The Effect of Local Simvastatin on Alveolar Bone Regeneration, Pain, and Swelling After Tooth Extraction: a Systematic Review

Abstract

OBJECTIVES: The purpose of this systematic literature review was to evaluate the effects of local simvastatin on alveolar bone regeneration, pain and swelling after tooth extraction, with a minimum follow-up of two months. MATERIAL AND METHODS: A literature search was conducted using PubMed (MEDLINE) database to identify studies published between January 2015 and January 2025 containing a minimum of 20 sockets per study to evaluate the effect of local simvastatin in promoting bone regeneration after tooth extraction. Data synthesis in test and control groups included following parameters: Extraction socket filling material and method, regenerated bone morphology, pain, and swelling. Quality and risk-of-bias assessment were evaluated by the Joanna Briggs Institute Critical Appraisal Tools. Descriptive statistics were used. RESULTS: A total of 628 articles were screened, with 6 articles meeting the inclusion criteria and being utilized for this review. A total of 326 sockets with different types were evaluated, the effect of local simvastatin on the morphology of regenerated bone showed statistically significant (P < 0.05) progressive improvement in most cases. Furthermore, pain and swelling assessments revealed a decrease in the test groups compared to the control groups suggesting that local simvastatin may promote bone regeneration while reducing post-treatment discomfort. However, different tools were used to measure regenerated bone morphology pain and swelling, making it hard to draw consistent conclusions about patient comfort. CONCLUSIONS: Local simvastatin application promotes bone regeneration without increasing pain or swelling, supporting its use as a safe and effective supplement in regenerative bone treatment after tooth extraction.