Sub-gingival delivery of simvastatin and rosuvastatin for treatment of chronic periodontitis with diabetes mellitus: A randomized controlled clinical-radiographic pilot study

BACKGROUND: Statins are lipid-lowering medications that work by blocking rate-limiting enzyme in cholesterol formation. In patients with Chronic periodontitis (CP) and Diabetes mellitus (DM), subgingival delivery of simvastatin (SMV) and rosuvastatin (RSV) have demonstrated to have bone-stimulatory and anti-inflammatory properties. The current study intended to assess and compare the efficacy of sub-gingivally delivered SMV gel and RSV gel as an adjunctive medication to scaling and root planing (SRP) in the management of intrabony defects in CP patients with type 2 DM. METHODS: 30 patients with CP and type 2 DM were classified into three treatment groups - SRP + placebo, SRP +1.2% SMV and SRP +1.2% RSV. Clinical parameters: site-specific plaque index, modified sulcus bleeding index (mSBI), pocket probing depth (PPD), and relative attachment level (RAL) were documented at baseline, 3 and 6 months and radiographic parameter: intrabony defect depth (IBD) at baseline and 6 months post-treatment. RESULTS: – LDD of 1.2% SMV and 1.2% RSV demonstrated greater clinical and radiographic improvement than placebo, the improvement being statistically significant for PI, mSBI, and PPD for 1.2% SMV and statistically significant for all clinical and radiological parameters for the 1.2% RSV. 1.2% RSV demonstrated greater IBD fill and RAL gain than 1.2% SMV. CONCLUSION: – Localized sub-gingival delivery of statins was beneficial in the treatment intrabony defects in patients with CP and well-controlled type 2 DM. IBD fill and RAL gain were higher with 1.2% RSV than with 1.2% SMV.