Comparative efficacy of locally delivered 1.2% rosuvastatin and 1.2% simvastatin gel as an adjunct to non-surgical periodontal therapy in chronic periodontitis: a clinical and microbiological assay.

Abstract

To evaluate and compare the clinical and microbiological efficacy of locally administered 1.2% Rosuvastatin (RSV) gel and 1.2% Simvastatin (SMV) gel as an adjunct to scaling and root planing (SRP) in the treatment of patients with chronic periodontitis. In this exploratory comparative study, 60 qualifying periodontal pockets (probing pocket depth [PPD] of 5-7 mm) from patients aged 25-55 years were randomized into three groups ($n = 20$ pockets per group): Group I received SRP + local delivery of 1.2% RSV gel; Group II received SRP + local delivery of 1.2% SMV gel; and Group III (control) received SRP + placebo gel. Clinical parameters-Plaque Index (PI), Modified Gingival Index (MGI), Sulcus Bleeding Index (SBI), PPD, and Clinical Attachment Loss (CAL)-were evaluated at baseline, 6 weeks, and 3 months. Microbiological assessment of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) was performed using Polymerase Chain Reaction (PCR) at baseline and 6 weeks. All 60 sites completed the study with no dropouts or adverse reactions. At 6 weeks and 3 months, both statin groups (Groups I and II) demonstrated statistically significant reductions in MGI, SBI, PPD, and CAL compared to the placebo group ($P < 0.05$). The statin groups also showed significantly lower levels of Aa and Pg at 6 weeks. Comparison between the two statins revealed that the SMV group achieved greater reductions in clinical indices (MGI, SBI, PPD, CAL) and bacterial counts (Aa and Pg) than the RSV group; however, this difference was not statistically significant (P < 0.05). No significant differences in PI scores were found between any of the groups at any interval (P < 0.05). The local delivery of both 1.2% simvastatin gel and 1.2% rosuvastatin gel as adjuncts to non-surgical periodontal therapy significantly improved clinical and microbiological outcomes in chronic periodontitis. While simvastatin demonstrated slightly greater absolute improvements than rosuvastatin, the overall therapeutic difference between the two statins was not statistically significant.