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      The effects of statins on dental and oral health: a review of preclinical and clinical studies

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          Abstract

          The statin family of drugs are safe and effective therapeutic agents for the treatment of arteriosclerotic cardiovascular disease (CVD). Due to a wide range of health benefits in addition to their cholesterol lowering properties, statins have recently attracted significant attention as a new treatment strategy for several conditions, which are not directly related to normalizing a lipid profile and preventing CVD. Statins exert a variety of beneficial effects on different aspects of oral health, which includes their positive effects on bone metabolism, their anti-inflammatory and antioxidant properties, and their potential effects on epithelization and wound healing. Additionally, they possess antimicrobial, antiviral, and fungicidal properties, which makes this class of drugs attractive to the field of periodontal diseases and oral and dental health. However, to the best of our knowledge, there has been no comprehensive study to date, which has investigated the effects of statin drugs on different aspects of dental and oral health. Therefore, the primary objective of this paper was to review the effect of statins on dental and oral health. Results of our extensive review have indicated that statins possess remarkable and promising effects on several aspects of dental and oral health including chronic periodontitis, alveolar bone loss due to either extraction or chronic periodontitis, osseointegration of implants, dental pulp cells, orthodontic tooth movement, and orthodontic relapse, tissue healing (wound/bone healing), salivary gland function, and finally, anti-cancer effects. Hence, statins can be considered as novel, safe, inexpensive, and widely-accessible therapeutic agents to improve different aspects of dental and oral health.

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          A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans.

          Removal of teeth results in both horizontal and vertical changes of hard and soft tissue dimensions. The magnitude of these changes is important for decision-making and comprehensive treatment planning, with provisions for possible solutions to expected complications during prosthetic rehabilitation. To review all English dental literature to assess the magnitude of dimensional changes of both the hard and soft tissues of the alveolar ridge up to 12 months following tooth extraction in humans. An electronic MEDLINE and CENTRAL search complemented by manual searching was conducted to identify randomized controlled clinical trials and prospective cohort studies on hard and soft tissue dimensional changes after tooth extraction. Only studies reporting on undisturbed post-extraction dimensional changes relative to a fixed reference point over a clearly stated time period were included. Assessment of the identified studies and data extraction was performed independently by two reviewers. Data collected were reported by descriptive methods. Weighted means and percentages of the dimensional changes over time were calculated where appropriate. The search provided 3954 titles and 238 abstracts. Full text analysis was performed for 104 articles resulting in 20 studies that met the inclusion criteria. In human hard tissue, horizontal dimensional reduction (3.79 ± 0.23 mm) was more than vertical reduction (1.24 ± 0.11 mm on buccal, 0.84 ± 0.62 mm on mesial and 0.80 ± 0.71 mm on distal sites) at 6 months. Percentage vertical dimensional change was 11-22% at 6 months. Percentage horizontal dimensional change was 32% at 3 months, and 29-63% at 6-7 months. Soft tissue changes demonstrated 0.4-0.5 mm gain of thickness at 6 months on the buccal and lingual aspects. Horizontal dimensional changes of hard and soft tissue (loss of 0.1-6.1 mm) was more substantial than vertical change (loss 0.9 mm to gain 0.4 mm) during observation periods of up to 12 months, when study casts were utilized as a means of documenting the changes. Human re-entry studies showed horizontal bone loss of 29-63% and vertical bone loss of 11-22% after 6 months following tooth extraction. These studies demonstrated rapid reductions in the first 3-6 months that was followed by gradual reductions in dimensions thereafter. © 2011 John Wiley & Sons A/S.
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            Statins: mechanism of action and effects

            The beneficial effects of statins are the result of their capacity to reduce cholesterol biosyntesis, mainly in the liver, where they are selectively distributed, as well as to the modulation of lipid metabolism, derived from their effect of inhibition upon HMG‐CoA reductase. Statins have antiatherosclerotic effects, that positively correlate with the percent decrease in LDL cholesterol. In addition, they can exert antiatherosclerotic effects independently of their hypolipidemic action. Because the mevalonate metabolism generates a series of isoprenoids vital for different cellular functions, from cholesterol synthesis to the control of cell growth and differentiation, HMG‐CoA reductase inhibition has beneficial pleiotropic effects. Consequently, statins reduce significantly the incidence of coronary events, both in primary and secondary prevention, being the most efficient hypolipidemic compounds that have reduced the rate of mortality in coronary patients. Independent of their hypolipidemic properties, statins interfere with events involved in bone formation and impede tumor cell growth.
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              Statins: new American guidelines for prevention of cardiovascular disease.

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                Author and article information

                Contributors
                sahebkara@mums.ac.ir , amir_saheb2000@yahoo.com
                Journal
                J Transl Med
                J Transl Med
                Journal of Translational Medicine
                BioMed Central (London )
                1479-5876
                6 April 2020
                6 April 2020
                2020
                : 18
                : 155
                Affiliations
                [1 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Dental Research Center, Department of Orthodontics, Dental Research Institute, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [2 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [3 ]GRID grid.266756.6, ISNI 0000 0001 2179 926X, Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, , University of Missouri-Kansas City, ; Kansas City, MO USA
                [4 ]Halal Research Center of IRI, FDA, Tehran, Iran
                [5 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Neurogenic Inflammation Research Center, , Mashhad University of Medical Sciences, ; Mashhad, Iran
                [6 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Biotechnology Research Center, Pharmaceutical Technology Institute, , Mashhad University of Medical Sciences, ; Mashhad, Iran
                [7 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Department of Medical Biotechnology, School of Medicine, , Mashhad University of Medical Sciences, ; P.O. Box: 91779-48564 Mashhad, Iran
                Article
                2326
                10.1186/s12967-020-02326-8
                7132955
                32252793
                ca47e11a-a0ac-405f-9244-7214bae7a07c
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 25 January 2020
                : 1 April 2020
                Categories
                Review
                Custom metadata
                © The Author(s) 2020

                Medicine
                statin,periodontal disease,dental health,oral health,therapeutic agent
                Medicine
                statin, periodontal disease, dental health, oral health, therapeutic agent

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