Comparison of simvastatin 1.2% gel and alendronate 1% gel in chronic periodontitis as local drug delivery: A randomized clinical trial

INTRODUCTION: Simvastatin (SMV) is used for the treatment of hypercholesterolemia. Long-term systemic administration of SMV has been shown to result in increased bone mineral density. Alendronate (ALN) is known to inhibit osteoclastic bone resorption and has osteostimulative properties. AIM: To compare percentile changes in gain in clinical attachment level and reduction of pocket depth, and to radiographically evaluate osseous defect fill with subgingival local drug delivery of 1.2% SMV gel and 1% ALN gel. MATERIALS AND METHODS: A split-mouth study was conducted with 40 infrabony defects from 20 patients diagnosed with chronic periodontitis. The sites were assigned as test site 1 (SMV gel) or test site 2 (ALN gel). After phase I therapy, a single application of SMV gel or ALN gel was done into periodontal pockets. Clinical periodontal parameters and percentage of bone fill were evaluated at baseline, 3 and 6 months. RESULTS: There was a statistically significant reduction in pocket depth, plaque index, and bleeding index scores, gain in Clinical attachment level (CAL) and bone defect fill from baseline to 6 months at both sites. On comparison between the groups, test site 2 showed significant improvement in clinical attachment level than in test site 1 at 6-month follow-up. Test site 2 showed more percentage bone fill than test site 1. CONCLUSION: Usage of both SMV and ALN gels in periodontal intra bony defects can lead to significant improvements in clinical and radiographic parameters; however, ALN showed better osseous defect fill.