STATINS -THE ROAD AHEAD

STATINS – THE ROAD AHEAD:

STATINS – THE ROAD AHEAD SCIENTIFIC POSTER, BY Dr.D.SHIVA KUMAR M.D.S. I-YEAR, SAVEETHA DENTAL COLLEGE AND HOSPITALS. ACKNOWLEDGEMENT Dr.N.D.Jayakumar , Dr.O.Padmalatha , Dr.Shreeja Varghese, Dr.Sankari , Dr.Karthikeyan . Dr.Jaiganesh ,

STATINS -THE ROAD AHEAD:

STATINS -THE ROAD AHEAD STATINS , NEW ADVANCEMENT IN TREATING CHRONIC PERIODONTITIS HAVE A EDGE OVER OTHER DRUGS IN TREATING CP BY ITS VARIOUS ACTION, MAINLY PROTECTING HEART AND IMPROVING LIFE OF MANKIND. SHORT HISTORY 1976 Mevastatin from Penicillinum citrinum 1980 Mevinolin from Aspergillus terreus 1987 FDA approves Lovastatin 1988 Lovastatin not effective in FH homozygotes 1994- simvastatin by merck . 1995 Pravastatin decreases heart transplant rejection and mortality independently of lowering cholesterol levels

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ACTIONS OF STATINS IN TREATING CHRONIC PERIODONTITIS

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%LDL REDUCTION ATORVA STATIN FLUVA STATIN LOVA STATIN PRAVA STATIN ROSUVA STATIN SIMVA STATIN 10-20% ------ 20mg 10mg 10mg -------- 5mg 20-30% ------ 40mg 20mg 20mg --------- 10mg 30-40% 10mg 80mg 40mg 40mg 5mg 20mg 40-45% 20mg ------- 80mg 80mg 5-10ng 40mg 46-50% 40mg -------- ------- -------- 10-20mg 80mg 50-55% 80mg -------- -------- -------- 20mg ------- 56-60% ------- -------- -------- -------- 40mg -------- Starting dose 10-20mg 20ng 10-20mg 40mg 10 mg; 5 mg if hypothyroid, >65 yo , Asian 20 mg If higher ldl reduction goal 40mg if >45% 40mg if >25% 20mg if >20% ------- 20 mg if LDL >190 mg/ dL (4.87 mmol /L) 40 mg if >45% Optimal timing anytime Evening With evening meals Any time Anytime Evening Starting dose

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Side effects Nausea &Vomiting constipation Diarrhoea Headache Muscle Pain Severe Muscle pain Rhabidomyolysis

STATIN USE IS ASSOCIATED WITH FEWER PERIODONTAL LESIONS:A RETROSPECTIVE STUDY. :

STATIN USE IS ASSOCIATED WITH FEWER PERIODONTAL LESIONS:A RETROSPECTIVE STUDY. Otso lindy,Kimmosuomalainen , Marja makela and seppo lindy. BMC Oral health 2008; 8 :16 doi10.1186/1472-6831-8-16 Background Inflammatory processes are considered to participate in the development of cardiovascular disease (CVD). Statins have been used successfully in the prevention and treatment of coronary heart disease. Chronic periodontitis has been suggested to contribute to CVD . The aim of this study was to examine the association of statin use and clinical markers of chronic periodontitis . Methods Periodontal probing pocket depth (PPD) values were collected from dental records of 100 consecutive adult patients referred to a university dental clinic for treatment of advanced chronic periodontitis . A novel index, Periodontal Inflammatory Burden Index (PIBI ), was derived from the PPD values to estimate systemic effects of periodontitis

STATIN USE IS ASSOCIATED WITH FEWER PERIODONTAL LESIONS:A RETROSPECTIVE STUDY.:

STATIN USE IS ASSOCIATED WITH FEWER PERIODONTAL LESIONS:A RETROSPECTIVE STUDY. Results Periodontitis patients taking statins had a 37% lower number of pathological periodontal pockets than those without statin medication (P = 0.00043). PIBI, which combines and unifies the data on PPD, was 40% smaller in statin using patients than in patients without statin (P = 0.00069 ) PIBI of subjects on simvastatin and atorvastatin both differed significantly from patients without statin and were on the same level. Conclusion Patients on statin medication exhibit fewer signs of periodontal inflammatory injury than subjects without the statin regimen. PIBI provides a tool for monitoring inflammatory load of chronic periodontitis . The apparent beneficial effects of statins may in part be mediated by their pleiotropic anti-inflammatory effect on periodontal tissue.

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STATINS J Clin Periodontol . 2010 Nov;37(11):1016-22. Effect of atorvastatin on chronic periodontitis : a randomized pilot study. Rocha ML , Sánchez -Marin FJ , Espinosa- Chávez EJ . AIM: We studied the effect of atorvastatin (ATV) treatment on bone loss prevention in subjects with chronic periodontitis . CONCLUSIONS: The results suggest that ATV might have beneficial effects on bone alveolar loss and tooth mobility in subjects with periodontal disease. Oral Dis. 2010 Oct;16(7):648-54. Short-term effects of periodontal therapy as an adjunct to anti- lipemic treatment. Fentoğlu O , Sözen T , Oz SG , Kale B , AIM: Assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti- lipemic treatment. CONCLUSION: Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care. J Periodontol . 2010 Feb;81(2):214-22. Clinical effect of subgingivally delivered simvastatin in the treatment of patients with chronic periodontitis : a randomized clinical trial. Pradeep AR , Thorat MS . AIM: To determine efficiency of subgingival administered simvastatin in treating chronic periodontitis CONCLUSION: greater decrease in gingival index and PD and more CAL gain when treated with SRP plus locally delivered SMV in patients with chronic periodontitis . J Endod . 2009 May;35(5):657-62. Simvastatin as a novel strategy to alleviate periapical lesions. Lin SK , Kok SH , Lee YL , Hou KL , Lin YT , Chen MH , Wang CC , Hong CY . AIM: To determine effectof simvastatin in treating chronic periodontitis CONCLUSION: Simvastatin suppresses the progression of apical periodontitis , possibly by diminishing Cyr61 expression in osteoblasts and, subsequently, macrophage chemotaxis into the lesions.

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. Development of novel therapeutic approaches available, if uses of statins on both CVD and periodontal diseases are confirmed by consecutive prospective studies SCOPE FOR YOUNG RESEARCH SCHOLARS LIKE US, STATINS - HAVE THE ROAD AHEAD STATINS