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. 2019 Jun 13;19(1):105.
doi: 10.1186/s12903-019-0789-2.

Efficacy of locally-delivered statins adjunct to non-surgical periodontal therapy for chronic periodontitis: a Bayesian network analysis

Ruoyan Cao  1 , Qiulan Li  2 , Yu Chen  1 , Mianfeng Yao  3 , Qiqi Wu  4 , Hongbo Zhou  5
Affiliations

Efficacy of locally-delivered statins adjunct to non-surgical periodontal therapy for chronic periodontitis: a Bayesian network analysis

Ruoyan Cao et al. BMC Oral Health. .

Abstract

Background: Studies indicate locally-delivered statins offer additional benefits to scaling and root planning (SRP), however, it is still hard to say which type of statins is better. This network meta-analysis aimed to assess the effect of locally-delivered statins and rank the most efficacious statin for treating chronic periodontitis (CP) in combination with SRP.

Methods: We screened four literature databases (Pubmed, Embase, Cochrane Library, and Web of Science) for randomized controlled clinical trials (RCTs) published up to June 2018 that compared different statins in the treatment of chronic periodontitis. The outcomes analyzed were changes in intrabony defect depth (IBD), pocket depth (PD), and clinical attachment level (CAL). We carried out Bayesian network meta-analysis of CP without systemic diseases. Traditional and Bayesian network meta-analyses were conducted using random-effects models.

Results: Greater filling of IBD, reduction in PD, and gain in CAL were observed for SRP treated in combination with statins when compared to SRP alone for treating CP without systemic diseases. Specifically, SRP+ Atorvastatin (ATV) (mean difference [MD]: 1.5 mm, 1.4 mm, 1.8 mm, respectively), SRP + Rosuvastatin (RSV) (MD: 1.8 mm, 2.0 mm, 2.1 mm, respectively), and SRP + Simvastatin (SMV) (MD: 1.1 mm, 2.2 mm, 2.1 mm, respectively) were identified. However, no difference was found among the statins tested. In CP patients with type 2 diabetic (T2DM) or in smokers, additional benefits were observed from locally delivered statins.

Conclusion: Local statin use adjunctive to SRP confers additional benefits in treating CP by SRP, even in T2DM and smokers. RSV may be the best one to fill in IBD. However, considering the limitations of this study, clinicians must use cautious when applying the results and further studies are required to explore the efficacy of statins in CP with or without the risk factors (T2DM comorbidity or smoking history).

Keywords: Chronic periodontitis; Network meta-analysis; Periodontal therapy; Statins.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of articles search and screening process
Fig. 2
Fig. 2
Network of the interventional comparisons for the Bayesian network analysis. The size of the nodes is proportional to the number of subjects (sample size) randomized to receive the therapy. The width of the lines is proportional to the number of trials comparing each pair of treatments. SRP, scaling and root planing; SMV, simvastatin; ATV, atorvastatin; RSV, rosuvastatin
Fig. 3
Fig. 3
Multiple-treatment comparisons for ΔPD, ΔCAL, IBD fill in CP without systemic diseases. PD, probing depth; CAL, clinical attachment loss; IBD, intrabony defect; SRP, scaling and root planing; SMV, simvastatin; ATV, atorvastatin; RSV, rosuvastatin
Fig. 4
Fig. 4
The rank of different treatments. PD, probing depth; CAL, clinical attachment loss; IBD, intrabony defect; SRP, scaling and root planing; SMV, simvastatin; ATV, atorvastatin; RSV, rosuvastatin
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