Antimicrobial Efficacy of Simvastatin and Double Antibiotic Paste as Intracanal Medicaments: A Randomised Clinical Study

Abstract

Abstract Introduction: Root canal debridement, irrigation and a microorganism-free environment are key factors in the success of root canal treatment. Intracanal medicaments are used to enhance root canal disinfection. Simvastatin is derived from lovastatin and is a semisynthetic medication. This study compares and evaluates the effect of simvastatin and double antibiotic paste (DAP) as an intracanal medicament in single-rooted teeth with apical periodontitis using colony-forming units (CFUs)/ml. Materials and Methods: Twenty-eight patients with single-rooted teeth diagnosed with apical periodontitis were selected. Under aseptic conditions, patency was gained, sterile saline solution was deposited in the canal and the first sample (S1) was collected. Cleaning and shaping were then carried out following an appropriate technique depending on the configuration of the canal. After irrigation and biomechanical preparation, teeth were randomly assigned to two different groups, and the test intracanal medicament was applied to the root canals. Coronal openings were sealed with temporary restorative cement. The second sample (S2) was collected after 7 days. The samples obtained were checked for a reduction in the bacterial load. They were incubated aerobically for 48 h, and the CFUs were calculated. The Mann–Whitney U and Wilcoxon’s signed-rank tests were used to analyse the results statistically. Results: A significant reduction in bacterial count was present after administration of the intracanal medicament. On intergroup comparison, there was no statistically significant difference in bacterial decrease between the two groups. Comparatively, the mean reduction in the bacterial count was higher in the DAP group. Conclusion: It can be concluded that DAP and simvastatin were effective in the reduction of the bacterial count in single-rooted teeth diagnosed with apical periodontitis. However, DAP demonstrated a better performance in the reduction of bacterial counts.