Table 7.

Clinical studies evaluating impact of systemic statin administration on periodontal wound healing.

Systemic drug delivery
Reference Study area Type of study	Drug Mode of delivery Dose	Number of patients Periodontal status Type of patients	Type of treatment Study design (groups) Follow-up	Results	Periodontal considerations
[109] (USA) Retrospective cohort study	Not reported	1021 Chronic periodontal disease All types of patients (diabetic, smokers, antibiotic users, anti-inflammatory users…)	Nonsurgical treatment Hyperlipidemic vs healthy Mean follow-up = 7.1 years	Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years	Statins reduced tooth loss in chronic periodontitis
[112] (Mexico) RCT	Atorvastatin 20 mg/day	38 Chronic periodontitis Healthy (all types of smoking status)	Nonsurgical treatment Group I: SRP + ATV Group II: SRP + placebo 3 months follow-up	↘ dental mobility ↘ distance from the crestal alveolar bone to the cementoenamel junction	Atorvastatin reduced tooth mobility and bone loss
[110] (Turkey) No control group Longitudinal	Atorvastatin 10 or 20 mg	20 Chronic periodontitis Hyperlipidemic patients (nonsmokers)	Nonsurgical treatment SRP 6 months follow-up	↘ median values for the PI, GI, PD, and BOP (%) ↗ median value of CAL gain All lipid parameters decreased after the periodontal treatment No comparison with the control group	Atorvastatin reduced periodontal breakdown Improved periodontal health may influence metabolic control of hyperlipidemia
[113] (Turkey) Cohort study	Atorvastatin 10 or 20 mg	80 Chronic periodontitis Healthy or hyperlipidemic patients (nonsmokers)	Nonsurgical treatment Group I: healthy patient + SRP Group II: hyperlipidemic patients + prescribed diet (HD) Group III: hyperlipidemic patients + atorvastatin (HS) 3 months follow-up	↗ BOP ↘ IL-6 (serum and GCF) ↘ TNF-α (GCF) levels	Systemic atorvastatin had beneficial effects on periodontal inflammation
[111] (Germany) Cohort study	Simvastatin (n = 87), lovastatin (n = 27), pravastatin (n = 53), fluvastatin (n = 37), atorvastatin (n = 34), and cerivastatin (n = 42)	2689 All types of periodontal disease Hyperlipidemic vs normolipidemic All types of smoking status	All types of periodontal treatment Group I: participants undergoing statin treatment Group II: patients without statins 5.3 years mean follow-up	No effect on PD and CAL ↘ tooth loss	Statins had the beneficial effect of protecting against tooth loss
[56] (USA) Cohort study	Simvastatin Not reported	117 Chronic periodontitis Diabetic vs healthy All types of smoking status	Nonsurgical treatment Group I: nondiabetic patients not taking statin Group II: nondiabetic patients taking statin Group III: diabetic patients not taking statin Group IV: diabetic patients taking statin 6 weeks follow-up	↘ PD in diabetic patients ↗ CAL in nondiabetic patients ↘ MMP-1 level in GCF of nondiabetic and diabetic patients No difference was found for MMP-8 and MMP-9 levels in GCF	Statin intake was associated with reduced PD in diabetic patients and MMP-1 level in GCF in either nondiabetic or diabetic patients
[114] (India) Cohort study	Atorvastatin 20 mg/day	107 Chronic periodontitis Hyperlipidemic vs normolipidemic Nonsmokers	Nonsurgical periodontal treatment Group 1: hyperlipidemic + SIM Group 2: hyperlipidemic + diet Group 3: normolipidemic patients 3 months follow-up	↘ GI Mean change in PD is negatively associated with LDL-C Mean change in GI is positively associated with HDL-C	Patients with hyperlipidemia were more prone to periodontal disease Statin intake had beneficial effects on periodontal inflammation