Abstract
A deciduous tooth affected by dental caries involving the pulp tissue with subsequent periradicular pathosis at times makes the conventional endodontic procedures a dilemma for a variety of reasons. In this situation, lesion sterilization and tissue repair (LSTR) stands out as the only option by which dentists could increase the longevity of the deciduous teeth of a young child. This therapy aims to eliminate bacteria from the root canals by sterilizing the lesion and promoting tissue repair and regeneration by the host’s natural tissue responses. This article reviews the rationale, indications, contraindications and the procedure in detail.How to cite this article: Sain S, Reshmi J, Anandaraj S, George S, Issac JS, John SA. Lesion Sterilization and Tissue Repair-Current Concepts and Practices, Int J Clin Pediatr Dent. 2018;11(5):446-450.
Highlights
In routine dental practice, clinicians come across a number of cases where a deciduous tooth is affected by dental caries followed by periradicular change and are beyond conservation by traditional endodontic procedures.[1]
The lesion sterilization and tissue repair (LSTR) is an endodontic treatment procedure that involves non-instrumentation or minimal instrumentation followed by placement of antibiotic mixture in a propylene glycol vehicle to disinfect root canal systems, and periapical lesions
In an in vivo study conducted by Prabhakar et al on 60 infected primary molars, even though the teeth with root canals left unprepared exhibited a clinical and radiographic success, the success rates were more for the biomechanically prepared (BMP) ones than the others.[12]
Summary
Clinicians come across a number of cases where a deciduous tooth is affected by dental caries followed by periradicular change and are beyond conservation by traditional endodontic procedures.[1]. The LSTR is an endodontic treatment procedure that involves non-instrumentation or minimal instrumentation followed by placement of antibiotic mixture in a propylene glycol vehicle to disinfect root canal systems, and periapical lesions. Most commonly a combination of three antibiotics along with solvent macrogol and propylene glycol are used, so it is known as three mix MP pastes. Minocycline is a broad spectrum antibiotic that acts by inhibiting protein synthesis, collagenases, and matrix metalloproteinase It destroys gram-positive as well as gram-negative microorganisms and Spirochetes.[2,6,7,8] Discolouration of teeth being a disadvantage of minocycline, antibiotics like amoxicillin, cefaclor, cefroxadine, fosfomycin or rokitamycin can be used as alternatives. If the mix turns translucent on storage, it has to be discarded.[10,11,12]
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