Simvastatin Demonstrates Effectiveness as a Pulpotomy Agent in Carious Permanent Teeth: Study
India: Study outcomes indicate that simvastatin (SMV) can be effectively used as a pulpotomy agent in carious permanent teeth, supporting its potential role in vital pulp therapy.
In a recent randomized controlled trial published in the Australian Endodontic Journal, researchers evaluated the clinical effectiveness of simvastatin combined with alpha tricalcium phosphate (αTCP) as a pulpotomy material in permanent molars affected by symptomatic irreversible pulpitis. The study was led by Sudeepender Gehlot from the Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India, along with colleagues.
Pulpotomy in permanent teeth with irreversible pulpitis has traditionally been considered challenging, with mineral trioxide aggregate (MTA) widely regarded as the gold standard material. However, the search for alternative agents that are cost-effective, biologically favorable, and readily available has gained momentum. Simvastatin, known primarily for its lipid-lowering effects, has also demonstrated anti-inflammatory, angiogenic, and osteogenic properties, making it a potential candidate for vital pulp therapy.
The study enrolled 60 patients with cariously exposed permanent mandibular molars diagnosed with symptomatic irreversible pulpitis. Participants were randomly allocated into two equal groups: one group received pulpotomy using an SMV-αTCP combination, while the other group was treated with MTA. All procedures were performed under standardized clinical conditions, and patients were followed for 12 months to assess treatment outcomes.
Treatment success was evaluated based on clinical and radiographic criteria, including absence of pain, swelling, sinus tract formation, or periapical pathology. Postoperative pain was another important outcome measure. Patients recorded their pain levels before treatment and at multiple intervals after the procedure, including 6, 12, and 18 hours, as well as daily from day 1 to day 7.
The trial revealed the following findings:
- At the end of follow-up, the overall treatment success rate was 92.5% in the SMV-αTCP group and 96.2% in the MTA group.
- The difference in success rates between the two groups was not statistically significant, showing comparable effectiveness of simvastatin and MTA.
- A statistically significant difference in postoperative pain intensity was observed between the groups on the first and second days after treatment.
- No significant differences in pain levels were noted between the groups at other postoperative time points.
- Pain levels gradually decreased in both groups over the first postoperative week.
The findings suggest that simvastatin combined with αTCP can achieve favorable clinical outcomes similar to MTA when used for pulpotomy in carious permanent molars with irreversible pulpitis. According to the authors, the biological properties of simvastatin may contribute to inflammation control and pulp healing, supporting its use in vital pulp therapy.
The researchers note that longer follow-up periods and larger clinical trials are needed to further validate these results. However, the current evidence highlights simvastatin as a promising alternative pulpotomy agent, particularly in settings where cost or material availability may limit the use of conventional options.
Reference:
Gehlot, S., Kumar, V., Mittal, S., Duhan, J., Sangwan, P., Arora, M., & Chauhan, N. Effect of Simvastatin on Success of Pulpotomy in Carious Permanent Molars With Symptomatic Irreversible Pulpitis: A Randomised Controlled Trial. Australian Endodontic Journal. https://doi.org/10.1111/aej.70062
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