Effect of hyperlipidemia on response to nonsurgical periodontal therapy: Statin users versus nonusers

Eur J Dent. 2016 Jan-Mar;10(1):69-76. doi: 10.4103/1305-7456.175685.

Abstract

Objective: To evaluate the response to nonsurgical periodontal therapy among hyperlipidemic subjects and whether statin use by hyperlipidemic subjects influences the response.

Materials and methods: This study was conducted on 107 chronic periodontitis subjects (35 normolipidemic [NL] controls, 36 hyperlipidemics on nonpharmacological therapy and 36 hyperlipidemics on statins). Periodontal (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]) and biochemical (plasma triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-DL-C [HDL-C] levels) examination was done at baseline and 3 months after nonsurgical periodontal treatment.

Results: Both the NL and statin groups exhibited significantly greater improvement in GI as compared to the hyperlipidemic group on nonpharmacological therapy (P = 0.004 and 0.006, respectively). Mean change in PD correlated negatively with baseline TC (r = -0.306) and LDL-C (r = -0.360) while mean change in GI positively correlated with baseline HDL-C (r = 0.219). Regression analyses revealed that mean change in PD was negatively associated with LDL-C (β = -0.358, P < 0.001) while mean change in GI was positively associated with HDL-C (β = 0.219, P = 0.023).

Conclusions: While higher baseline lipid levels were somewhat detrimental to the resolution of inflammation postperiodontal treatment, the inclusion of statin therapy among hyperlipidemic subjects seemed to improve clinical response as compared to those devoid of the drug. The findings of the study are suggestive of a possible adjunctive role of statins in periodontal treatment that warrants future studies.

Keywords: Cholesterol; hydroxymethylglutaryl coenzyme A reductase inhibitors; hyperlipidemia; nonsurgical periodontal therapy; periodontitis.