title: Pleiotropic effects of statins on the treatment of chronic periodontitis--a systematic review.
abstract: OBJECTIVE
  Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss.
  
  
  METHODS
  In order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected.
  
  
  RESULTS
  Statins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts.
  
  
  CONCLUSIONS
  Although we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis.
authors.affiliation: Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Ilanna Mara Gomes
authors.initials: IM
authors.lastname: Estanislau
authors.affiliation: Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Icrólio Ribeiro Colares
authors.initials: IR
authors.lastname: Terceiro
authors.affiliation: Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Mario Roberto Pontes
authors.initials: MR
authors.lastname: Lisboa
authors.affiliation: Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Patrícia de Barros
authors.initials: Pde B
authors.lastname: Teles
authors.affiliation: Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Rosimary de Sousa
authors.initials: Rde S
authors.lastname: Carvalho
authors.affiliation: Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Ricardo Souza
authors.initials: RS
authors.lastname: Martins
authors.affiliation: Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Maria Mônica Studart Mendes
authors.initials: MM
authors.lastname: Moreira
mesh_terms: D016301:Alveolar Bone Loss / Q000188:drug therapy*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D055396:Bone Morphogenetic Protein 2 / Q000378:metabolism; D055113:Chronic Periodontitis / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000378:metabolism; D053244:Osteoprotegerin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; C525718:BMP2 protein, human; D050071:Bone Density Conservation Agents; D055396:Bone Morphogenetic Protein 2; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human
keywords: alveolar bone loss; chronic periodontitis; hydroxymethylglutaryl-CoA reductase inhibitors