Impacto do uso sistêmico de estatinas e de bisfosfonatos nos tecidos periodontais: revisão narrativa da literatura
DOI:
https://doi.org/10.5335/rfo.v28i1.15097Palavras-chave:
Doenças periodontais, periodontite, farmacologia, estatinas, bisfosfonatosResumo
Introdução: A literatura tem apontado uma possível relação entre diversas condições sistêmicas e as doenças periodontais. Dentro das doenças sistêmicas que podem gerar o uso crônico de medicamentos, com potencial associação com as doenças periodontais, destacam-se a hipercolesterolemia e o uso de estatinas; e as doenças do metabolismo ósseo e o uso de bisfosfonatos. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura sobre o efeito das estatinas e dos bisfosfonatos nos parâmetros clínicos e radiográficos periodontais de indivíduos adultos. Resultados: Apenas estudos observacionais em humanos foram incluídos. Um estudo mostrou que, em pacientes que apresentam doença periodontal e usam estatina, houve 37% menos bolsas periodontais (profundidade de sondagem ≥4mm) quando comparadas aos que não utilizam a medicação, além de apresentarem menor índice de carga inflamatória e menor perda de inserção clínica. Em relação aos bisfosfonatos em indivíduos com doenças que envolvem o metabolismo ósseo, sugere-se que a utilização do fármaco tem obtido resultados positivos nos parâmetros periodontais, como menores sinais clínicos de inflamação gengival, menor profundidade de sondagem, menor perda de inserção clínica e maior nível de osso alveolar, quando comparados aos que nunca realizam essa terapia. Conclusão: Dessa forma, as estatinas e os bisfosfonatos apresentam efeitos promissores, em pacientes sob tratamento para suas respectivas condições sistêmicas, na melhoria dos parâmetros periodontais, porém é importante salientar que são necessários mais estudos sobre o assunto para melhor entender os reais efeitos a longo prazo do uso desses fármacos.
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Referências
Van Dyke TE, Sima C. Understanding resolution of inflammation in periodontal diseases: Is chronic inflammatory periodontitis a failure to resolve? Periodontol 2000 2020:82(1):205-13.
Monsarrat P, Blaizot A, Kémoun P, Ravaud P, Nabet C, Sixou M, Vergnes JN. Clinical research activity in periodontal medicine: a systematic mapping of trial registers. J Clin Periodontol 2016:43(5):390-400.
Diniz M, Pereira G, Barreto R, Vasconcelos L, Veloso D, Cunha P, Gherse E, Ghersel H. Principais Drogas com as Possíveis Interações Medicamentosas Prescritas na Clínica Odontológica. Revista Brasileira de Ciência de Saúde 2009:13(1):66-70.
Uzel MI, Kantarci A, Hong HH, Uygur C, Sheff MC, Firatli E, Trackman PC. Connective tissue growth factor in drug-induced gingival overgrowth. J Periodontol 2001:72(7):921-31.
Lindy O, Suomalainen K, Mäkelä M, Lindy S. Statin use is associated with fewer periodontal lesions: A retrospective study. BMC Oral Health 2008:8:16.
Muniz FWMG, Taminski K, Cavagni J, Celeste RK, Weidlich P, Rösing CK. The effect of statins on periodontal treatment-a systematic review with meta-analyses and meta-regression. Clin Oral Investig 2018:22(2):671-87.
Nicolini AC, Grisa TA, Muniz FWMG, Rösing CK, Cavagni J. Effect of adjuvant use of metformin on periodontal treatment: a systematic review and meta-analysis. Clin Oral Investig 2019:23(6):2659-66.
Dimopoulos MA, Kastritis E, Bamia C, Melakopoulos I, Gika D, Roussou M, Migkou M, Eleftherakis-Papaiakovou E, Christoulas D, Terpos E, Bamias A. Reduction of osteonecrosis of the jaw (ONJ) after implementation of preventive measures in patients with multiple myeloma treated with zoledronic acid. Ann Oncol 2009:20(1):117-20.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P, Razak F, Sharma AM, Anand SS, Investigators IS. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 2005:366(9497):1640-9.
Thomas H, Diamond J, Vieco A, Chaudhuri S, Shinnar E, Cromer S, Perel P, Mensah GA, Narula J, Johnson CO, Roth GA, Moran AE. Global Atlas of Cardiovascular Disease 2000-2016: The Path to Prevention and Control. Glob Heart 2018:13(3):143-63.
Sacks FM. The relative role of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in coronary artery disease: evidence from large-scale statin and fibrate trials. Am J Cardiol 2001:88(12A):14N-8N.
Koren MJ, Sabatine MS. PCSK9 Inhibitors, Statins, Low-Density Lipoprotein Cholesterol, Mevalonate Pathway, and Toxicity-Reply. JAMA Cardiol 2017:2(10):1169.
Meor Anuar Shuhaili MFR, Samsudin IN, Stanslas J, Hasan S, Thambiah SC. Effects of Different Types of Statins on Lipid Profile: A Perspective on Asians. Int J Endocrinol Metab 2017:15(2):e43319.
Shepherd J. The West of Scotland Coronary Prevention Study: a trial of cholesterol reduction in Scottish men. Am J Cardiol 1995:76(9):113C-7C.
Downs JR, Clearfield M, Tyroler HA, Whitney EJ, Kruyer W, Langendorfer A, Zagrebelsky V, Weis S, Shapiro DR, Beere PA, Gotto AM. Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TEXCAPS): additional perspectives on tolerability of long-term treatment with lovastatin. Am J Cardiol 2001:87(9):1074-9.
Leira Y, Seoane J, Blanco M, Rodríguez-Yáñez M, Takkouche B, Blanco J, Castillo J. Association between periodontitis and ischemic stroke: a systematic review and meta-analysis. Eur J Epidemiol 2017:32(1):43-53.
Sever PS, Poulter NR, Dahlof B, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes G, Mehlsen J, Nieminen MS, O'Brien ET, Ostergren J, Investigators A. The Anglo-Scandinavian Cardiac Outcomes Trial lipid lowering arm: extended observations 2 years after trial closure. Eur Heart J 2008:29(4):499-508.
Ford I, Blauw GJ, Murphy MB, Shepherd J, Cobbe SM, Bollen EL, Buckley BM, Jukema JW, Hyland M, Gaw A, Lagaay AM, Perry IJ, Macfarlane P, Norrie J, Meinders AE, Sweeney BJ, Packard CJ, Westendorp RG, Twomey C, Stott DJ, Group TPS. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER): Screening Experience and Baseline Characteristics. Curr Control Trials Cardiovasc Med 2002:3(1):8.
Austin PC, Mamdani MM. Impact of the pravastatin or atorvastatin evaluation and infection therapy-thrombolysis in myocardial infarction 22/Reversal of Atherosclerosis with Aggressive Lipid Lowering trials on trends in intensive versus moderate statin therapy in Ontario, Canada. Circulation 2005:112(9):1296-300.
Thapa S, Wei F. Association Between High Serum Total Cholesterol and Periodontitis: National Health and Nutrition Examination Survey 2011 to 2012 Study of American Adults. J Periodontol 2016:87(11):1286-94.
Sangwan A, Tewari S, Singh H, Sharma RK, Narula SC. Periodontal status and hyperlipidemia: statin users versus non-users. J Periodontol 2013:84(1):3-12.
Scardina GA, Pisano T, Cacioppo A, Messina P. Periodontal alteration of the microcirculation and hypercholesterolemia: a possible correlation? South Med J 2011:104(2):116-20.
Cutler CW, Shinedling EA, Nunn M, Jotwani R, Kim BO, Nares S, Iacopino AM. Association between periodontitis and hyperlipidemia: cause or effect? J Periodontol 1999:70(12):1429-34.
Margaritis M, Channon KM, Antoniades C. Statins as regulators of redox state in the vascular endothelium: beyond lipid lowering. Antioxid Redox Signal 2014:20(8):1198-215.
Saxlin T, Suominen-Taipale L, Knuuttila M, Alha P, Ylöstalo P. Dual effect of statin medication on the periodontium. J Clin Periodontol 2009:36(12):997-1003.
Sayar F, Fallah S, Akhondi N, Jamshidi S. Association of serum lipid indices and statin consumption with periodontal status. Oral Dis 2016:22(8):775-80.
Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med 1991:90(1):107-10.
Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 2013:8:136.
Fernandes C, Leite R, FM L. Bisfosfonatos:
Síntese, análises químicas e aplicações farmacológicas. Química Nova 2005:28(2):274-80.
Bagan JV, Jimenez Y, Murillo J, Hernandez S, Poveda R, Sanchis JM, Diaz JM, Scully C. Jaw osteonecrosis associated with bisphosphonates: multiple exposed areas and its relationship to teeth extractions. Study of 20 cases. Oral Oncol 2006:42(3):327-9.
Neves M, Gano L, Pereira N, Costa MC, Costa MR, Chandia M, Rosado M, Fausto R. Synthesis, characterization and biodistribution of bisphosphonates Sm-153 complexes: correlation with molecular modeling interaction studies. Nucl Med Biol 2002:29(3):329-38.
Sahni M, Guenther HL, Fleisch H, Collin P, Martin TJ. Bisphosphonates act on rat bone resorption through the mediation of osteoblasts. J Clin Invest 1993:91(5):2004-11.
Lin JH. Bisphosphonates: a review of their pharmacokinetic properties. Bone 1996:18(2):75-85.
BRASIL, Ministério da Saúde SdC, Tecnologia de Insumos Estratégicos,, Estratégicos. DdAFeI. Relação nacional de medicamentos essenciais. Brasília, 2014.
Brennan RM, Genco RJ, Hovey KM, Trevisan M, Wactawski-Wende J. Clinical attachment loss, systemic bone density, and subgingival calculus in postmenopausal women. J Periodontol 2007:78(11):2104-11.
Otomo-Corgel J. Osteoporosis and osteopenia: implications for periodontal and implant therapy. Periodontol 2000 2012:59(1):111-39.
Yoshihara A, Seida Y, Hanada N, Miyazaki H. A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J Clin Periodontol 2004:31(8):680-4.
Martínez-Maestre M, González-Cejudo C, Machuca G, Torrejón R, Castelo-Branco C. Periodontitis and osteoporosis: a systematic review. Climacteric 2010:13(6):523-9.
Palomo L, Bissada NF, Liu J. Periodontal assessment of postmenopausal women receiving risedronate. Menopause 2005:12(6):685-90.
Buduneli N, Saygan BH, Karaduman U, Saraç F, Karaduman M, Ayçelik N. Calcium, vitamin D supplements with or without alendronate and supragingival calculus formation in osteoporotic women: a preliminary study. Expert Opin Pharmacother 2008:9(12):2015-20.
Grgić O, KovaÄev-ZaviÅ¡ić B, Veljović T, Novaković-Paro J, Maravić T, Bajkin B. The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women. Clin Oral Investig 2017:21(1):151-7.
Bahrami A, Parsamanesh N, Atkin SL, Banach M, Sahebkar A. Effect of statins on toll-like receptors: a new insight to pleiotropic effects. Pharmacol Res 2018:135:230-8.
Psarros C, Economou EK, Koutsilieris M, Antoniades C. Statins as Pleiotropic Modifiers of Vascular Oxidative Stress and Inflammation. J Crit Care Med (Targu Mures) 2015:1(2):43-54.
Sakoda K, Yamamoto M, Negishi Y, Liao JK, Node K, Izumi Y. Simvastatin decreases IL-6 and IL-8 production in epithelial cells. J Dent Res 2006:85(6):520-3.
Jeger R, Dieterle T. Statins: have we found the Holy Grail? Swiss Med Wkly 2012:142:w13515.
Weinreb M, Quartuccio H, Seedor JG, Aufdemorte TB, Brunsvold M, Chaves E, Kornman KS, Rodan GA. Histomorphometrical analysis of the effects of the bisphosphonate alendronate on bone loss caused by experimental periodontitis in monkeys. J Periodontal Res 1994:29(1):35-40.
Altundal H, Sayrak H, Yurtsever E, Göker K. Inhibitory effect of alendronate on bone resorption of autogenous free bone grafts in rats. J Oral Maxillofac Surg 2007:65(3):508-16.
Kaynak D, Meffert R, Bostanci H, Günhan O, Ozkaya OG. A histopathological investigation on the effect of systemic administration of the bisphosphonate alendronate on resorptive phase following mucoperiosteal flap surgery in the rat mandible. J Periodontol 2003:74(9):1348-54.
Buduneli E, Buduneli N, Vardar-Sengül S, KardeÅŸler L, Atilla G, Lappin D, Kinane DF. Systemic low-dose doxycycline and alendronate administration and serum interleukin-1beta, osteocalcin, and C-reactive protein levels in rats. J Periodontol 2005:76(11):1927-33.
Akram Z, Abduljabbar T, Kellesarian SV, Abu Hassan MI, Javed F, Vohra F. Efficacy of bisphosphonate as an adjunct to nonsurgical periodontal therapy in the management of periodontal disease: a systematic review. Br J Clin Pharmacol 2017:83(3):444-54.
Tipton DA, Seshul BA, Dabbous MKh. Effect of bisphosphonates on human gingival fibroblast production of mediators of osteoclastogenesis: RANKL, osteoprotegerin and interleukin-6. J Periodontal Res 2011:46(1):39-47.
Kanzaki H, Chiba M, Shimizu Y, Mitani H. Dual regulation of osteoclast differentiation by periodontal ligament cells through RANKL stimulation and OPG inhibition. J Dent Res 2001:80(3):887-91.
Aghaloo TL, Kang B, Sung EC, Shoff M, Ronconi M, Gotcher JE, Bezouglaia O, Dry SM, Tetradis S. Periodontal disease and bisphosphonates induce osteonecrosis of the jaws in the rat. J Bone Miner Res 2011:26(8):1871-82.
Lo JC, O'Ryan F, Yang J, Hararah MK, Gonzalez JR, Gordon N, Silver P, Ansfield A, Wang B, Go AS. Oral health considerations in older women receiving oral bisphosphonate therapy. J Am Geriatr Soc 2011:59(5):916-22.
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