Socket preservation with and without lovastatin in combination with synthetic bone graft substitute: A double-blind clinical trial

Background. The present study examined how bone improvement techniques, particularly the use of lovastatin with ridge preservation strategies, affect bone maintenance after tooth extraction. The goal of these strategies is to potentially decrease bone resorption and enhance the quality of alveolar bone, while also taking into account the associated risks of using high doses of statins. Methods. Twenty healthy patients undergoing bone grafting after tooth extraction in the anterior region of the maxilla were randomly divided into groups A and B. After non-invasive extraction, group A received a synthetic bone graft substitute combined with 10 mg of lovastatin, while group B received a synthetic bone graft alone. The graft was placed in the tooth socket and covered with a collagen cone for support. After nine months, a histomorphometric analysis assessed horizontal changes, using a clipper in the area compared to pre-treatment clinical measurements (P≤0.05). Results. The study examined 40 areas and found that the bone formation rate was 51.69% for those receiving only a synthetic bone graft substitute. When combined with 10 mg of lovastatin, the bone formation rate increased to 60.79%, indicating a significant improvement. The group receiving only the synthetic graft had an average of 1.70 mm leftover particles, while the lovastatin group had only 0.4844 mm particles, suggesting that lovastatin reduced residual material. Additionally, the lovastatin group exhibited a smaller ridge width and no signs of inflammation or foreign body reaction. In contrast, the group receiving only Nanobone showed inflammatory responses, primarily from mononuclear cells. Conclusion. According to the results, lovastatin shows promise in enhancing osteogenesis, narrowing the ridge, and decreasing residual connective tissue, while avoiding inflammation and foreign body reactions. The study was registered on clinicaltrials.gov under the ID NCT03981601.