Evaluation of Healing of Periodontal Tissues with and Without Simvastatin 1.2% Gel as a Local Drug Delivery in Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients - A Clinical Study

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. These agents are widely used to lower cholesterol and also they seem to modulate bone formation by increasing the expression of bone morphogenetic protein-2, inflammation, and angiogenesis, thus providing a new direction in the field of periodontal therapy. Aims & Objective: The present study was designed to investigate healing of periodontal tissues with and without simvastatin 1.2% gel as a local drug delivery in adjunct to scaling and root planing in chronic periodontitis patients. Materials and Methods: A total of 60 sites of patients aged between 25-50 years of age with chronic moderate periodontitis with localized probing pocket depth of ≥4≤ 6mm, clinical attachment loss of ≥ 4 mm & vertical bone loss of ≤3mm (intrabony defects) were categorized into two treatment groups, for SRP (Gp 1) & 1.2 % SMV gel (Gp 2). Clinical Parameters were recorded at baseline and at 3,6 and 9 months comprising of oral hygiene index simplified, modified plaque index, modified sulcular bleeding index index, probing pocket Depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical bone fill, using grid IOPA from baseline to 6 & 9months. Results: All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal healing in both the groups. There was a greater decrease in OHIs, mPI, mSBI and PD and more CAL gain with significant IBD fill at sites treated with SRP plus locally delivered SMV gel. Conclusion: Local Drug delivery of 1.2% SMV gel enhanced the beneficial effect of SRP in pocket reduction, gain in CAL and bone fill suggestive of better periodontal tissue healing