Can Simvastatin Improve Healing in Avulsed Teeth? A Case Series Explores the Possibility
India: Tooth avulsion, a severe dental injury involving the complete displacement of a tooth from its socket, presents significant challenges in reimplantation, particularly when extraoral dry time is prolonged. The success of reimplantation is largely dependent on the viability of the periodontal ligament cells, which deteriorate with extended exposure outside the socket. While existing treatment approaches aim to improve outcomes, no single method is universally effective, especially in cases of delayed reimplantation.
A recent case series published in Cureus Journal explored using simvastatin as an adjunct therapy to enhance bone healing and inhibit resorption in delayed tooth avulsion cases.
Simvastatin, commonly known for its cholesterol-lowering properties, has demonstrated additional benefits, including anti-inflammatory effects, promotion of bone regeneration, and enhancing periodontal ligament cell survival. These attributes suggest that simvastatin could be a valuable addition to treating avulsed teeth with extended dry times, potentially improving long-term prognosis.
The case series described by Rajesh Kumar, Paediatric Dentistry, Malla Reddy Institute of Dental Sciences, Hyderabad, IND, and colleagues included four pediatric patients who presented with avulsed teeth due to trauma. In all cases, the avulsed teeth were stored in dry conditions for extended periods, ranging from 24 to 46 hours, before reimplantation. Standard reimplantation procedures were followed, which included root surface decontamination, socket debridement, and repositioning of the teeth. Additionally, platelet-rich fibrin (PRF) and hydroxyapatite were used to enhance healing.
Simvastatin was applied with bone graft material to further inhibit bone resorption and stimulate bone regeneration. Following reimplantation, the teeth were stabilized using an orthodontic splint, and patients were prescribed antibiotics and analgesics for post-procedural care.
During follow-up evaluations, probing depths and radiographic assessments were used to monitor healing progress. Across all cases, initial probing depths were significantly reduced over time, indicating improved periodontal stability. Radiographic analysis demonstrated reduced bone loss and evidence of new bone formation, supporting the beneficial effects of simvastatin in promoting healing.
By the third recall, probing depths had notably decreased, and by the fourth recall, splints were removed as the teeth demonstrated sufficient stability. A one-year follow-up confirmed maintained periodontal integrity and bone health.
The case series suggests that incorporating simvastatin into treatment protocols for delayed tooth reimplantation may enhance healing and improve long-term outcomes. However, limitations such as the short follow-up period highlight the need for further clinical trials.
"Future randomized controlled studies could provide more definitive evidence regarding the optimal dosage and application of simvastatin in managing delayed tooth avulsion cases," the authors concluded.
Reference:
Kumar R, Atluri S N, Achanta A, et al. (February 17, 2025) Efficacy of Simvastatin in Inhibiting Bone Resorption and Promoting Healing in DelayedTooth Avulsion: A Case Series. Cureus 17(2): e79139. DOI 10.7759/cureus.79139
