July 2010

Background: Statins are widely used agents for lowering cholesterol and reducing the risk for a heart attack. Recent data suggest that statins regulate bone metabolic activity by stimulating new bone formation both in vitro and in vivo. Statins were identified as a potent activator of bone morphogenic protein-2, an important promoter of osteoblastic differentiation. In addition, statins inhibit mevalonate production and isoprenoids required for osteoclastogenesis, which may contribute to their bone-sparing effect. These findings suggest that statins could be considered as potential agents for treating osteoporosis and possibly periodontal disease. Objective: The purpose of this article is to review existing literature on in vitro studies investigating bone morphogenic protein-2 promoting activity of statins and in vivo studies investigating effects of statins on bone formation and preservation in the oral cavity. Materials and methods: An electronic search of MEDLINE-PubMed was performed through December 2008 for in vitro studies addressing effects of statins on bone morphogenic protein-2 production and in vivo studies evaluating the effects of statins on bone formation and preservation. Results: Simvastatin was the agent in the majority of reviewed investigations. Most studies supported the hypothesis that simvastatin possessed osteoinductive properties mediated via bone morphogenic protein-2 and osteoprotective properties arising from the inhibition of osteoclast activation. Conclusions: Simvastatin shows potential as a therapeutic agent in the prevention and treatment of inflammation-induced bone destruction.