Efficacy of topically delivered statins in the surgical management of periodontal intrabony and furcation defects: A systematic review
A. Rizwan Ali, Arun Kumar Patnana, Pravin Kumar, Sharmila Shanmugam, Ankita ChughAbstract:
Background:
Statins, beyond their hypolipidemic effects, are recognized for their anti-inflammatory, antioxidant, and immunomodulatory properties with an anabolic effect on bone. This review evaluates the effectiveness of open flap debridement (OFD) for intrabony and furcation defects, with and without adjunctive topical statin therapy.
Methods:
A comprehensive search of electronic databases was performed using various combinations of relevant keywords to identify randomized controlled trials (RCTs). Study selection and risk-of-bias (RoB) assessment were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The RoB was assessed using version 2 of the Cochrane RoB tool. Owing to substantial clinical and methodological heterogeneity among the included studies, data extraction and the findings were synthesized narratively. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach.
Results:
A total of 12 RCTs were included in the qualitative synthesis. Several studies reported greater reductions in periodontal probing depth and defect depth, along with improvements in clinical attachment level, following adjunctive topical statin therapy compared with OFD alone. However, the magnitude of benefit varied across studies, potentially owing to differences in statin type, defect characteristics, follow-up duration, and study quality. Overall, the RoB was low in one study, some concerns in six studies, and high in five studies. The certainty of evidence for all outcomes was judged to be very low.
Conclusions:
Adjunctive topical statin therapy with OFD may improve periodontal clinical and radiographic outcomes compared with OFD alone. However, these findings should be interpreted cautiously given the substantial heterogeneity, methodological limitations, and very low certainty of evidence.