Discussion
aphthous lesions, granuloma, bone loss, Tahamtan, trauma, inflammation, cancer, blood lipid disorders, periodontitis, arthritis, pain, aphthous, aphthous ulcers, ulcer, orthodontic, Alzheimer
GRANULOMA, BONE LOSS, ULCER, SECONDARY INFECTION, INFLAMMATION, DISEASES, CANCER, PERIODONTITIS, ARTHRITIS, EPITHELIALIZATION, CHRONIC PERIODONTITIS, PROLIFERATIVE, APHTHOUS ULCERS, CHRONIC INFLAMMATION, OXIDATIVE STRESS, ACUTE AND CHRONIC INFLAMMATION, PATHOGENESIS, ALZHEIMER
This study examined the effect of atorvastatin mucoadhesive tablets on the diameter of the inflammatory halo and the pain intensity of aphthous ulcers in patients. This study was conducted as a double-blinded clinical trial on 44 patients participating in the study (22 patients in the atorvastatin group and 22 patients in the placebo group), and the findings of this study were compared inter-groups and intra-groups. The results of this study show that the halo diameter in the atorvastatin group had significantly reduced compared to the placebo group, so that on the seventh day of the study, the aphthous lesions in the atorvastatin group had improved significantly. However, in the placebo group, the average diameter of the inflammatory halo was more than one millimeter. The pain intensity of participants (VAS) showed a notable decrease in the atorvastatin group except on days one, two, and seven of the study. In addition, the pain reduction process was faster in the atorvastatin group than in the control group.Many studies have investigated the anti-inflammatory, analgesic, and antioxidant effects of atorvastatin [Statins are among the least complicated and most effective drugs used to treat blood lipid disorders. This category of drugs effectively reduces low-density lipoprotein in the blood; in addition, they have a beneficial outcomes in reducing oxidative stress, anti-inflammatory effects, immune modulation, analgesia, Etc. [Most of the side effects mentioned for atorvastatin are related to anti-inflammatory properties because inflammation plays a significant role in the pathogenesis of various diseases such as cancer, arthritis, and Alzheimer’s. The anti-inflammatory function of these drugs is mainly related to the reduction of C-reactive protein, which is one of the most prominent factors in inflammation. However, in various studies, many other processes have been described for this function [The analgesic effect of atorvastatin is caused by processes such as inhibiting cytokines, MMP-2, and NGF in the sciatic nerves and spinal cord, as well as increasing the level of antioxidants and reducing the production of prostaglandins, all of which act in peripheral sensory receptors [Masoumi et al. investigated the effect of oral atorvastatin and local injection of this drug on treating periodontitis in rats. This study states that both forms of atorvastatin reduce inflammation and the cascade of oxidant production and subsequent tissue destruction, as well as bone loss caused by collagen destruction in periodontitis. The results obtained from systemic use are not significantly different from topical use, but the topical form of this drug is preferable due to fewer side effects [In a study, Tahamtan et al. systemically reviewed articles related to the effects of Statins on oral and dental health. In their research, due to the positive impact of Statins on bone metabolism, inflammation, and antioxidant properties, also strong effects on epithelialization and wound healing, and antibacterial, antiviral and, antifungal properties, the effect of this drug on oral health was investigated. The study’s results demonstrated that Statins have a significant impact on chronic periodontitis, implant osseointegration, orthodontic dental movements, soft and hard tissue repair, anticancer effects, Etc. [Ghasias et al. investigated the antioxidant, analgesic, and anti-inflammatory function of atorvastatin and rosuvastatin in different animal models, the findings showed that these two medicines have no effect on central pain receptors, but their analgesic property is due to their role in peripheral analgesic processes so that they observed a remarkable inhibition of pain caused by acetic acid, which leads to pain sensation by increasing the levels of PGE2 and PGF2a. It was also observed that atorvastatin reduces pain sensitivity by reducing bradykinin and cytokines; as a result, the analgesic effect observed in atorvastatin is similar to the effect of anti-inflammatory agents. Examining the anti-inflammatory effect of these two medicines on acute and chronic inflammation showed that atorvastatin reduces acute inflammation by inhibiting the release of bradykinin, prostaglandin, and substance P. In chronic inflammation, these medicines reduce the mass of granuloma by inhibiting the proliferative phase of inflammation. The oxidative stress reduction action of these two drugs is also due to the increase in cellular antioxidants, the decrease in NADPH oxidase expression, and the regulation of catalase overexpression [Nowadays, the use of mucoadhesive tablets made with herbals and chemicals is a common method in the treatment of aphthous lesions, and many studies have been conducted in this field, which includes the efficacy of mucoadhesive tablets containing propolis, licorice, and zinc sulfate on aphthous lesions. The results of these studies were favorable and promising because the combination of the medicines with mucoadhesive tablets has anti-inflammatory properties; on the other hand, the tablets last longer at the lesion site and increase the treatment effectiveness [In general, the use of topical mucoadhesive tablets is a new and efficient method against mechanical trauma and inflammation of the lesion. In fact, in this method, a protective layer is created on the lesion as an auxiliary method and decreases the pain and discomfort caused by aphthous lesions and eliminates the lesion faster. Among the other advantages of this method, we can indicate the prevention of secondary infection of the ulcer, and as a result, no antibiotic or antifungal prescription will be needed [According to the previous studies and considering the findings of the present study, it seems that the significant reduction in the size of the aphthous lesion and the pain intensity of patients in the atorvastatin group compared with a control group is related to the anti-inflammatory, analgesic or antioxidant properties of atorvastatin. However, due to the lack of similar articles in this field, we cannot only rely on this study and judge atorvastatin mucoadhesive tablets efficacy, and more studies are needed on this subject. In addition, the lack of direct access to patients during the seven days of study can be considered another limitation of this study.