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Simvastatin: Its potential new role in periodontal regeneration

Kinra P,*Khan S

Periodontal therapy is aimed at the restoration of tissues destroyed by disease. However, achieving greater predictability with regenerative therapy requires the introduction of an agent which not only hampers tissue destruction but also enhances the regenerative capabilities of the periodontal tissues. Pharmacologic agents offer great promise in this direction. Simvastatin, which is used for the treatment of hypercholesterolaemia, is a universally accepted and relatively inexpensive drug. Its long-term systemic administration in humans has been shown to result in increased bone mineral density. Local application of simvastatin has been shown to stimulate bone formation in rodents both in vitro and in vivo and in human periodontal ligament cells in vitro. These effects seem to be associated with an increased expression of BMP-2 and reduced formation of metabolites of the mevalonate pathway, which it blocks. Many other mechanisms of action have also been proposed and studied. This article reviews the effects of simvastatin and examines its potential role in periodontal regenerative therapy.