Effectiveness of simvastatin with antibiotics compared to other material on clinical and radiographic outcomes following non-surgical endodontic treatment

Postoperative endodontics complications can influence the patient's quality of life. One method of lesion sterilization and tissue repair (LSTR) therapy combines simvastatin with metronidazole, ciprofloxacin, and minocycline, which are used for primary teeth. This review assesses the clinical and radiographic effects of combining simvastatin with antibiotics compared with other materials on pediatric patients. The study protocol was registered on the International Prospective Register of Systematic Reviews with registration number CRD42024552895. The following electronic databases were utilized to search Randomized Clinical Trials (RCTs): MEDLINE(PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, Embase, and OVID up to and including July 2024. The Cochrane Risk of Bias tool was used to evaluate the potential for bias in randomized clinical studies. In the initial search through electronic databases and registers, 1368,764 studies were found, and 8 RCTs met the eligibility criteria. Six out of 8 studies showed that combining simvastatin with antibiotics was effective clinically and radiographically following non-surgical endodontic treatment compared to other treatment modalities. This review suggests that combining simvastatin with antibiotics may be effective clinically and radiographically following non-surgical endodontic treatment. However, further studies are needed to confirm the potential of that combination in non-surgical endodontic management.