Simvastatin vs. alendronate gel in chronic periodontitis: a trial.

| Posted in: Science Health Sciences

Journal name: Journal of Indian Society of Periodontology
Original article title: Comparison of simvastatin 1.2% gel and alendronate 1% gel in chronic periodontitis as local drug delivery: A randomized clinical trial
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Bhavya Shetty, Pallavi Karegowda, Safiya Fatima Khan, Umesh Yadalam, Manjusha Nambiar


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Comparison of simvastatin 1.2% gel and alendronate 1% gel in chronic periodontitis as local drug delivery: A randomized clinical trial

Year: 2022 | Doi: 10.4103/jisp.jisp_37

Copyright (license): CC BY-NC-SA


Summary of article contents:

1) Introduction

Periodontal disease results in the inflammation and destruction of supporting structures of the teeth, often leading to tooth loss due to bone resorption. Traditional treatments have included systemic antimicrobials, but concerns regarding antibiotic resistance have led to a shift towards local drug delivery methods. This study investigates the effects of locally applied 1.2% simvastatin (SMV) gel and 1% alendronate (ALN) gel in managing infrabony defects in patients with chronic periodontitis. Both SMV and ALN have shown potential in promoting bone density and healing in various studies, prompting exploration of their efficacy when used in periodontal treatments.

2) Improved Clinical Outcomes with Alendronate

Both SMV and ALN gels were found to significantly reduce pocket depth, plaque index, and bleeding index scores while improving clinical attachment level (CAL) and bone defect fill over the course of the study. However, at the six-month follow-up, ALN gel demonstrated superior outcomes compared to SMV gel. Specifically, ALN led to a greater percentage of bone fill in radiographic evaluations, indicating its effectiveness in stimulating bone regeneration and enhancing periodontal healing. These results suggest that local delivery of ALN is more advantageous for achieving favorable clinical parameters in the management of periodontal defects than SMV.

3) Conclusion

In conclusion, the study highlights the significant improvements in clinical and radiographic parameters associated with the use of SMV and ALN in treating periodontal intrabony defects. While both agents were beneficial, ALN consistently outperformed SMV in terms of radiographic bone fill and clinical attachment gains. This suggests that ALN may be the preferred option for clinicians seeking to enhance periodontal healing in patients suffering from chronic periodontitis. The findings underscore the potential for localized drug delivery therapies in periodontal treatments, contributing to more effective management strategies for periodontal disease.

FAQ section (important questions/answers):

What is the purpose of using simvastatin and alendronate in periodontal treatment?

Simvastatin and alendronate are used to improve outcomes in periodontal therapy, specifically by increasing clinical attachment levels and reducing pocket depth in patients with chronic periodontitis.

How was the efficacy of simvastatin and alendronate evaluated in the study?

The study utilized a split-mouth design with 40 infrabony defects in 20 patients, comparing the effects of 1.2% simvastatin gel and 1% alendronate gel on clinical parameters and radiographic bone fill.

What significant results were found after applying simvastatin and alendronate?

Both treatments led to significant improvements in clinical and radiographic parameters, but alendronate demonstrated better osseous defect fill compared to simvastatin at the six-month follow-up.

What clinical parameters were measured during the study?

The study measured plaque index, probing pocket depth, clinical attachment level, and modified sulcus bleeding index at baseline, 3 months, and 6 months after treatment.

What conclusion can be drawn regarding the effectiveness of the gels used?

The study concluded that both simvastatin and alendronate can significantly improve clinical outcomes in periodontal defects; however, alendronate was more effective at enhancing bone fill.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Simvastatin vs. alendronate gel in chronic periodontitis: a trial.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
Table refers to a structured arrangement of data, often organized in rows and columns, to represent findings or summaries from the study. In a clinical study context, tables help visualize results and make comparisons easier, enhancing understanding for researchers and practitioners evaluating treatment effectiveness.

2) Study (Studying):
In medical research, a study is a systematic investigation aimed at discovering or confirming facts and principles. It defines the methodology and objective, such as testing a treatment's effectiveness or understanding disease mechanisms. The rigor of a study influences its robustness and the validity of its conclusions.

3) Drug:
A drug is a chemical substance used to diagnose, treat, or prevent disease. In the study, simvastatin and alendronate were local delivery agents administered for periodontal defects. Understanding the pharmacodynamics and pharmacokinetics of drugs is crucial for ensuring patient safety and treatment efficacy in clinical settings.

4) Visit:
Visit refers to a scheduled appointment in the clinical study to evaluate a patient's progress post-treatment. It allows for the monitoring of clinical parameters over time, ensuring that the effects of the medication can be documented and analyzed accurately, reinforcing the study's findings.

5) Rules:
Rules are guidelines or principles that dictate conduct or procedures within the study. They ensure consistency in methodology, participant treatment, and data collection. Adhering to rules is essential in clinical research to maintain ethical standards and the integrity of study results, preventing bias.

6) Measurement:
Measurement is the process of obtaining quantitative data for clinical parameters like plaque index or probing depth. Accurate measurements are vital in assessing treatment effectiveness over time. They provide a basis for statistical analysis and comparison between treatment groups to validate the study's hypotheses.

7) Activity:
Activity in a clinical context often refers to biological processes, such as the engagement of osteoblasts or osteoclasts in bone remodeling. Understanding activity levels can indicate the response to treatments and help inform further therapeutic strategies in managing conditions like periodontitis.

8) Bleeding:
Bleeding in clinical studies often indicates the presence of inflammation or periodontal disease. The modified sulcus bleeding index (mSBI) is used to assess bleeding tendencies after treatment. Monitoring bleeding is important for evaluating the success of interventions and ensuring patient safety during recovery.

9) Inflammation:
Inflammation is the body's response to injury or infection, often characterized by pain, redness, and swelling. In periodontal studies, assessing inflammation is crucial for determining the efficacy of treatment. Successful interventions typically result in reduced inflammation, indicating healing and improved health of the periodontal tissues.

10) Disease:
Disease refers to a pathological condition that disrupts normal bodily functions, such as chronic periodontitis studied here. Understanding the disease mechanisms is vital for developing targeted therapies and improving patient outcomes. Disease management strategies are essential for restoring health and function in affected individuals.

11) Antibiotic (Antibacterial):
Antibiotics are agents that inhibit the growth of bacteria and are often used in treating infections. Though systemic antibiotics have been historically used in periodontal therapy, concerns about resistance have led researchers to explore localized drug delivery methods that may effectively target pathogenic bacteria with fewer systemic effects.

12) Hygiene (Hygienic):
Hygiene, particularly oral hygiene, is critical in preventing and managing periodontal disease. The study may observe the impact of oral hygiene practices on treatment outcomes. Improved hygiene can enhance treatment efficacy and is often emphasized in patient education to support long-term periodontal health.

13) Surface:
Surface refers to the outer or superficial layer, such as the gingival or mucosal surface in periodontal interventions. The effectiveness of treatments can be influenced by the surface conditions, including biofilm presence and tissue integrity, which can affect drug absorption and healing processes.

14) Water:
Water is the solvent used in drug formulation and plays a crucial role in drug delivery systems, including gels. Its purity and quality impact the stability and efficacy of formulated drugs. Additionally, hydration is essential for maintaining tissue health during periodontal treatments.

15) Vina:
Veena likely refers to one of the authors or researchers involved in the study. Author contributions are crucial for establishing credibility in scientific research. Their previous work and findings provide a foundation for the current study and help contextualize the results within the broader scientific discourse.

16) Line:
Line refers to a linear measurement used in various assessments, including radiographic evaluations. In orthodontics and periodontics, lines help quantify changes from baseline measurements and facilitate comparisons across different time points, ultimately informing treatment decisions and therapeutic efficacy.

17) Rheumatoid arthritis:
Rheumatoid arthritis is an autoimmune disease impacting joint health. While it may not be directly linked to periodontal disease, understanding systemic conditions like rheumatoid arthritis is important, as they can influence treatment responses and outcomes. This awareness helps clinicians personalize patient care effectively.

18) Pharmacological:
Pharmacological refers to the effects and mechanisms of drugs in biological systems. In the study, understanding the pharmacological properties of simvastatin and alendronate is vital to assess their therapeutic efficacy and safety when used as local drug delivery options in treating periodontal conditions.

19) Transformation (Transform, Transforming):
Transformed indicates a significant change or adaptation in approach or understanding, particularly in treatment methodologies. In the study context, it reflects how new research findings can alter practitioners' perspectives on managing periodontal disease, leading to improved strategies based on recent evidence and insights.

20) Observation:
Observation is the act of closely monitoring a subject or phenomenon, crucial in clinical studies for assessing treatment effects. Through structured observations, researchers can gather data on patient responses, contributing to the overall understanding of treatment efficacy and guiding future clinical practices.

21) Discussion:
Discussion refers to the section where study findings are interpreted and contextualized within existing literature. It allows for analyzing the implications of results, exploring limitations, and suggesting future research directions, ultimately contributing to the advancement of knowledge in the field of periodontology.

22) Collecting:
Collecting data is an essential step in clinical research, involving the systematic gathering of measurements and observations. Accurate data collection ensures the credibility of the study's findings and underpins statistical analysis, influencing the validity and reliability of the conclusions drawn from the research.

23) Alcoholism:
Alcoholism refers to a chronic condition characterized by excessive drinking, impacting overall health and possibly influencing periodontal disease progression. Recognizing such confounding factors is important in clinical studies to ensure proper participant selection and address potential biases affecting the treatment outcomes.

24) Knowledge:
Knowledge in medical research encompasses the information obtained from studies, experiences, and literature. It guides clinical practice and informs treatment strategies, emphasizing the importance of keeping updated with recent research findings to enhance patient care and promote effective therapeutic interventions.

25) Swelling:
Swelling is a common clinical sign indicating inflammation or pathological change in tissues. In studies, assessing swelling helps evaluate treatment effects, particularly in periodontal therapy, where reducing swelling is often an important goal, indicating decreased inflammation and improved tissue health.

26) Dressing:
Dressing refers to protective coverings applied to wounds or surgical sites. In the context of periodontal treatments, dressings may be employed to protect the area during healing. However, in some protocols, absence of dressings post-treatment is sought to allow for natural recovery without interference.

27) Relative:
Relative comparisons assess outcomes or measurements in relation to one another, providing context to clinical findings. In studies, understanding relative differences between treatment groups can highlight the efficacy of approaches, ultimately informing treatment protocols and clinical decision-making.

28) Pregnant:
Pregnant women may face unique health challenges and are often excluded from certain medical studies to avoid potential risks. Understanding the implications of pregnancy on periodontal health is crucial for tailoring effective treatments and offering appropriate guidance to affected patients during and after pregnancy.

29) Mineral:
Minerals play essential roles in various physiological processes, including bone health. In periodontal therapy, ensuring adequate mineralization is vital for supporting bone regeneration. Knowledge of mineral dynamics can guide the selection of treatment modalities aimed at enhancing periodontal healing and stability.

30) Science (Scientific):
Science refers to the systematic study of the natural world through observation and experimentation, forming the basis of evidence-based medicine. In periodontal research, scientific methods lead to the discovery, validation, and refinement of therapeutic interventions intended to improve patient outcomes in gum diseases.

31) Repair:
Repair refers to the process of restoring tissue structure and function after damage, a key goal in periodontal therapy. Successful repair outcomes signify effective treatment and restoration of periodontal health, which is often monitored through clinical and radiographic evaluations in research studies.

32) Sharman (Sarma, Sharma, Sarman):
Sharma denotes one of the authors or contributors involved in the study, enhancing its credibility. Authorial contribution highlights the collaborative nature of research, ensuring diverse expertise and perspectives inform findings, potentially influencing clinical practice and guiding future experimental endeavors.

33) Reason:
Reason indicates the rationale behind research hypotheses or treatment selection. Understanding underlying reasons for treatment choices in studies helps articulate objectives and justifications, aligning methodologies with anticipated outcomes, and guiding the interpretation of results within the broader landscape of existing knowledge.

34) Animal:
Animal studies are often employed to explore therapeutic effects prior to human trials. They provide essential insights into biological mechanisms and safety profiles, paving the way for clinical applications. Such studies are crucial for translating findings into effective practices in human populations.

35) Powder:
Powder refers to the physical form of simvastatin and other agents used in gel formulations. Understanding the properties of powdered drugs is critical for ensuring effective delivery, stability, and optimal pharmacological performance, influencing the overall success of therapeutic interventions in periodontal treatments.

36) Kappa:
Kappa may relate to an aspect of inflammation or immunity, such as kappa light chains in immunoglobulins. Understanding kappa's role in immune responses can deepen the understanding of inflammation in periodontal conditions, contributing to knowledge about treatment responses in individuals with chronic periodontitis.

37) India:
India, likely referencing the study's geographical context, helps situate the research within a specific socio-economic and cultural framework. Understanding local health issues and practices can contextualize findings, inform public health policies, and guide community-specific interventions in periodontal health.

38) Field:
Field refers to the area of study or practice, such as periodontology. Advancements in specific fields drive clinical practices and research agendas. Understanding trends within a field can facilitate innovation and enhance patient care by integrating new knowledge and techniques.

39) Food:
Food impacts systemic health and oral conditions, playing a role in disease prevention and management. Nutritional considerations are important in periodontal health, emphasizing the need for holistic approaches that incorporate dietary habits into periodontal treatment plans for optimal patient outcomes.

40) Post:
Post refers to the timeline after treatment or intervention. Monitoring post-treatment outcomes allows researchers to assess the sustainability of treatment effects, providing valuable insights into the long-term efficacy and safety of interventions used in the management of periodontal diseases.

41) Male:
Male may indicate a demographic factor in the study participants. Understanding gender differences is important in clinical research, as biological and lifestyle variations can influence disease prevalence and treatment responses, thereby impacting the interpretation of study findings and patient management strategies.

42) Life:
Life encompasses the holistic view of health, integrating physical, mental, and social well-being. Medical research aims to enhance quality of life through effective treatments. In periodontal studies, understanding how diseases affect patients' lives is essential to measure treatment success and patient satisfaction.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Simvastatin vs. alendronate gel in chronic periodontitis: a trial.’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Therapeutic agent, Statistical analysis, Clinical attachment level, Radiographic evaluation, Periodontal therapy, Local Drug Delivery, Simvastatin treatment, Osteoclastic bone resorption.

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