Clinical efficacy of simvastatin gel combined with polypropylene membrane on the healing of extraction sockets: A triple‐blind, randomized clinical trial

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.

Minimal invasiveness in the alveolar ridge preservation, with or without concomitant implant placement

“…The periosteum was raised from the underlying bone to allow space to adapt a membrane or a CTG. [29][30][31][32][34][35][36][40][41][42]44,[47][48][49][50][51][52][53] Only Mazzocco et al 43 compared a true flapless to a flap approach when performing RP with IIP. The authors observed no post-operative complications in both approaches.…”

“…34,35 The effect of the use of SIM associated to RP was also compared with a placebo group. 31 No significant differences were observed between RP with and without SIM on morbidity, esthetics, or patient-related outcomes. The few studies described above suggested that the use of biologicals may improve the healing process in RP procedures but the wide discrepancy among the studies precluded any definite conclusion.…”

“…Nine studies evaluated MI approaches for RP without IIP. [29][30][31][32][33][34][35][36][37] Most of the studies included incisor, canine, and/or premolar sites with at least three remaining socket walls and <50% loss of the buccal wall. In the majority of the studies, sites were grafted with deproteinized bovine bone mineral associated or not with 10% collagen (n = 6), while different studies were grafted with other xenografts (n = 1), allografts (n = 1), or nothing (n = 1).…”

“…In two studies, implants were placed 2 months following tooth extraction and RP, 33,37 in five studies implants were placed after 3-6 months, 30,31,[34][35][36] while two did not report the timing of implant placement. 29,32 Within these studies different MI approaches were compared to relatively more invasive approaches (Table 1).…”

“…32,33,36,37 In addition, four studies assessed the use or not of biological agents during the RP procedures. 31,32,34,35…”