Defense Date
2026
Document Type
Thesis
Degree Name
Master of Science in Dentistry
Department
Dentistry
First Advisor
Garry Myers
Abstract
Introduction: Diabetes is known to impair healing of apical periodontitis after non-surgical root canal therapy due to diminished leukocyte function, impaired inflammatory cell recruitment, and reduced tissue repair capacity. This dysregulated immune response increases susceptibility to infection and chronic inflammation. Statins, widely prescribed for atherosclerotic disease, possess pleiotropic effects that extend beyond lipid regulation, including anti-inflammatory and pro-angiogenic properties. Recent evidence suggests statin therapy may enhance periapical bone regeneration and post-endodontic healing.
Methods: A retrospective cohort study was conducted using clinical and radiographic records of diabetic and non-diabetic patients who underwent non-surgical root canal therapy by dental students, endodontic residents and faculty practice. Diabetic patatients were grouped by statin use. Periapical healing was evaluated radiographically at ≥12-month follow-up using the vii Periapical Index (PAI) score, with success defined as PAI ≤2 and absence of clinical symptoms. Statistical analyses compared healing outcomes between diabetic statin users, diabetic non-users, and non-diabetic controls.
Results: Overall, nonsurgical root canal therapy resulted in significant radiographic improvement, with a median reduction in Periapical Index (PAI) score of 2. Postoperatively, 68% of cases were classified as healed/healthy, 24% as healing, and 8% as uncertain. The mean patient age was 62.96 ± 13.19 years. No statistically significant differences were observed between statin and non-statin groups in pre/postoperative PAI scores or overall PAI reduction. Similarly, healing outcomes were not significantly associated with statin use, sex, or tooth location. Younger age and smaller baseline PAI score were significantly associated with improved healing. Stratified analysis demonstrated no difference in cases with smaller lesions (PAI ≤3), but suggested a possible trend in statin users with larger lesions.
Discussion: NSRCT is effective in diabetic patients with and without the use of statin therapy. In diabetic individuals—where chronic inflammation and impaired neutrophil function hinder repair—statins may counteract these effects via reduced pro-inflammatory cytokines (IL-1, IL-6, TNF-α) and enhanced osteoblastic activity; however more refined studies on the impact of statin therapy are warranted given the limitations of this study.
Conclusions: Statin therapy appears to positively influence periapical healing outcomes in diabetic patients following non-surgical root canal therapy. Adjunctive statin use may represent a valuable therapeutic consideration to mitigate diabetes-related healing deficits in endodontic treatment.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
6-2-2026