Histomorphometric Evaluation of Socket Preservation Healing Using Xenogeneic Bone Substitute Combined with Statin: A...

Statins exhibit pleiotropic effects on bone metabolism, including osteogenic and angiogenic activity. The aim of this pilot study was to evaluate whether local application of simvastatin combined with a bovine-derived xenogeneic bone substitute enhances histomorphometric outcomes of socket preservation compared with the bone substitute alone after a three-month healing period.

This prospective split-mouth clinical study included nine patients requiring bilateral tooth extraction. One socket was treated with cerabone® plus alone (control), while the contralateral socket received cerabone® plus combined with locally applied simvastatin (1 mg/0.2 mL saline). Bone core biopsies were harvested three months after grafting and analyzed histomorphometrically. The proportions of newly formed bone (NB/TV), residual bone substitute material (BSM/TV), and connective tissue (CT/TV) were quantified. Paired t-tests and Wilcoxon signed-rank tests were used for statistical analysis.

Histomorphometric analysis demonstrated a similar tissue composition in both groups. Connective tissue represented the predominant component in the control and statin-treated sites (59.1 ± 12.0% and 64.3 ± 9.4%, respectively; p = 0.31). Newly formed bone accounted for 31.0 ± 15.5% in the control group and 26.2 ± 11.6% in the statin group (p = 0.45). Residual bone substitute material showed comparable values between groups (9.9 ± 8.5% vs. 9.5 ± 9.7%; p = 0.91). No statistically significant differences were observed.

The addition of locally applied simvastatin to a bovine-derived xenogeneic bone substitute did not result in significant histomorphometric differences in socket preservation after three months. At the tested dose and delivery method, simvastatin did not enhance early mineralized tissue formation compared with the bone substitute alone.