Abstract
This systematic review aims to analyze the effect of the local application of statins in the regeneration of non-periodontal bone defects. A systematic study was conducted with the Pubmed/Medline, Embase, Cochrane Library and Scielo databases for in vivo animal studies published up to and including February 2019. Fifteen articles were included in the analysis. The local application of the drug increased the percentage of new bone formation, bone density, bone healing, bone morphogenetic protein 2, vascular endothelial growth factor, progenitor endothelial cells and osteocalcin. Meta-analyses showed a statistically significant increase in the percentage of new bone formation when animals were treated with local statins, in contrast to the no introduction of filling material or the introduction of polylactic acid, both in an early (4–6 weeks) and in a late period (12 weeks) (mean difference 39.5%, 95% confidence interval: 22.2–56.9, p <0.001; and mean difference 43.3%, 95% confidence interval: 33.6–52.9, p < 0.001, respectively). Basing on the animal model, the local application of statins promotes the healing of critical bone size defects due to its apparent osteogenic and angiogenic effects. However, given the few studies and their heterogenicity, the results should be taken cautiously, and further pilot studies are necessary, with radiological and histological evaluations to translate these results to humans and establish statins’ effect.
Highlights
Statins, inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, are widely used agents for lowering cholesterol concentrations
The titles and abstracts of all the articles located were read to select in vivo studies in animal models analyzing the effect of a local application of statins on bone defects’ regenerations
The evaluated variable was changes produced as a percentage of new bone under the following intervention: the local application of simvastatin in the created defect versus no introduction of filling material or introduction of placebo
Summary
Inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, are widely used agents for lowering cholesterol concentrations These drugs reduce the progression and may induce the regression of atherosclerosis and are associated with a reduction in cardiovascular morbidity and mortality [1,2,3,4,5,6,7]. This is their main application, because mevalonate, the product of HMG-CoA reductase’s reaction, is the precursor of many other non-steroidal isoprenoid compounds other than cholesterol; their inhibiting role has pleiotropic effects [1,3,5,6,7]. P: animals with induced bone defects; I: local application of statins; C: compared with no treatment or placebo; O: improvement in bone healing
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