title: Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients.
abstract: BACKGROUND
  Simvastatin (SMV), a new locally delivered drug of class statins, is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins, besides having lipid-lowering abilities, also have pleiotropic effects like host modulation and bone regeneration. The present study was designed to investigate the effectiveness of SMV, 1.2 mg, in an indigenously prepared biodegradable controlled-release gel as an adjunct to scaling and root planing (SRP).
  
  
  METHODS
  A total of 60 sites, with pocket depth ≥5 mm, two from each of 30 patients after SRP, were categorized into two treatment groups, for subgingival placement of placebo (Gp 1) or SMV (Gp 2). Clinical parameters were recorded at baseline and at 1, 3 and 6 months comprising plaque index, gingival index, probing pocket depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical gain, INFRA 1 and angle of the defect, INFRA 2 from baseline to 6 months.
  
  
  RESULTS
  All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal condition in both the groups but significant reductions in PPD (p= 0.04), and INFRA 1 (p= 0.000), along with gain in CAL (p= 0.02) and INFRA 2 (p= 0.000) were observed in Gp 2. In one site, an unexpected 5 mm decrease in INFRA 1 was found.
  
  
  CONCLUSIONS
  Local drug delivery of SMV enhanced the beneficial effect of SRP, in pocket reduction, gain in CAL and bone fill.
authors.affiliation: Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
authors.forename: Swati
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Chaubey
authors.affiliation: Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Chaubey
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Agarwal
authors.affiliation: Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
authors.forename: Ellora
authors.initials: E
authors.lastname: Madan
authors.affiliation: Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
authors.forename: Manvi Chandra
authors.initials: MC
authors.lastname: Agarwal
keywords: Chronic periodontitis; INFRA 1; INFRA 2; periodontal regeneration; simvastatin; subgingival drug delivery