title: Injectable simvastatin in periodontal defects and alveolar ridges: pilot studies.
abstract: BACKGROUND
  Topical injection of simvastatin in methylcellulose gel was shown to stimulate bone growth and inflammation over mouse calvaria and in rat mandible models. The purpose of these pilot studies was to evaluate the potential of locally injected simvastatin in human-sized periodontal defects.
  
  
  METHODS
  Chronic periodontal defects were created bilaterally in seven 1-year-old beagle dogs: 3-walled intrabony defects distal of the mandibular second premolar and mesial of the fourth premolar and Class II furcation defects at the buccal furcation of the mandibular first molars. The edentulous space distal to the mandibular canine was left undisturbed. After 16 weeks of healing, defect sites were treated with scaling and root planing, and mandible sides were randomly selected to receive three weekly injections of 0.5 mg simvastatin in 30 microl methylcellulose gel and contralateral gel alone (n=3) or 2.0 mg simvastatin/methylcellulose gel and contralateral gel alone (n=4). Two months following drug application, block sections, including teeth and surrounding tissues, and submandibular lymph nodes were obtained for histomorphometric analysis.
  
  
  RESULTS
  Two trends were noted in this pilot study: buccal edentulous ridge thickness was 29% greater with simvastatin, 0.5 mg, compared to gel alone (P=0.0845), and the simvastatin groups had bone-height loss in interproximal intrabony and furcation defects, but the length of new cementum in the interproximal intrabony defects was greater with simvastatin, 0.5 mg (0.35+/-0.14 mm), compared to gel alone (0.06+/-0.15 mm; P=0.069). No new cementum was found in furcations.
  
  
  CONCLUSIONS
  Multiple injections of simvastatin are not appropriate for the treatment of intrabony or furcation defects. However, this approach shows potential to augment bone thickness in closed alveolar environments.
authors.affiliation: Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583-0740, USA.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Morris
authors.forename: Yeonju
authors.initials: Y
authors.lastname: Lee
authors.forename: Mark T
authors.initials: MT
authors.lastname: Lavin
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Giannini
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Schmid
authors.forename: David B
authors.initials: DB
authors.lastname: Marx
authors.forename: Richard A
authors.initials: RA
authors.lastname: Reinhardt
mesh_terms: D016301:Alveolar Bone Loss / Q000188:drug therapy* / Q000473:pathology; D000539:Alveolar Process / Q000187:drug effects / Q000473:pathology; D000818:Animals; D001641:Bicuspid / Q000473:pathology; D001861:Bone Regeneration / Q000187:drug effects; D003739:Dental Cementum / Q000187:drug effects / Q000473:pathology; D004285:Dogs; D004337:Drug Carriers; D005260:Female; D017823:Furcation Defects / Q000188:drug therapy* / Q000473:pathology; D005782:Gels; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D007267:Injections; D007576:Jaw, Edentulous, Partially / Q000473:pathology; D008297:Male; D008336:Mandibular Diseases / Q000188:drug therapy / Q000473:pathology; D008747:Methylcellulose; D008963:Molar / Q000473:pathology; D010012:Osteogenesis / Q000187:drug effects*; D010865:Pilot Projects; D011897:Random Allocation; D019821:Simvastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D004337:Drug Carriers; D005782:Gels; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008747:Methylcellulose; D019821:Simvastatin