Simvastatin versus Calcium Hydroxide Direct Pulp Capping of Human Primary Molars: A Randomized Clinical Trial

Background and aims. The aim of present study was to investigate pulp-dentin complex reactions following direct pulp capping (DPC) with calcium hydroxide [Ca(OH)2] and simvastatin as pulp-capping materials in the primary human molars. Materials and methods. 120 primary molar teeth which had to be extracted for orthodontic reasons were randomly allocated into four groups. Group Ι as a control, underwent DPC with calcium hydroxide. The dental pulp in group ІІ, ІІІ and ІV were directly capped with simvastatin-based materials at concentrations of 1, 5 and 10 µM, respectively. All of the teeth were restored with stainless steel crown. After a mean period of 7.41 months teeth were extracted and processed for histological examination and categorized in terms of hard tissue formation and pulp inflammation. Results. Teeth in group I had statistically favorable outcomes in hard tissue formation and pulp inflammation than did the groups ІІ, ІІІ and ІV (P < 0.001). Considering three different concentrations of simvastatin, the result showed a dose dependent trend. Teeth in group ІV showed significantly lower rates of hard tissue formation and higher rates of pulp inflammation and necrosis compared to those of groups ІІ (P < 0.05). Conclusion. The findings of this study depicted that healing with no inflammation and hard tissue formation following statin treatment occurs with a lower rate than that with the calcium hydroxide.