1
|
Diniz JA, Dourado ACAG, Barbirato DDS, da Silveira KG, Vasconcellos RJDH, Laureano Filho JR. Effect of simvastatin topical use on alveolar bone after tooth extraction: a scoping review. Clin Oral Investig 2024; 28:86. [PMID: 38195898 DOI: 10.1007/s00784-023-05482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin's impact on alveolar bone regeneration and determine its level of support for clinical applications. MATERIALS AND METHODS This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. RESULTS Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. CONCLUSIONS Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. CLINICAL RELEVANCE This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF REGISTRY PROTOCOL: osf.io/q3bnf.
Collapse
Affiliation(s)
- Jiordanne Araújo Diniz
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | - Ana Cláudia Amorim Gomes Dourado
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil.
| | - Davi da Silva Barbirato
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | - Karoline Gomes da Silveira
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | | | - José Rodrigues Laureano Filho
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| |
Collapse
|
2
|
Issa DR, Elamrousy W, Gamal AY. Alveolar ridge splitting and simvastatin loaded xenograft for guided bone regeneration and simultaneous implant placement: randomized controlled clinical trial. Clin Oral Investig 2024; 28:71. [PMID: 38172458 DOI: 10.1007/s00784-023-05427-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES The present study goal was to assess clinically and radiographically using simvastatin (SMV) loaded xenograft for guided bone regeneration (GBR) around simultaneously placed implants with alveolar ridge splitting in patients with horizontally atrophic jaw defect. MATERIALS AND METHODS Randomized distribution of the twenty-two patients into two groups (11 patients each) was performed. Group I participants received alveolar ride splitting (ARS) with GBR using SMV gel mixed bone graft and a barrier membrane with simultaneous implant placement. Group II received the same treatment protocol without SMV gel. At the baseline, 6- and 9-months post-surgery, clinical and radiological alterations were assessed. RESULTS Six months after therapy, PES records of group I were statistically significantly improved than those of group II (P < .001). Group I exhibited statistically significant expansion of the alveolar ridge over group II after 6 and 9 months (P < .001). When compared to group II over the evaluation interval between 6 and 9 months, group I demonstrated statistically substantially minimal loss of the mean marginal bone level (P < .001). At the 6- and 9-month observation periods, bone density gain was considerably higher in group I than that in group II (P < .001). CONCLUSION Alveolar ridge splitting along with GBR-augmented SMV improve the clinical and radiographical outcomes around dental implant over GBR alone. CLINICAL RELEVANCE Augmenting GBR with SMV in alveolar ridge splitting could boost implant osseointegration and enhance peri-implant tissue changes. CLINICAL TRIAL REGISTRATION NCT05020405.
Collapse
Affiliation(s)
- Dalia Rasheed Issa
- Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Walid Elamrousy
- Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - Ahmed Y Gamal
- Department of Periodontology, Faculty of Oral and Dental Medicine, Ain Shams University-Misr University for Science and Technology, Cairo, Egypt
| |
Collapse
|
3
|
Zahedipour F, Hosseini SA, Reiner Ž, Tedeschi-Reiner E, Jamialahmadi T, Sahebkar A. Therapeutic Effects of Statins: Promising Drug for Topical and Transdermal Administration. Curr Med Chem 2024; 31:3149-3166. [PMID: 37157198 DOI: 10.2174/0929867330666230508141434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023]
Abstract
Statins are HMG-CoA reductase inhibitors and decrease plasma low-density lipoprotein cholesterol (LDL-C) levels. They are well tolerated, and because of their LDL-C-lowering effect, they are utilized to decrease the risk of atherosclerosis and cardiovascular disease. However, statins have pleiotropic effects, including immunomodulatory, anti-inflammatory, antioxidant, and anticancer. Currently, oral administration is the only Food and Drug Administration (FDA)-approved route of administration for statins. However, other administration routes have demonstrated promising results in different pre-clinical and clinical studies. For instance, statins also seem beneficial in dermatitis, psoriasis, vitiligo, hirsutism, uremic pruritus, and graft-versus-host disease. Topically applied statins have been studied to treat seborrhea, acne, rhinophyma, and rosacea. They also have beneficial effects in contact dermatitis and wound healing in animal studies, (HIV) infection, osseointegration, porokeratosis, and some ophthalmologic diseases. Topical and transdermal application of statins is a non-invasive drug administration method that has shown significant results in bypassing the first-pass metabolism in the liver, thereby reducing possible adverse effects. This study reviews the multifaceted molecular and cellular impacts of statins, their topical and transdermal application, novel delivery systems, such as nanosystems for topical and transdermal administration and the challenges concerning this approach.
Collapse
Affiliation(s)
- Fatemeh Zahedipour
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyede Atefe Hosseini
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Željko Reiner
- University Hospital Center Zagreb, Department of Internal Medicine, Zagreb, Croatia
- Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | | | - Tannaz Jamialahmadi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
4
|
Deepanjali M, Prasad TS, Manodh P. Efficacy of simvastatin in bone regeneration after surgical removal of mandibular third molars. Oral Maxillofac Surg 2023; 27:427-432. [PMID: 35648294 DOI: 10.1007/s10006-022-01081-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to assess the efficacy of simvastatin in bone regeneration in extraction sockets of mandibular third molars using cone beam computed tomography (CBCT) at 6th post-operative month. METHODS This is a prospective randomized split-mouth study involving 15 patients who underwent surgical extraction of bilaterally impacted mandibular third molars with similar morphology on the same day. The efficacy of drug was analyzed by implanting 10 mg of simvastatin into the socket (study site) and observations were made over 6 months to compare the healing with the control site. RESULTS The study results demonstrated a statistically significant difference in bone regeneration: mean gray value of 429.133 in study site compared with mean gray value of 310.153 in the control site. CONCLUSION These values demonstrate significant change in bone regeneration in simvastatin site as compared to that of control site.
Collapse
Affiliation(s)
| | | | - Pedamally Manodh
- Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
5
|
Pruthi G, Mahajan R, Gupta A, Patil AN, Paramasivam V, Kaundal S. The Effects of Statins on Bone Formation Around Implants Placed in Animal Bones: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2023; 22:265-286. [PMID: 37122799 PMCID: PMC10130266 DOI: 10.1007/s12663-023-01873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/11/2023] [Indexed: 03/02/2023] Open
Abstract
Background Implants are preferred for replacement of missing teeth by the clinicians as well as the patients. Lesser alveolar bone density doesn't preclude any individual for choosing this option but warrants for extra caution. Preclinical studies have explored the osteoinductive potential of statins, but results should be analyzed vigorously before implementing them in humans. There is no meta-analysis to document effect of statins on bone formation around implants in osteoporotic animals. Methods and material PubMed, Embase and Cochrane were searched for studies investigating the effect of statins on bone implant contact (BIC %), bone mineral density (BMD %) and bone volume (BV %) around implants at 2, 4 and 12 weeks. Meta-analysis was performed on subgroups with osteoporotic animals which were administered statins through different routes. Results Quantitative data from 12 studies showed favorable effect of statins on bone around implants. Positive difference was observed at 4 weeks in BIC (parenteral [SMD = 4.33 (2.89, 5.77); I 2 = 3%)], BMD (local [SMD = 1.33 (0.51, 2.15); I 2 = 0%] and BV (local [SMD = 1.58 (0.76, 2.40); I 2 = 0%]. BIC [SMD = 1.40 (0.89, 1.90); I 2 = 0%] and BV [SMD = 3.91 (2.33, 5.50); I 2 = 43%] were higher in experimental group after 12 weeks of oral administration. Conclusions Statins can be investigated as potential bone graft materials to increase the predictability of osseointegration especially in osteoporotic individuals. Future research should focus to reproduce homogeneous data and conclusive recommendations which can be applied in clinical trials. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-023-01873-z.
Collapse
Affiliation(s)
- Gunjan Pruthi
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Rhea Mahajan
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Arpit Gupta
- Public Health Dentistry, Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | | | - Vijayabharathi Paramasivam
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
- Present Address: Prosthodontics, AIIMS, Raipur, India
| | | |
Collapse
|
6
|
Oustadi F, Imani R, Haghbin Nazarpak M, Sharifi AM, McInnes SJP. Nanofiber/hydrogel composite scaffold incorporated by silicon nanoparticles for sustained delivery of osteogenic factor: in vitro study. INT J POLYM MATER PO 2022. [DOI: 10.1080/00914037.2022.2147176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Fereshteh Oustadi
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Rana Imani
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Masoumeh Haghbin Nazarpak
- New Technologies Research Center, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Ali Mohammad Sharifi
- Stem Cell and Regenerative Medicine Research Center, and Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedics Surgery, Faculty of Medicine, Tissue Engineering Group (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - Steven J. P. McInnes
- UniSA STEM, Mawson Lakes Campus, University of South Australia, Mawson Lakes, South Australia, Australia
| |
Collapse
|
7
|
Mohammadi A, Dehkordi NR, Mahmoudi S, Rafeie N, Sabri H, Valizadeh M, Poorsoleiman T, Jafari A, Mokhtari A, Khanjarani A, Salimi Y, Mokhtari M, Deravi N. Effects of Drugs and Chemotherapeutic Agents on Dental Implant Osseointegration: Narrative Review. Curr Rev Clin Exp Pharmacol 2022; 19:CRCEP-EPUB-124232. [PMID: 35674294 DOI: 10.2174/2772432817666220607114559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/27/2022] [Accepted: 03/03/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dental implants have been one of the most popular treatments for rehabilitating individuals with single missing teeth or fully edentulous jaws since their introduction. As more implant patients are well-aged and take several medications due to various systemic conditions, clinicians should be mindful of possible drug implications on bone remodeling and osseointegration. OBJECTIVE The present study aims to study and review some desirable and some unwelcomed implications of medicine on osseointegration. METHODS A broad search for proper relevant studies were conducted in four databases, including Web of Science, Pubmed, Scopus, and Google Scholar. RESULTS Some commonly prescribed medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), anticoagulants, metformin, and chemotherapeutic agents may jeopardize osseointegration. On the contrary, some therapeutic agents such as anabolic, anti-catabolic, or dual anabolic and anti-catabolic agents may enhance osseointegration and increase the treatment's success rate. CONCLUSION Systemic medications that enhance osseointegration include mineralization promoters and bone resorption inhibitors. On the other hand, medications often given to the elderly with systemic problems might interfere with osseointegration, leading to implant failure. However, to validate the provided research, more human studies with a higher level of evidence are required.
Collapse
Affiliation(s)
- Aida Mohammadi
- Dental Materials Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Nazanin Roqani Dehkordi
- Department of Periodontology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadaf Mahmoudi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Niyousha Rafeie
- Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamoun Sabri
- Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Valizadeh
- Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Taniya Poorsoleiman
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aryan Jafari
- Dental Materials Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Mokhtari
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arshia Khanjarani
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Yasaman Salimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Melika Mokhtari
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran
| |
Collapse
|
8
|
Tomographic evaluation of the effect of simvastatin topical use on alveolar bone microarchitecture, pain and swelling after mandibular third molar extraction: a randomized controlled trial. Clin Oral Investig 2022; 26:3533-3545. [DOI: 10.1007/s00784-021-04322-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/24/2021] [Indexed: 11/03/2022]
|
9
|
ŞENGÜL M, BOSTANCI V. INVESTIGATION OF THE EFFECT OF HUMIC ACID ON BONE REGENERATION IN PARIETAL DEFECTS FORMED IN RATS RATLARDA OLUŞTURULAN PARİETAL DEFEKTLERDE HUMİK ASİTİN KEMİK REJENERASYONU ÜZERİNE ETKİSİNİN ARAŞTIRILMASI. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.999234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
10
|
Shevchuk OO, Panasiuk YV, Korda MM. Locally delivered lovastatin-containing chitosan nanoparticles promote bone regeneration in rats. UKRAINIAN BIOCHEMICAL JOURNAL 2021. [DOI: 10.15407/ubj93.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
11
|
Cruz R, Moraschini V, Calasans-Maia MD, de Almeida DCF, Sartoretto SC, Granjeiro JM. Clinical efficacy of simvastatin gel combined with polypropylene membrane on the healing of extraction sockets: A triple-blind, randomized clinical trial. Clin Oral Implants Res 2021; 32:711-720. [PMID: 33715258 DOI: 10.1111/clr.13740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to evaluate dimensional changes, level of soft tissue healing, and pain/discomfort perception in post-extraction sockets filling with 1.2% simvastatin (SIM) gel covered with polypropylene membranes (PPPM). MATERIAL AND METHODS Twenty-six post-extraction sockets of posterior teeth were randomly allocated in two groups: (a) socket filling with 1.2% SIM gel and covered with PPPM (n = 13) and (b) socket filling with placebo gel and covered with PPPM (n = 13). Cone-beam computed tomography (CBCT) images before and 90 days after the extraction enabled alveolar bone dimensional changes calculation using horizontal and vertical measurements. The measurements occurred at three different levels for thickness located 1, 3, and 5 mm from the top of the bone crest. The vertical (depth) measure was assessed from the most apical portion of the socket to the bone crest's most coronal portion. Seven days after the extractions, the level of soft tissue healing and pain perception were also analyzed. RESULTS After 90 days of extractions, the dimensional changes in thickness in the test group were significantly smaller in sections A (p = .044), B (p = .036) and C (p = .048) when compared to the control group. The test group showed a significantly lower height-dimensional change than the control group (p < .0001). Soft tissue healing index (p = .63), perception of pain (p = .23), and number of analgesics consumed (p = .25) were similar between groups. CONCLUSIONS Simvastatin at 1.2% compared with placebo effectively reduced the dimensional changes in post-extraction sockets covered with PPPM. There was no significant difference in the level of soft tissue healing and postoperative pain between the test and control groups.
Collapse
Affiliation(s)
- Rebecca Cruz
- Doctoral Program, Fluminense Federal University, Niteroi Rio de Janeiro, Brazil
| | - Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
| | | | | | - Suelen Cristina Sartoretto
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
| | - José Mauro Granjeiro
- Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Brazil.,National Institute of Metrology, Quality, and Technology (INMETRO), Rio de Janeiro, Brazil
| |
Collapse
|
12
|
Ion R, Necula MG, Mazare A, Mitran V, Neacsu P, Schmuki P, Cimpean A. Drug Delivery Systems Based on Titania Nanotubes and Active Agents for Enhanced Osseointegration of Bone Implants. Curr Med Chem 2020; 27:854-902. [PMID: 31362646 DOI: 10.2174/0929867326666190726123229] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 01/16/2019] [Accepted: 05/04/2019] [Indexed: 12/31/2022]
Abstract
TiO2 nanotubes (TNTs) are attractive nanostructures for localized drug delivery. Owing to their excellent biocompatibility and physicochemical properties, numerous functionalizations of TNTs have been attempted for their use as therapeutic agent delivery platforms. In this review, we discuss the current advances in the applications of TNT-based delivery systems with an emphasis on the various functionalizations of TNTs for enhancing osteogenesis at the bone-implant interface and for preventing implant-related infection. Innovation of therapies for enhancing osteogenesis still represents a critical challenge in regeneration of bone defects. The overall concept focuses on the use of osteoconductive materials in combination with the use of osteoinductive or osteopromotive factors. In this context, we highlight the strategies for improving the functionality of TNTs, using five classes of bioactive agents: growth factors (GFs), statins, plant derived molecules, inorganic therapeutic ions/nanoparticles (NPs) and antimicrobial compounds.
Collapse
Affiliation(s)
- Raluca Ion
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Madalina Georgiana Necula
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Anca Mazare
- University of Erlangen-Nuremberg, Department of Materials Science, Erlangen, Germany
| | - Valentina Mitran
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Patricia Neacsu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Patrik Schmuki
- University of Erlangen-Nuremberg, Department of Materials Science, Erlangen, Germany
| | - Anisoara Cimpean
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| |
Collapse
|
13
|
Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part III - Further strategies for local and systemic modulation. Clin Hemorheol Microcirc 2020; 73:439-488. [PMID: 31177207 DOI: 10.3233/ch-199104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this third in a series of reviews on adjuvant drug-assisted bone healing, further approaches aiming at influencing the healing process are discussed. Local and systemic modulation of bone metabolism is pursued with use of a number of drugs with completely different indications, which are characterized by a pleiotropic spectrum of action. These include drugs used to treat lipid disorders (HMG-CoA reductase inhibitors), hypertension (ACE inhibitors), osteoporosis (bisphosphonates), cancer (proteasome inhibitors) and others. Potential applications to enhance bone healing are discussed.
Collapse
Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, Dresden
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
| |
Collapse
|
14
|
Camacho-Alonso F, Martínez-Ortiz C, Plazas-Buendía L, Mercado-Díaz AM, Vilaplana-Vivo C, Navarro JA, Buendía AJ, Merino JJ, Martínez-Beneyto Y. Bone union formation in the rat mandibular symphysis using hydroxyapatite with or without simvastatin: effects on healthy, diabetic, and osteoporotic rats. Clin Oral Investig 2020; 24:1479-1491. [PMID: 31925587 DOI: 10.1007/s00784-019-03180-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/19/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective is to compare new bone formation in critical defects in healthy, diabetic, and osteoporotic rats filled with hydroxyapatite (HA) alone and HA combined with simvastatin (SV). MATERIALS AND METHODS A total of 48 adult female Sprague-Dawley rats were randomized into three groups (n = 16 per group): Group, 1 healthy; Group 2, diabetics; and Group 3, osteoporotics. Streptozotocin was used to induce type 1 diabetes in Group 2, while bilateral ovariectomy was used to induce osteoporosis in Group 3. The central portion of the rat mandibular symphysis was used as a physiological critical bone defect. In each group, eight defects were filled with HA alone and eight with HA combined with SV. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). RESULTS In all groups (healthy, diabetics, and osteoporotics), the defects filled with HA + SV presented greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with bone defects treated with HA alone. CONCLUSIONS Combined application of HA and SV improves bone regeneration in mandibular critical bone defects compared with application of HA alone in healthy, diabetic, and osteoporotic rats. CLINICAL RELEVANCE This study might help to patients with osteoporosis or uncontrolled diabetes type 1, but future studies should be done.
Collapse
Affiliation(s)
- F Camacho-Alonso
- Department of Oral Surgery, University of Murcia, Murcia, Spain.
| | | | | | | | | | - J A Navarro
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - A J Buendía
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - J J Merino
- Department of Biochemistry and Molecular Biology, Complutense University of Madrid, Madrid, Spain
| | - Y Martínez-Beneyto
- Department of Preventive and Community Dentistry, University of Murcia, Murcia, Spain
| |
Collapse
|
15
|
Formulation of transdermal nanoemulsion gel drug delivery system of lovastatin and its in vivo characterization in glucocorticoid induced osteoporosis rat model. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
16
|
Sandoval KR, Machado MCR, de Oliveira ZNP, Nico MMS. CHILD syndrome: successful treatment of skin lesions with topical lovastatin and cholesterol lotion. An Bras Dermatol 2019; 94:341-343. [PMID: 31365666 PMCID: PMC6668949 DOI: 10.1590/abd1806-4841.20198789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/08/2018] [Indexed: 01/10/2023] Open
Abstract
CHILD syndrome (Congenital Hemidysplasia, Ichthyosiform erythroderma, Limb Defects) is a rare X-linked dominant disease. The authors report a 2-month-old patient presenting with typical features of CHILD syndrome that was treated with a topical solution containing cholesterol and lovastatin, with complete clearance of her CHILD nevus. The changes in skin lipid metabolism that explain the CHILD ichthyosiform nevus and their correction through topical application of cholesterol and lovastatin are discussed.
Collapse
Affiliation(s)
- Karina Romero Sandoval
- Department of Dermatology, Hospital das Clínica, Faculdade
de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Cecília Rivitti Machado
- Division of Dermatology, Ambulatório de Dermatologia
Pediátrica, Hospital das Clínicas, Faculdade de Medicina, Universidade
de São Paulo, São Paulo, SP, Brazil
| | - Zilda Najjar Prado de Oliveira
- Division of Dermatology, Ambulatório de Dermatologia
Pediátrica, Hospital das Clínicas, Faculdade de Medicina, Universidade
de São Paulo, São Paulo, SP, Brazil
| | - Marcello Menta Simonsen Nico
- Department of Dermatology, Hospital das Clínica, Faculdade
de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
17
|
Laçin N, İzol BS, Özkorkmaz EG, Deveci B, Tuncer MC. The effect of graft application and simvastatin treatment on tibial bone defect in rats. A histological and immunohistochemical study. Acta Cir Bras 2019; 34:e201900408. [PMID: 31066788 PMCID: PMC6583937 DOI: 10.1590/s0102-865020190040000008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/05/2019] [Indexed: 01/27/2023] Open
Abstract
Purpose: To evaluate histologically and immunohistochemically the bone regeneration after application of simvastatin on tibial bone defects in rats. Methods: Sixty Wistar albino rats were divided into 3 groups as control (6 mm tibial bone defect), defect + graft (allograft treatment), and defect + graft + simvastatin (10 mg/kg/day) for 28 days. Results: Histopathological examination revealed inflammation in control group (defect group), congestion in blood vessels, and an increase in osteoclast cells. In defect + graft group, osteoclastic activity was observed and osteocyte cells were continued to develop. In defect + graft + simvastatin group, osteocytes and matrix formation were increased in the new bone trabeculae. Osteopontin and osteonectin expression were positive in the osteclast cells in the control group. Osteoblasts and some osteocytes showed a positive reaction of osteopontin and osteopontin. In defect + graft + simvastatin group, osteonectin and osteopontin expression were positive in osteoblast and osteocyte cells, and a positive expression in osteon formation was also seen in new bone trabeculae. Conclusion: The simvastatin application was thought to increase bone turnover by increasing the osteoinductive effect with graft and significantly affect the formation of new bone.
Collapse
Affiliation(s)
- Nihat Laçin
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Katip Çelebi, İzmir, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Bozan Serhat İzol
- PhD, Research Assistant, Department of Periodontology, Faculty of Dentistry, University of Bingöl, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Ebru Gökalp Özkorkmaz
- Assistant Professor, Department of Histology and Embryology, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey. Technical procedures, histological examinations, manuscript preparation and writing, final approval
| | - Buşra Deveci
- PhD, Research Assistant, Department of Periodontology, Faculty of Dentistry, University of Dicle, Diyarbakir, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Mehmet Cudi Tuncer
- PhD, Professor, Department of Anatomy, Faculty of Medicine, Dicle University, Diyarbakır, Turkey. Technical procedures, histological examinations, manuscript preparation and writing, final approval
| |
Collapse
|
18
|
Xue Y, Wu M, Liu Z, Song J, Luo S, Li H, Li Y, Jin L, Guan B, Lin M, Chen F, Jin C, Liu D, Li Y, Zhang X. In vitro and in vivo evaluation of chitosan scaffolds combined with simvastatin-loaded nanoparticles for guided bone regeneration. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:47. [PMID: 30980130 DOI: 10.1007/s10856-019-6249-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to fabricate and characterize chitosan combined with different amounts of simvastatin-loaded nanoparticles and to investigate their potential for guided bone regeneration in vitro and in vivo. Different SIM-CSN formulations were combined into a chitosan scaffold (SIM-CSNs-S), and the morphology, simvastatin release profile, and effect on cell proliferation and differentiation were investigated. For in vivo experiments, ectopic osteogenesis and the critical-size cranial defect model in SD rats were chosen to evaluate bone regeneration potential. All three SIM-CSNs-S formulations had a porous structure and exhibited sustained simvastatin release. CSNs-S showed excellent degradation and biocompatibility characteristics. The 4 mg SIM-CSNs-S formulation stimulated higher BMSC ALP activity levels, demonstrated significantly earlier collagen enhancement, and led to faster bone regeneration than the other formulations. SIM-CSNs-S should have a significant effect on bone regeneration.
Collapse
Affiliation(s)
- Yan Xue
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Mingyao Wu
- LangFang Health Vocational College, South Siguang Road, 065001, Langfang, China
| | - Zongren Liu
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
- Department of Stomatology of Tianjin Medical University General Hospital, Binhai Hospital, No. 28, Hangu hospital road, Binhai new district, 300480, Tianjin, China
| | - Jinhua Song
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Shuyu Luo
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Hongjie Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Yuan Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Lichun Jin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Binbin Guan
- Department of Stomatology of Tianjin Medical University General Hospital, No.154, FeiLong road, 300052, Tianjin, China
| | - Mingli Lin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Fuyu Chen
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Chenxin Jin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, 100730, Beijing, China.
| | - Yanqiu Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China.
| | - Xu Zhang
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China.
| |
Collapse
|
19
|
Gupta S, Del Fabbro M, Chang J. The impact of simvastatin intervention on the healing of bone, soft tissue, and TMJ cartilage in dentistry: a systematic review and meta-analysis. Int J Implant Dent 2019; 5:17. [PMID: 30963362 PMCID: PMC6453984 DOI: 10.1186/s40729-019-0168-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 02/19/2019] [Indexed: 11/10/2022] Open
Abstract
The review aimed at assessing the osteopromotive potential as well as soft tissue and temporomandibular joint (TMJ) cartilage healing properties of simvastatin by summarizing its efficacy on the current dental treatment of periodontal bone and soft tissue defects, and temporomandibular joint (TMJ) arthritis from the available animals and human studies. An electronic search was performed on MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) using a combination of keywords. A hand search was undertaken on seven oral surgery journals. No limitation of publication year in the English language was placed. Controlled randomized animal and human clinical trials, as well as prospective comparative studies, were included. Data on the comparison of topical/systemic simvastatin on bone healing in intrabony and furcation defects, extraction sockets, distraction osteogenesis, as well as soft tissue healing in mucogingival grafting procedures and cartilage protection in TMJ arthritis were extracted from all the eligible studies. Studies with a minimum of ten participants and follow up at least 6 months were included. Ten animal studies and six clinical studies were included in this study. All the animal studies included a minimum of eight sites per group assessed clinically, histologically, and radiographically. All human studies included clinical and radiological evaluation. The results of the review show that simvastatin administration displays positive treatment outcomes in the full range of therapies investigated in the oral regions such as periodontal infection control, periodontal and alveolar bone regeneration, soft tissue grafting, TMJ inflammation reduction, and cartilage repair. Its mechanism includes stimulating bone formation, promoting soft tissue healing, increasing articular and condylar cartilage thickness, as well as reducing inflammation at surgical sites in TMJ disorders. Simvastatin administration is beneficial to the healing of oral bone and cartilage. More studies are desired to determine its potential in soft tissue healing.
Collapse
Affiliation(s)
- Swati Gupta
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Jia Chang
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA.
| |
Collapse
|
20
|
Degala S, Bathija NA. Evaluation of the Efficacy of Simvastatin in Bone Regeneration after Surgical Removal of Bilaterally Impacted Third Molars-A Split-Mouth Randomized Clinical Trial. J Oral Maxillofac Surg 2018; 76:1847-1858. [PMID: 29859160 DOI: 10.1016/j.joms.2018.04.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Simvastatin has been reported to promote osteoblastic activity, inhibit osteoclastic activity, and support osteoblast differentiation induced by bone morphogenetic protein. This split-mouth randomized clinical trial evaluated the effect of local application of simvastatin (10 mg) on bone regeneration after surgical removal of bilaterally impacted mandibular third molars. MATERIALS AND METHODS A randomized, split-mouth, single-blinded, single-center trial was performed in 30 patients 18 to 40 years old requiring surgical extraction of bilaterally impacted mandibular third molars. These patients underwent 2 surgical sessions, with extraction of 1 third molar during each session. Each participant was randomly assigned to receive Gelfoam soaked with normal saline or with the drug simvastatin (10 mg) at the first session and were blinded to the use of drug for that particular socket. The alternate regimen was used during the second session. The study was conducted over a period of 3 months. Patients were evaluated for pain, postoperative swelling, and bone density measurement and analysis using intraoral periapical radiographs at the end of 1, 4, 8 and 12 weeks, respectively. In addition, cone-beam computed tomographic (CBCT) images were obtained for every fifth patient at the end of 12 weeks. RESULTS Mean gray-level histographic values were significantly higher for the study sockets at the end of 1, 4, 8, and 12 weeks (P = .001) compared with the control sockets (30 sockets each). CBCT analysis further substantiated accelerated bone regeneration in the study sockets. CONCLUSION The study was statistically and radiographically in favor of the drug, indicating that local application of simvastatin could be a cost-effective and simple way to stimulate and hasten osseous regeneration.
Collapse
Affiliation(s)
- Saikrishna Degala
- Professor and Head of Department, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru, Karnataka, India.
| | - Nikita A Bathija
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru, Karnataka, India
| |
Collapse
|
21
|
Gouda A, Helal E, Ali S, Bakry S, Yassin S. Maxillary sinus lift using osteoinductive simvastatin combined with β-TCP versus β-TCP - a comparative pilot study to evaluate simvastatin enhanced and accelerated bone formation. Acta Odontol Scand 2018; 76:39-47. [PMID: 28952824 DOI: 10.1080/00016357.2017.1381345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to evaluate available bone quality and quantity after performing sinus augmentation using simvastatin/β-TCP combination versus β-TCP alone. MATERIALS AND METHODS This study included eight sinus lift procedures conducted on six patients. The sinuses were divided into two equal groups. The patients were recalled one, two weeks two, five, nine months post-operatively for post-operative evaluation. Radiographic evaluation involved cone beam computed tomography (CBCT) radiographs taken for every patient one week and nine months post-operatively to evaluate the changes in bone height, while histomorphometric evaluation involved transcortical bone biopsies taken after nine months during the second-stage surgery for implant placement. RESULTS The histomorphometric results showed that the amount of newly formed bone was higher in the simvastatin group when compared to the β-TCP group nine months after the surgery; the difference between the two groups was statistically significant. On the other hand, the radiographic evaluation showed that the rate of resorption of the simvastatin group was found to be higher than the control group; however, the difference between both groups was statistically insignificant. CONCLUSION These results showed that Simvastatin is safe to be used in sinus lift with promising osteoinductive capacity, yet further studies using larger sample size is needed.
Collapse
Affiliation(s)
- Ayman Gouda
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Eman Helal
- Fixed and Removable Prosthodontics Department, National Research Center, Cairo, Egypt
| | - Sherif Ali
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Saleh Bakry
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Salah Yassin
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| |
Collapse
|
22
|
Burdurlu C, Deniz E, Olgac V. Histopathologic evaluation of the effects of local simvastatin application and photobiomodulation by light-emitting diode on bone healing of rat calvarial defects. BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1416673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Cagri Burdurlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Ediz Deniz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Vakur Olgac
- Department of Pathology, Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Turkey
| |
Collapse
|
23
|
Saifi AM, Giraddi GB, Ahmed N. Healing of extraction socket following local application of simvastatin: A split mouth prospective study. J Oral Biol Craniofac Res 2017; 7:106-112. [PMID: 28706784 DOI: 10.1016/j.jobcr.2017.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/02/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The role of simvastatin in lowering serum cholesterol level is well described. However, recent findings suggest they have a role in bone formation as well. AIM AND OBJECTIVES The present prospective study was conducted to evaluate the efficacy of simvastatin on bone formation in extraction sockets. MATERIALS AND METHODS 15 patients undergoing all four first premolar extraction were selected based on inclusion and exclusion criteria. Extraction sockets of left premolars (24 and 34) were considered as cases and right premolars (14 and 44) as controls. Overall 30 extraction sites were assigned to each group. Atraumatic extraction was done in all cases following which simvastatin mixed with gelatin sponge was placed in extraction socket of 24 and 34 while only gelatin sponge was placed in 14 and 44. All sockets were then closed with 3-0 vicryl. The patients were kept on follow-up and complications such as dry socket, pain, and swelling were recorded. Intra oral peri apical radiographs were taken immediately after extraction and at 2nd month and 4th month to record changes in the density of alveolar bone. The radiographic measurements were compared and the differences were statistically analyzed. RESULT Percent increase in bone density at the end of 8th week and 16th week was significantly high in case as compared to the control group. CONCLUSION Local application of simvastatin induces bone formation in extraction sockets. Application is very simple and provides a very cost effective way of faster bone regeneration following tooth extraction.
Collapse
Affiliation(s)
- Aamir Malick Saifi
- Department of Oral & Maxillofacial Surgery, Government Dental College & Research Institute, Bangalore, India
| | - Girish B Giraddi
- Department of Oral & Maxillofacial Surgery, Government Dental College & Research Institute, Bangalore, India
| | - Nausheer Ahmed
- Department of Orthodontics, Government Dental College & Research Institute, Bangalore, India
| |
Collapse
|
24
|
Abstract
Mandibular fracture is the most common injury seen in facial fractures and plays an important role for oral and maxillofacial surgery department. The purpose of this study is to investigate the potential of the local administration of rosuvastatin (RSV) on mandibular fracture healing in rats. Thirty-two rats were divided into 4 groups: group C-14 (control), group R-14, group C-28 (control), and group R-28. A unilateral standard vertical osteotomy was performed right side of the mandibula extending from the tooth to the mandibular basis for each animal. In groups C-14 and C-28 sterile saline treated absorbable collogen sponge was applied to the fracture area, in groups R-14 and R-28 absorbable collogen sponge with saline solution containing 1 mg RSV was applied to the fracture area. Animals in groups C-14 and R-14 were euthanized on the 14th day, groups C-28 and R-28 were euthanized on the 28th day after operation. Stereologic analyses were performed. New bone area and connective tissue volumes were measured. Stereologic analysis showed that group R-14 had significantly more new bone at 2 weeks compared with group C-14. Connective tissue volumes were also significantly higher in R-14. New bone and connective tissue volume differences were not statistically significant between groups C-28 and R-28. Locally administered RSV enhances early bone regeneration on mandibular fracture in rats.
Collapse
|
25
|
|
26
|
Ibrahim HK, Fahmy RH. Localized rosuvastatin via implantable bioerodible sponge and its potential role in augmenting bone healing and regeneration. Drug Deliv 2016; 23:3181-3192. [PMID: 26942653 DOI: 10.3109/10717544.2016.1160458] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Statins proved potential bone healing properties. Rosuvastatin is a synthetic, hydrophilic, potent and highly efficacious statin. In the current work, an attempt was investigated to develop, evaluate various bioerodible composite sponges enclosing rosuvastatin and explore their potential in augmenting bone healing and regeneration. METHOD Twelve lyophilized sponge formulae were prepared adapting a 41.31 full factorial design. Xanthan gum, polycarbophil, Carbopol® and sodium alginate were investigated as anionic polymers, each at three chitosan:anionic polymer ratios (1:3, 1:1, 3:1). The formula of choice was implanted in fractured rat femora. RESULTS Visual and microscopic examination showed flexible homogenous porous structures with considerable bending ability. Polyelectrolyte complex formation was proved by DSC and FT-IR for all chitosan/anionic combinations except with xanthan gum where chitosan probably bound to the drug rather than xanthan gum. Statistical analysis proved that anionic polymer type and chitosan: polymer ratio, as well as, their interactions, exhibited significant effects on the release parameters at p ≤ 0.05. The optimum chitosan/anionic polymer complexation ratios were 3:1 for polycarbophil and 1:1 for Carbopol and alginate. The release at these ratios followed Fiction diffusion while other ratios had anomalous diffusion. Imwitor® 900K and HPMC K100M were added as release retarardants for further release optimization. The formula of choice was implanted in fractured rat femora. Histopathological examination revealed advanced stages of healing in treated femora compared to control ones. CONCLUSION Biodegradable sponges for local rosuvastatin delivery proved significantly enhanced wound healing and regeneration properties to fractured bones.
Collapse
Affiliation(s)
- Howida Kamal Ibrahim
- a Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Cairo University , Cairo , Egypt and
| | - Rania Hassan Fahmy
- a Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Cairo University , Cairo , Egypt and.,b Department of Pharmaceutics , Faculty of Pharmacy, Ahram Canadian University , Cairo , Egypt
| |
Collapse
|
27
|
Enhanced solubility and bioavailability of lovastatin using stabilized form of self-emulsifying drug delivery system. Colloids Surf A Physicochem Eng Asp 2015. [DOI: 10.1016/j.colsurfa.2015.04.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
28
|
Influence of simvastatin-loaded implants on osseointegration in an ovariectomized animal model. BIOMED RESEARCH INTERNATIONAL 2015; 2015:831504. [PMID: 25893198 PMCID: PMC4393925 DOI: 10.1155/2015/831504] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 03/11/2015] [Indexed: 11/29/2022]
Abstract
The success of bone implants in the presence of osteoporosis is limited by lack of osseointegration between the implant and the natural bone. This study applied an electrochemical process to deposit simvastatin-nanohydroxyapatite (HA) coatings on porous implant surfaces and investigated the effects of these simvastatin-HA coatings on implant surfaces in an animal model of osteoporosis. In this study, simvastatin-HA coated implants were inserted into the tibia of osteoporotic rats. After 2, 4, and 12 weeks, tissue was retrieved for histomorphometric evaluation. The results indicated that the simvastatin-HA coatings increased bone-implant contact and new bone formation around implant surfaces. In conclusion, implants loaded with simvastatin by an electrochemical process improved implant osseointegration in osteoporotic rats. Furthermore, the increased concentration of simvastatin could affect the osseointegration, but the dose-effects also need further investigation.
Collapse
|
29
|
Jia Z, Zhang Y, Chen YH, Dusad A, Yuan H, Ren K, Li F, Fehringer EV, Purdue PE, Goldring SR, Daluiski A, Wang D. Simvastatin prodrug micelles target fracture and improve healing. J Control Release 2014; 200:23-34. [PMID: 25542644 DOI: 10.1016/j.jconrel.2014.12.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/12/2014] [Accepted: 12/22/2014] [Indexed: 01/20/2023]
Abstract
Simvastatin (SIM), a widely used anti-lipidemic drug, has been identified as a bone anabolic agent. Its poor water solubility and the lack of distribution to the skeleton, however, have limited its application in the treatment of bone metabolic diseases. In this study, an amphiphilic macromolecular prodrug of SIM was designed and synthesized to overcome these limitations. The polyethylene glycol (PEG)-based prodrug can spontaneously self-assemble to form micelles. The use of SIM trimer as the prodrug's hydrophobic segment allows easy encapsulation of additional free SIM. The in vitro studies showed that SIM/SIM-mPEG micelles were internalized by MC3T3 cells via lysosomal trafficking and consistently induced expression of both BMP2 and DKK1 mRNA, suggesting that the prodrug micelle retains the biological functions of SIM. After systemic administration, optical imaging suggests that the micelles would passively target to bone fracture sites associated with hematoma and inflammation. Furthermore, flow cytometry study revealed that SIM/SIM-mPEG micelles had preferred cellular uptake by inflammatory and resident cells within the fracture callus tissue. The treatment study using a mouse osteotomy model validated the micelles' therapeutic efficacy in promoting bone fracture healing as demonstrated by micro-CT and histological analyses. Collectively, these data suggest that the macromolecular prodrug-based micelle formulation of SIM may have great potential for clinical management of impaired fracture healing.
Collapse
Affiliation(s)
- Zhenshan Jia
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yijia Zhang
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yen Hsun Chen
- Hospital for Special Surgery, New York, NY 10021, USA
| | - Anand Dusad
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Hongjiang Yuan
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Ke Ren
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Fei Li
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Edward V Fehringer
- the Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | | | | | | | - Dong Wang
- The Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| |
Collapse
|
30
|
Abdul-Majeed S, Mohamed N, Soelaiman IN. The use of delta-tocotrienol and lovastatin for anti-osteoporotic therapy. Life Sci 2014; 125:42-8. [PMID: 25534439 DOI: 10.1016/j.lfs.2014.12.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/23/2014] [Accepted: 12/05/2014] [Indexed: 12/22/2022]
Abstract
AIMS Statins are competitive inhibitors of HMGCoA reductase and are commonly used as antihypercholesterolemic agents. Experimental studies clearly demonstrate the beneficial effects of statins on bone. Tocotrienols have also been shown to have anti-osteoporotic effects on the skeletal system. This study was conducted to observe the effect of a combination of delta-tocotrienol and lovastatin on structural bone histomorphometry and bone biomechanical strength in a postmenopausal rat model at clinically tolerable doses, and to compare it with the effect of delta-tocotrienol or lovastatin. MAIN METHODS Forty-eight female Sprague Dawley rats were randomly divided into six groups: baseline control; sham-operated control; ovariectomised control; ovariectomised+11mg/kg lovastatin; ovariectomised+60mg/kg delta-tocotrienol and ovariectomised+60mg/kg delta-tocotrienol+11mg/kg lovastatin. These treatments were given via oral gavage daily for eight weeks. After sacrificing the rats, the left and right femurs were dissected and processed for bone histomorphometric analysis and a bone biomechanical test, respectively. KEY FINDINGS Delta-tocotrienol in combination with lovastatin significantly improved the trabecular volume, trabecular number, trabecular thickness and trabecular separation; and it significantly increased bone strength in oestrogen-deficient rats. Delta-tocotrienol alone enhanced bone formation and maintained bone strength in ovariectomised rats. Delta-tocotrienol plus lovastatin treatment promoted better trabecular volume and trabecular number and received higher load than delta-tocotrienol alone. Lovastatin alone was not effective. SIGNIFICANCE Thus, the combination of delta-tocotrienol and lovastatin has the potential to be used for anti-osteoporotic therapy in postmenopausal women.
Collapse
Affiliation(s)
- Saif Abdul-Majeed
- Department of Life Sciences, School of Pharmacy, International Medical University, No. 126, Jalan 19/155b, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital UKM, Jalan Ya'acob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Ima-Nirwana Soelaiman
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital UKM, Jalan Ya'acob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.
| |
Collapse
|
31
|
Montagnani A. Bone anabolics in osteoporosis: Actuality and perspectives. World J Orthop 2014; 5:247-54. [PMID: 25035827 PMCID: PMC4095017 DOI: 10.5312/wjo.v5.i3.247] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 05/19/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Vertebral and nonvertebral fractures prevention is the main goal for osteoporosis therapy by inhibiting bone resorption and/or stimulating bone formation. Antiresorptive drugs decrease the activation frequency, thereby determining a secondary decrease in bone formation rate and a low bone turnover. Bisphosphonates are today's mainstay among antiresorptive treatment of osteoporosis. Also, oral selective estrogen receptor modulators and recently denosumab have a negative effect on bone turnover. Agents active on bone formation are considered a better perspective in the treatment of severe osteoporosis. Recombinant-human parathyroid hormone (PTH) has showed to increase bone formation and significantly decrease vertebral fractures in severe patients, but with a modest effect on nonvertebral fractures. The study of Wnt signaling pathway, that induces prevalently an osteoblastic activity, opens large possibilities to antagonists of Wnt-inhibitors, such as sclerostin antibodies and dickkopf-1 antagonists, with potential effects not only on trabecular bone but also on cortical bone.
Collapse
|
32
|
Balli U, Keles GC, Cetinkaya BO, Mercan U, Ayas B, Erdogan D. Assessment of vascular endothelial growth factor and matrix metalloproteinase-9 in the periodontium of rats treated with atorvastatin. J Periodontol 2013; 85:178-87. [PMID: 23646851 DOI: 10.1902/jop.2013.130018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study is to examine, for the first time, the role of systemic and local atorvastatin application on periodontium using histomorphometric and immunohistochemical analysis during and after experimental periodontitis induction with or without the presence of microbial dental biofilm. METHODS One hundred ten male Wistar rats were used. Silk ligatures were placed around the cervical area of the mandibular first molars; rats in the healthy control group received no ligatures (n = 10). In experimental periodontitis groups (n = 90), systemic and local atorvastatin and saline were administered in three different periods; the control periodontitis group (n = 10) received no treatment. Histomorphometric analysis, which included alveolar bone area, alveolar bone level, and attachment loss, and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)-9, were performed after the rats were sacrificed at the end of the experimental procedure. RESULTS There was a greater increase in alveolar bone area and VEGF immunoreactivity, as well as a greater decrease in alveolar bone and attachment loss and MMP-9 immunoreactivity, with systemic and local atorvastatin application during and after induction of experimental periodontitis. Local atorvastatin application showed better results on periodontium with regard to alveolar bone findings. CONCLUSIONS Systemic and local atorvastatin application showed beneficial effects on periodontium during and after induction of experimental periodontitis. Within the limits of this study, it can be concluded that atorvastatin, which is used for hypercholesterolemia treatment, can also be used as a protective and therapeutic agent for periodontal disease.
Collapse
Affiliation(s)
- Umut Balli
- Department of Periodontology, Faculty of Dentistry, Ondokuzmayis University, Samsun, Turkey
| | | | | | | | | | | |
Collapse
|
33
|
Ezirganlı Ş, Kazancıoğlu HO, Mihmanlı A, Aydın MŞ, Sharifov R, Alkan A. The effect of local simvastatin application on critical size defects in the diabetic rats. Clin Oral Implants Res 2013; 25:969-76. [PMID: 23600677 DOI: 10.1111/clr.12177] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To evaluate bone-healing effects of local simvastatin application to critical size defects (CSDs) in the experimental diabetes mellitus (DM) rat model. MATERIALS AND METHODS A total of 35 male Sprague-Dawley rats with an average weight of 350 g and aged 3 months were used in this study. The rats were divided into five groups of seven animals each: passive control (group A), active control (group B), 0.5 mg simvastatin (group C), 1.0 mg simvastatin (group D), and 1.5 mg simvastatin (group E). Streptozotocin was used to induce Type 1 diabetes in all rats. Eight mm CSDs were created under anesthesia in each rat calvarium. CSDs were left empty in group A. Defects in group B were grafted alone with a gelatin sponge mixed with normal saline. Defects in the experimental groups (groups A, B, and C) were grafted with gelatin sponge mixed saline solutions contain 0.5, 1.0, 1.5 mg simvastatin. Rats were sacrificed after 1 month, and the defects were prepared for radiologic and histomorphometric assessment of regenerated bone. RESULTS None of the specimens exhibited complete closure of new bone across the 8-mm defect. A correlation between computed tomography and histomorphometric analysis was not determined. Both amount of volume and area of regenerated bone were found higher in the experimental groups than in the control groups. However, these values were not found statistically significant degree (P < 0.05) for each groups. The density of regenerated bone in the region of interest was higher in the control groups in contrast to in the experimental groups. However, statistical significance was just found between groups C and A and between groups C and B (P < 0.05). CONCLUSION The local simvastatin application enhanced healing of the bone defects in the diabetic rat model CSDs.
Collapse
Affiliation(s)
- Şeref Ezirganlı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| | | | | | | | | | | |
Collapse
|
34
|
Mathieu S, Palat S, Pereira B, Kemeny JL, Marceau G, Dubray C, Soubrier M. Response to 'Statins accelerate the onset of collagen type II-induced arthritis in mice'. Arthritis Res Ther 2013; 15:402. [PMID: 23472824 PMCID: PMC3672816 DOI: 10.1186/ar4169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
35
|
Liu X, Li X, Zhou L, Li S, Sun J, Wang Z, Gao Y, Jiang Y, Lu H, Wang Q, Dai J. Effects of simvastatin-loaded polymeric micelles on human osteoblast-like MG-63 cells. Colloids Surf B Biointerfaces 2013; 102:420-7. [DOI: 10.1016/j.colsurfb.2012.06.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 06/18/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
|
36
|
Baba TT, Ohara-Nemoto Y, Miyazaki T, Nemoto TK. Involvement of geranylgeranylation of Rho and Rac GTPases in adipogenic and RANKL expression, which was inhibited by simvastatin. Cell Biochem Funct 2013; 31:652-9. [DOI: 10.1002/cbf.2951] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/20/2012] [Accepted: 12/11/2012] [Indexed: 01/29/2023]
Affiliation(s)
- T. T. Baba
- Department of Oral Molecular Biology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Y. Ohara-Nemoto
- Department of Oral Molecular Biology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - T. Miyazaki
- Department of Cell Biology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - T. K. Nemoto
- Department of Oral Molecular Biology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| |
Collapse
|
37
|
Pauly S, Back DA, Kaeppler K, Haas NP, Schmidmaier G, Wildemann B. Influence of statins locally applied from orthopedic implants on osseous integration. BMC Musculoskelet Disord 2012; 13:208. [PMID: 23102098 PMCID: PMC3495199 DOI: 10.1186/1471-2474-13-208] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 10/15/2012] [Indexed: 12/02/2022] Open
Abstract
Background Simvastatin increases the expression of bone morphogenetic protein 2 (BMP-2) in osteoblasts, therefore it is important to investigate the influence of statins on bone formation, fracture healing and implant integration. The aim of the present study was to investigate the effect of Simvastatin, locally applied from intramedullary coated and bioactive implants, on bone integration using biomechanical and histomorphometrical analyses. Methods Eighty rats received retrograde nailing of the femur with titanium implants: uncoated vs. polymer-only (poly(D,L-lactide)) vs. polymer plus drug coated (either Simvastatin low- or high dosed; “SIM low/ high”). Femurs were harvested after 56 days for radiographic and histomorphometric or biomechanical analysis (push-out). Results Radiographic analysis revealed no pathological findings for animals of the control and SIM low dose group. However, n=2/10 animals of the SIM high group showed osteolysis next to the implant without evidence of bacterial infection determined by microbiological analysis. Biomechanical results showed a significant decrease in fixation strength for SIM high coated implants vs. the control groups (uncoated and PDLLA). Histomorphometry revealed a significantly reduced total as well as direct bone/implant contact for SIM high- implants vs. controls (uncoated and PDLLA-groups). Total contact was reduced for SIM low vs. uncoated controls. Significantly reduced new bone formation was measured around SIM high coated implants vs. both control groups. Conclusions This animal study suggests impaired implant integration with local application of Simvastatin from intramedullary titanium implants after 8 weeks when compared to uncoated or carrier-only coated controls.
Collapse
Affiliation(s)
- Stephan Pauly
- Julius Wolff Institut, Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, Berlin, Germany.
| | | | | | | | | | | |
Collapse
|
38
|
Pan X, Cheng W, Wang J, Qin L, Lai Y, Tang J, Shang P, Ren P, Zhang P. 'Old drugs for new applications': can orthopedic research benefit from this strategy? Ther Adv Musculoskelet Dis 2012; 3:201-5. [PMID: 22870479 DOI: 10.1177/1759720x11408487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
New drug exploration is difficult in a clinical setting and the development of new drugs may be costly and time consuming. With further research into the pathological mechanisms and etiology of diseases as well as the rapid development of biological techniques, many 'old drugs' that have been applied in clinics may have new therapeutic functions which may shed light on clinical management. Based on this, we have investigated the 'old drugs for new applications' strategy in pharmacology which may be less expensive and more efficient in the clinical setting. In this paper we have explored and illustrated the potential applications of 'old drugs' for the treatment of orthopedic diseases, especially in arthritis and osteoporosis therapy.
Collapse
Affiliation(s)
- Xiaohua Pan
- Department of Orthopaedics, Second Clinical Medical College, Ji'nan University, Shenzhen, Guangdong Province, China
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Handal JA, John TK, Goldstein DT, Khurana JS, Saing M, Braitman LE, Samuel SP. Effect of atorvastatin on the cortical bones of corticosteroid treated rabbits. J Orthop Res 2012; 30:872-6. [PMID: 22161768 DOI: 10.1002/jor.22030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 11/15/2011] [Indexed: 02/04/2023]
Abstract
Osteoporosis ("secondary" osteoporosis) and avascular necrosis (AVN) of the femoral head are well-known adverse effects of corticosteroid therapy. Statins have been reputed to increase bone strength and bone density. In this study, we evaluated the effect of atorvastatin calcium on the flexural properties (3-point bending strength and modulus) of corticosteroid (methylprednisolone acetate) treated rabbit femurs and tibias. Our study hypothesis was that the use of statins would counteract the loss of bone strength caused by corticosteroid treatment. The 40 rabbits were divided into 5 groups: control, corticosteroid alone and corticosteroid combined with oral doses of atorvastatin calcium (2, 10, or 20 mg/day). A daily oral dose of atorvastatin calcium treatment for 70 days weakened the long bones of methylprednisolone acetate treated rabbits irrespective of the dosage (2, 10, or 20 mg). Cortical bone strength was assessed using the 3-point bending test at the end of the study period. A daily oral dose of atorvastatin calcium did not attenuate the loss of cortical bone strength caused by corticosteroid treatment in rabbits. It appeared to decrease that bone strength. If these results hold true in humans, they would have wide applicability given the frequent combined use of corticosteroids and statins in many patients.
Collapse
Affiliation(s)
- John A Handal
- Department of Orthopedic Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Walsh JS, Newman C, Eastell R. Heart drugs that affect bone. Trends Endocrinol Metab 2012; 23:163-8. [PMID: 22136934 DOI: 10.1016/j.tem.2011.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 10/14/2011] [Accepted: 10/24/2011] [Indexed: 12/11/2022]
Abstract
There have been important developments in our understanding of the mechanisms underlying the development of osteoporosis, and several of these mechanisms also underlie atherosclerosis. Drugs given to treat cardiovascular disease may impact on bone health in either a beneficial or a harmful way. There is evidence that nitrates are beneficial to bone, but evidence for the benefit of statins, thiazide diuretics, and β-blockers is weaker. By contrast, it is likely to be that some drugs such as loop-acting diuretics are harmful to bone, whereas evidence for harm caused by drugs such as warfarin is weaker. These observations point towards opportunities for new drug development for bone diseases, and possibly the development of treatments that will benefit more than one disease.
Collapse
Affiliation(s)
- Jennifer S Walsh
- National Institute for Health Research Biomedical Research Unit for Musculoskeletal Disease at University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK
| | | | | |
Collapse
|
41
|
Weivoda MM, Hohl RJ. The effects of direct inhibition of geranylgeranyl pyrophosphate synthase on osteoblast differentiation. J Cell Biochem 2011; 112:1506-13. [PMID: 21503955 DOI: 10.1002/jcb.23087] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Statins, drugs commonly used to lower serum cholesterol, have been shown to stimulate osteoblast differentiation and bone formation. These effects have been attributed to the depletion of geranylgeranyl pyrophosphate (GGPP). In this study, we tested whether specific inhibition of GGPP synthase (GGPPS) with digeranyl bisphosphonate (DGBP) would similarly lead to increased osteoblast differentiation. DGBP concentration dependently decreased intracellular GGPP levels in MC3T3-E1 pre-osteoblasts and primary rat calvarial osteoblasts, leading to impaired Rap1a geranylgeranylation. In contrast to our hypothesis, 1 µM DGBP inhibited matrix mineralization in the MC3T3-E1 pre-osteoblasts. Consistent with this, DGBP inhibited the expression of alkaline phosphatase and osteocalcin in primary osteoblasts. By inhibiting GGPPS, DGBP caused an accumulation of the GGPPS substrate farnesyl pyrophosphate (FPP). This effect was observed throughout the time course of MC3T3-E1 pre-osteoblast differentiation. Interestingly, DGBP treatment led to activation of the glucocorticoid receptor in MC3T3-E1 pre-osteoblast cells, consistent with recent findings that FPP activates nuclear hormone receptors. These findings demonstrate that direct inhibition of GGPPS, and the resulting specific depletion of GGPP, does not stimulate osteoblast differentiation. This suggests that in addition to depletion of GGPP, statin-stimulated osteoblast differentiation may depend on the depletion of upstream isoprenoids, including FPP.
Collapse
Affiliation(s)
- Megan M Weivoda
- Department of Pharmacology, 2-471 Bowen Science Building, 51 Newton Road, University of Iowa, Iowa City, Iowa 52242, USA
| | | |
Collapse
|
42
|
Abstract
BACKGROUND The definition of bone quality is evolving particularly from the perspective of anabolic agents that can enhance not only bone mineral density but also bone microarchitecture, composition, morphology, amount of microdamage, and remodeling dynamics. QUESTIONS/PURPOSES This review summarizes the molecular pathways and physiologic effects of current and potential anabolic drugs. METHODS From a MEDLINE search (1996-2010), articles were identified by the search terms "bone quality" (1851 articles), "anabolic agent" (5044 articles), "PTH or parathyroid hormone" (32,229 articles), "strontium" or "strontium ranelate" (283 articles), "prostaglandin" (77,539 articles), and "statin" or "statins" (14,233 articles). The search strategy included combining each with the phrase "bone quality." Another more limited search aimed at finding more novel potential agents. RESULTS Parathyroid hormone is the only US Food and Drug Administration-approved bone anabolic agent in the United States and has been the most extensively studied in in vitro animal and human trials. Strontium ranelate is approved in Europe but has not undergone Food and Drug Administration trials in the United States. All the studies on prostaglandin agonists have used in vivo animal models and there are no human trials examining prostaglandin agonist effects. The advantages of statins include the long-established advantages and safety profile, but they are limited by their bioavailability in bone. Other potential pathways include proline-rich tyrosine kinase 2 (PYK2) and sclerostin (SOST) inhibition, among others. CONCLUSIONS The ongoing research to enhance the anabolic potential of current agents, identify new agents, and develop better delivery systems will greatly enhance the management of bone quality-related injuries and diseases in the future.
Collapse
Affiliation(s)
- Tarek Sibai
- Department of Orthopaedic Surgery, Boston University Medical Center, 720 Harrison Avenue, Suite 808, Boston, MA 02118 USA
| | - Elise F. Morgan
- Department of Mechanical Engineering, Boston University, Boston, MA USA
| | - Thomas A. Einhorn
- Department of Orthopaedic Surgery, Boston University Medical Center, 720 Harrison Avenue, Suite 808, Boston, MA 02118 USA
| |
Collapse
|
43
|
Lima CEVDC, Calixto JC, Anbinder AL. Influence of the association between simvastatin and demineralized bovine bone matrix on bone repair in rats. Braz Oral Res 2011; 25:42-8. [DOI: 10.1590/s1806-83242011000100008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 12/02/2010] [Indexed: 12/16/2022] Open
|
44
|
Cho YE, Alcantara E, Kumaran S, Son KH, Sohn HY, Lee JH, Choi CS, Ha TY, Kwun IS. Red yeast rice stimulates osteoblast proliferation and increases alkaline phosphatase activity in MC3T3-E1 cells. Nutr Res 2010; 30:501-10. [PMID: 20797483 DOI: 10.1016/j.nutres.2010.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 06/05/2010] [Accepted: 06/17/2010] [Indexed: 02/07/2023]
Abstract
Red yeast (Monascus purpureus) is used as a traditional hypocholesterolemic dietary food component in Asia due to its bioactive component, lovastatin. Recently, new evidence suggesting that the statins in red yeast enhance bone formation has been reported, but more research is still needed in order to support these claims of osteogenic effects. Therefore, in this study, we hypothesized that red yeast rice (in which red yeast is fermented) can improve osteogenic function through osteoblast cell proliferation and differentiation. We studied the effect of methanol extract of red yeast rice powder (RYRP) on osteoblast proliferation and differentiation by measuring mitochondrial enzyme activity and bone marker alkaline phosphatase (ALP) activity, respectively. Osteoblast-like MC3T3-E1 cells were cultured in various concentrations of RYRP methanol extract (0.001-1 mg/mL) during the osteoblast differentiation period (1, 5, 10, and 15 days). As measured by 3-[4,5-dimethylthiazol-2-y]-2,5-diphenyltetrazolium bromide assay, RYRP extracts stimulated cell proliferation during a 24-hour period, compared to cooked white rice powder extract. The most pronounced effect was observed at the concentration range between 0.075 and 0.1 mg/mL. This RYRP stimulatory effect for cell proliferation was observed during the whole osteogenic period. Cellular (synthesized) ALP activity was increased at a RYRP extract concentration of 0.075 mg/mL during 15 days of culture, but the medium (secreted) ALP activity did not show any significant change. This cellular ALP activity stimulation by RYRP extract was confirmed by the staining of ALP activity on cell matrix layers for matrix calcification. The results imply that RYRP extract may increase osteogenic effect by stimulating cell proliferation and ALP activity in osteoblastic cells.
Collapse
Affiliation(s)
- Young-Eun Cho
- Department of Food Science and Nutrition, Andong National University, Andong, Kyungbook, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Lazzerini PE, Capecchi PL, Selvi E, Lorenzini S, Bisogno S, Baldari CT, Galeazzi M, Laghi-Pasini F. Statins and the joint: multiple targets for a global protection? Semin Arthritis Rheum 2010; 40:430-46. [PMID: 20884043 DOI: 10.1016/j.semarthrit.2010.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 06/15/2010] [Accepted: 06/25/2010] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Evidence exists that the pleiotropic properties of the hydroxy-methyl-glutaryl Coenzyme A reductase inhibitors (statins) are not restricted to the cardiovascular system, as they can also favorably affect the joints, with intriguing implications for the treatment of many rheumatic diseases. In the view of the increasing interest on this topic, we here review the current state of the art. METHODS The PubMed database was searched for articles published between 1966 and 2010 for key words referring to statins and joint diseases. All relevant English-written articles were reviewed. RESULTS Many pivotal studies clearly demonstrated that HMG-CoA reductase inhibitors exert a wide spectrum of beneficial effects on the 3 main compartments of the joint, ie, the synovium, the cartilage, and the subchondral bone. Such (1) anti-inflammatory, (2) immunomodulating, and (3) anabolic effects strongly support a potential role of these drugs in the treatment and/or the prevention of the most important chronic joint diseases. However, although the majority of the in vivo studies with statins on animal models of inflammatory and degenerative joint diseases showed a marked protective activity substantially confirming the in vitro experiments, data arising from clinical trials are less probative and more conflicting. CONCLUSIONS Statins display multiple joint-protective effects. Since oral administration of statins could result in a relatively low drug bioavailability to the joints, alternative routes of administration of the drug (transdermal, intra-articular) and/or specific delivery systems should be developed to establish the entire therapeutic potential of statins in this clinical setting.
Collapse
Affiliation(s)
- Pietro Enea Lazzerini
- Department of Clinical Medicine and Immunological Sciences, Division of Clinical Immunology, University of Siena, Siena, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
A Sustained Release of Lovastatin from Biodegradable, Elastomeric Polyurethane Scaffolds for Enhanced Bone Regeneration. Tissue Eng Part A 2010; 16:2369-79. [DOI: 10.1089/ten.tea.2009.0585] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
47
|
Wang W, Nyman JS, Moss HE, Gutierrez G, Mundy GR, Yang X, Elefteriou F. Local low-dose lovastatin delivery improves the bone-healing defect caused by Nf1 loss of function in osteoblasts. J Bone Miner Res 2010; 25:1658-67. [PMID: 20200958 PMCID: PMC3154004 DOI: 10.1002/jbmr.42] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Postfracture tibial nonunion (pseudoarthrosis) leads to lifelong disability in patients with neurofibromatosis type I (NF1), a disorder caused by mutations in the NF1 gene. To determine the contribution of NF1 in bone healing, we assessed bone healing in the Nf1(ob) (-/-) conditional mouse model lacking Nf1 specifically in osteoblasts. A closed distal tibia fracture protocol and a longitudinal study design were used. During the 21- to 28-day postfracture period, callus volume, as expected, decreased in wild-type but not in Nf1(ob) (-/-) mice, suggesting delayed healing. At these two time points, bone volume (BV/TV) and volumetric bone mineral density (vBMD) measured by 3D micro-computed tomography were decreased in Nf1(ob) (-/-) callus-bridging cortices and trabecular compartments compared with wild-type controls. Histomorphometric analyses revealed the presence of cartilaginous remnants, a high amount of osteoid, and increased osteoclast surfaces in Nf1(ob) (-/-) calluses 21 days after fracture, which was accompanied by increased expression of osteopontin, Rankl, and Tgfbeta. Callus strength measured by three-point bending 28 days after fracture was reduced in Nf1(ob) (-/-) versus wild-type calluses. Importantly, from a clinical point of view, this defect of callus maturation and strength could be ameliorated by local delivery of low-dose lovastatin microparticles, which successfully decreased osteoid volume and cartilaginous remnant number and increased callus BV/TV and strength in mutant mice. These results thus indicate that the dysfunctions caused by loss of Nf1 in osteoblasts impair callus maturation and weaken callus mechanical properties and suggest that local delivery of low-dose lovastatin may improve bone healing in NF1 patients.
Collapse
Affiliation(s)
- Weixi Wang
- Vanderbilt University Medical Center, Department of Medicine, Nashville, TN 37232-0575, USA
| | | | | | | | | | | | | |
Collapse
|
48
|
Osteogenic activity of locally applied small molecule drugs in a rat femur defect model. J Biomed Biotechnol 2010; 2010:597641. [PMID: 20625499 PMCID: PMC2896701 DOI: 10.1155/2010/597641] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 03/30/2010] [Indexed: 11/17/2022] Open
Abstract
The long-term success of arthroplastic joints is dependent on the stabilization of the implant within the skeletal site. Movement of the arthroplastic implant within the bone can stimulate osteolysis, and therefore methods which promote rigid fixation or bone growth are expected to enhance implant stability and the long-term success of joint arthroplasty. In the present study, we used a simple bilateral bone defect model to analyze the osteogenic activity of three small-molecule drug implants via microcomputerized tomography (micro-CT) and histomorphometry. In this study, we show that local delivery of alendronate, but not lovastatin or omeprazole, led to significant new bone formation at the defect site. Since alendronate impedes osteoclast-development, it is theorized that alendronate treatment results in a net increase in bone formation by preventing osteoclast mediated remodeling of the newly formed bone and upregulating osteoblasts.
Collapse
|
49
|
Thillemann TM, Pedersen AB, Mehnert F, Johnsen SP, Søballe K. The risk of revision after primary total hip arthroplasty among statin users: a nationwide population-based nested case-control study. J Bone Joint Surg Am 2010; 92:1063-72. [PMID: 20439650 DOI: 10.2106/jbjs.h.01805] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Statins have been associated with beneficial effects on bone metabolism and inflammation in both experimental and clinical studies. The association between statin use and the risk of revision after primary total hip arthroplasty has not been examined. METHODS We identified 2349 patients from the Danish Hip Arthroplasty Registry who underwent revision of a primary total hip replacement in the period from 1996 to 2005 and matched them, using propensity score matching, with 2349 controls with a total hip replacement who had not had a revision. Using conditional logistic regression, we estimated the relative risk of revision due to all causes and due to specific causes according to postoperative statin use. RESULTS The ten-year cumulative implant revision rate in the underlying cohort of 57,581 total hip arthroplasties from the registry was 8.9% (95% confidence interval, 8.4% to 9.4%). Postoperative statin use was associated with an adjusted relative risk of revision of 0.34 (95% confidence interval, 0.28 to 0.41) compared with no use of statin. Statin use was associated with a reduced risk of revision due to deep infection, aseptic loosening, dislocation, and periprosthetic fracture. No difference in the risk of revision due to pain or implant failure was found between statin users and nonusers. CONCLUSIONS The use of statins was associated with a substantially lower revision risk following primary total hip arthroplasty. Statins, however, should not be prescribed to healthy patients undergoing total hip arthroplasty in order to improve the longevity of the replacement until further studies have confirmed our finding and the mechanisms for this association have been clarified.
Collapse
Affiliation(s)
- Theis M Thillemann
- Department of Orthopedics, Aarhus University Hospital, Aarhus N, Denmark.
| | | | | | | | | |
Collapse
|
50
|
Effects of lipophilic emulsifiers on the oral administration of lovastatin from nanostructured lipid carriers: Physicochemical characterization and pharmacokinetics. Eur J Pharm Biopharm 2010; 74:474-82. [DOI: 10.1016/j.ejpb.2009.12.008] [Citation(s) in RCA: 203] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 12/17/2009] [Accepted: 12/21/2009] [Indexed: 02/06/2023]
|