Hiperlipidemi için kullanýlan statin tedavisinin kemik etkilerini implantolojide basit bir yöntemle gözlemlemek mümkün müdür?

GÝRÝÞ ve AMAÇ: Oral ve maksillofasiyal cerrahide rutin iþlemlerden biri olan dental implant uygulamalarýnda, osseointegrasyon sürecinde kemik yoðunluðu önemli olduðundan, bu çalýþmada hiperlipidemi nedeniyle statin grubu ilaç kullanan ve hiç kullanmamýþ hastalarýn basit periapikal radyografilerinde kemik yoðunluðunun incelenmesi ve klinisyenler için faydalý olabilecek bir iliþkin varlýðýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Yaþlarý 55 ile 65 arasýnda deðiþen (59,72±3,21) 300 kadýn hastanýn 300 periapikal radyografisi deðerlendirildi. Hastalar 2 gruba ayrýldý; en az 1 yýldýr statin kullanan ilaç grubu (n: 200) ve statin kullanmayan kontrol grubu (n: 100). Hastalarýn yaþý, periapikal radyografi lokalizasyonu ve kemik yoðunluðu parametreleri, sigara içip içmediði kaydedildi. Osteoporotik ajan kullanan, metabolik kemik hastalýðý, kemoterapi veya radyoterapi öyküsü olan, erkek ve American Anesthesiologist Association (ASA) III ve üzeri olan hastalar çalýþma dýþý býrakýldý.
BULGULAR: Radyografilerin lokalizasyonuna göre sayý ve yüzdesi: Anterior mandibula (76; %25,33), anterior maksilla (77; %25,67), posterior maksilla (89; %29,67), posterior mandibula (58; %19,33) olarak izlendi. Atorvastatin (n: 148) ve Rosuvastatin (n: 52) kullanýlan statin ilaçlarý olup, kemik yoðunluðu deðerleri sýrasýyla 111,33±22,46 ve 105,62±8,8, kontrol grubunda 109,97±26,60 olarak gözlendi. Gruplar arasý ve ilaç grubu içerisinde Atorvastatin ve Rosuvastatin arasýnda istatistiksel olarak anlamlý fark izlenmedi.
TARTIÞMA ve SONUÇ: Statinlerin etkileri literatürde iyi belirlenmiþ olmasýna raðmen, bu çalýþmanýn sonuçlarýna dayanarak, günlük klinik rutinde kullanýlan periapikal radyografilerde anabolik etkiler gözlenmemiþtir.

Is it possible to observe the bone effects of statin theraphy used for hyperlipidemia by a simple method in implantology?

INTRODUCTION: Bone density is important in osseointegration process in dental implant surgery, which is one of the most routine procedures in oral and maxillofacial surgery. This study aimed to examine the bone density in periapical radiographs of patients who were in use and never used statin group medications for hyperlipidemia, and to evaluate the presence of a relationship that might be useful for clinicians.
METHODS: 300 periapical radiographs from 300 female patients aged between 55 and 65 (59.72±3.21) were evaluated. Patients were divided into 2 groups; medication group (n: 200) using statins for at least 1 year and control group (n: 100) not using statins. Age of the patients, periapical radiograph localization and bone density parameters, presence of smoking were recorded. Patients using osteoporotic agents, metabolic bone disease, chemoterapy or radiotherapy history and American Anesthesiologist Association (ASA) III or higher were excluded from the study.
RESULTS: According to localization of radiographs, number and percentage were as follows: Anterior mandibula (76; 25,33%), anterior maxilla (77; 25,67%), posterior maxilla (89; 29,67%), posterior mandibula (58; 19,33%). Atorvastatin (n: 148) and Rosuvastatin (n: 52) were among the statin medications used and bone density values were respectively 111,33±22,46 and 105,62±8,8, which was 109,97±26,60 in control group. There was no statistically significant difference between both Atorvastatin and Rosuvastatin in medication and control group.
DISCUSSION AND CONCLUSION: Effects of statins were well established in literature, based on the results of this study, the anabolic effects could not be observed in simple periapical radiographs by this measurement method, which is used in daily clinical routine.