Simvastatin Have a Positive Impact on the Wound Healing of Craniofacial Bone and Cartilage: A Systematic Review

Objectives: Preclinical and clinical studies, systematic reviews and meta-analyses have investigated the potential of statins in enhancing bone formation. This review aimed at analyzing the effect of simvastatin on wound healing of craniofacial bone and cartilage, which are essential for the homeostasis of craniofacial skeleton.
Methods: An electronic search was performed on MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) using a combination of keywords. A hand search was undertaken on seven oral surgery Journals: Previous systematic reviews were considered as eligible studies. No limitation of language and year was placed. Controlled randomized clinical trials as well as prospective studies with data on comparison of topical/systemic simvastatin on healing of bone in Intrabony and furcation defects/extraction sockets/distraction osteogenesis, osteoporotic conditions as well as cartilage healing in TMJ inflammation with a minimum of 10 participants in each study and follow up period of 6months-1 year were included.
Results: 23 animal studies, 8 clinical (5 randomized and 3 prospective) studies were included. Each study included minimum of 8 sites assessed clinically and radiographically. Histology was a mandatory criterion for the inclusion of animal studies. The histologic as well as clinical analysis revealed that, simvastatin significantly enhances the healing potential in tooth extraction wound, surgical distraction of alveolar bone, periodontal intra-bony and tooth furcation defect, TMJ cartilage damage caused by arthritis and in estrogen-deficiency induced osteoporosis like conditions. The outcomes were unrelated to the administration route.

Conclusions: This systematic review provided a detailed insight into the potential of simvastatin to stimulate bone and cartilage wound healing in craniofacial region, which was evident with increased bone volume and mineralization and reduced inflammation level within the wounds of bone and cartilage.
Keywords: Statin, wound healing, bone regeneration