Socket Preservation Using Atorvastatin versus Plasma Rich Fibrin: A Randomized Clinical and Histomorphometric Controlled Trial

Introduction: Statins such as atorvastatin (ATV), aside from their lipid lowering effects, are capable of modulating the process of bone turnover and regeneration owing to their effects on certain cells including osteoblasts, osteoclasts and stem cells of mesenchymal origin. Platelet rich fibrin (PRF) on the other hand is an autogenous platelet concentrate with a fibrin matrix having biomechanical properties that allows it to be used in regeneration. The purpose of this study is to evaluate the use of ATV gel and PRF in alveolar socket preservation. Patients and Methods: Thirty patients having upper premolars and canines scheduled for extraction were randomly assigned into three equal groups. Group I received ATV gel, Group II received PRF while Group III had their sockets left to heal spontaneously (control). Clinical parameters included ridge width, average crest heights measured at baseline and 8 weeks’ post-extraction. Core biopsies stained with Masson’s Trichrome were examined. Results: Group II had the lowest mean percentage reduction in ridge width however, the differences were non-significant regarding both ridge width and height. The total collagen surface area and the average trabecular size were significantly higher in sockets augmented with PRF. This finding suggested that PRF fibrin scaffold was osteoconductive and acted as a natural scaffold for new bone formation. Conclusion: This study showed no significant difference between ATV and PRF compared to the control as regards to clinical measurements. Sites augmented with ATV, PRF showed higher newly formed osteoid tissue and mineralized bone trabeculae than spontaneously healed sockets.