Efficacy of simvastatin with collagen plug and collagen plug alone following bilateral tooth extraction: a comparative study

Background: The healing process of extraction sockets involves a tightly regulated sequence of events, including blood clot formation, angiogenesis, inflammation resolution, granulation tissue maturation, osteoid deposition, and finally mineralized bone formation. The aim of the study is to evaluate the efficacy of simvastatin with collagen plug and collagen plug alone in healing of an extraction socket. Methods: A total of 30 patients were scheduled for bilateral extractions in two sessions, with 1 week interval in between. The extraction on either side will be divided into two groups: GROUP A sockets were filled with simvastatin with collagen plug and closure was done using 3-0 silk sutures. GROUP B sockets were filled with collagen plug alone and closure was done using 3- 0 silk sutures. The patients were assessed for bone density, post-operative pain, swelling, soft tissue healing in extraction sockets of the two groups. Results: Radiographic bone density at three months favored the simvastatin-augmented sites markedly. Group A exhibited a greater numerical reduction in pain by one week, though differences did not reach statistical significance. Objective measures of facial swelling were minimal and equivalent between groups at baseline, 24 hours, and one week. Soft tissue healing scores at 24 hours and one week were similar, with no significant between-group differences. Conclusions: Simvastatin offers a bioactive alternative or adjunct to conventional socket preservation techniques such as collagen plugs, mineralized bone allografts, and PRF.