Statin Use and Periodontal Inflammation

Objective: HMG CoA reductase inhibitors (statins) are a class of drugs used for their ability to lower cholesterol with resultant reductions in cardiac morbidity and mortality.  A growing body of evidence suggests that statins may also exert a proportion of their beneficial effect on cardiovascular events as a result of their pleiotropic anti-inflammatory properties. Statins are increasingly being used for non-cardiac inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematous.  The purpose of this study was to examine the possible effect of statins – including atorvastatin (Lipitor), simvastatin (Zocor), and cerivastatin (Crestor) – on the local inflammatory response associated with periodontal disease.

Methods: This retrospective chart review study included a total of 235 subjects diagnosed with periodontitis (mean age 54; 21-80) randomly selected from the records of the University of Texas Dental Branch at Houston Advanced Program in Periodontics. Medical histories were reviewed and periodontal parameters included plaque score, probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), mobility, and furcation involvement. 

Results: There was not a significant difference between groups in mean PPD, smoking status, or plaque levels; however, there was a significant difference between control and statin subjects in BOP (p < 0.001), age (p<0.001), and CAL (p<0.05); with the statin group being older on average, having less BOP, and less CAL.

Conclusion: In this study population, individuals taking statin drugs had significantly less periodontal inflammation, as measured by BOP, despite equivalent plaque levels, PPD, and smoking status.

	Control (n=154)	Statin (n=81)
Gender	65 male, 89 female	40 male, 41 female
*Mean Age (years)	52	59
Plaque control record (%)	52	50
Mean probing depths (PD, mm)	2.94	2.89
*Mean attachment level (CAL, mm)	2.99	2.67
*Bleeding on probing (BOP %)	34	19
Tobacco smokers (%)	17	21
Mean number of cigarettes/day (range)	12 (1-20)	15 (3-30)