 months. Measurements were compared by group and time using Chi-square, Wilcoxon rank-sum, and t-tests. Both PR/RP+SIM/MCLand PR/RP+MCL, respectively, resulted inimprovements in clinical outcomes (CAL: -1.9 ± 0.3mm, p<0.0001; -1.0 ± 0.3mm, p<0.003; PD:-2.3mm ± 0.3, p<0.0001; -1.3mm ± 0.3, p<0.0001; BOP: -58.7%; -41.7%, p<0.05) andstable IBH (-0.2 ±0.12, -0.4±0.2,p=0.22)from baseline to 12 months post-therapy.PR/RP+SIM/MCL had more improvement in CAL (p=0.03), PD (p=0.007), and BOP (p=0.047). The addition of SIM/MCL to PR/RP improvedCAL, PD, and BOP compared with PR/RP alone in periodontal maintenance patients.