Lesion Sterilization And Tissue Repair Research Articles

Lesion sterilization and tissue repair - A non-instrumental procedure: A systematic review

A primary tooth affected by dental caries involving the pulp tissues along with periradicular tissues need conventional endodontic treatment. Due to certain factors these treatments may be contraindicated. In that case Lesion Sterilization and Tissue Repair (LSTR) therapy is the better option to be preferred. The process of LSTR is to increase the longevity of the primary tooth. This procedure eliminates, sterilizes the canal system, repairs and regenerates the tissue. It needs minimal instrumentation and includes placement of an antibiotic mixture in the pulp chamber to disinfect the root canals. It is also known as Non-instrumental endodontic treatment (NIET).

A Comprehensive Review of Lesion Sterilization and Tissue Repair: An Alternative for Pulpectomy in Deciduous Teeth.

Pulpectomy has always been a treatment choice when irreversible damage to the pulpal and periapical tissues occurs, but in a pediatric patient, expecting cooperation and adequate chair side time is a huge task as they fear the dentists and the instruments. Hence, it was required that there come an advanced treatment protocol that helps overcome the drawbacks of the existing treatment modality. A new therapeutic strategy called lesion sterilization and tissue repair (LSTR) is revolutionizing how dental lesions are treated today. Through a non-invasive antimicrobial treatment, this cutting-edge method seeks to halt the spread of carious lesions while encouraging tissue repair and regeneration. In LSTR, the infected tooth tissues are treated directly with a special antimicrobial combination of antibiotics, reducing agents, and disinfectants. Through the elimination of the microorganisms that cause dental decay and the creation of an environment that is favorable for natural tissue healing, this intervention targets the microbial etiology. This article mainly focuses on using antibiotics as a treatment modality in a tooth affected by caries and where the pulp and periradicular tissues are irreversibly inflamed. Pulpectomy has always been the most practiced technique, but in children, due to the lack of cooperation during the treatment and harm to the underlying developing tooth bud, a less invasive protocol had to be used, which is LSTR. This review delves into the basic ideas, techniques, and clinical applications of lesion sterilization and tissue restoration to look at its various aspects. This review clarifies the effectiveness and safety of LSTR in controlling diverse dental diseases, ranging from early-stage caries to deep dentin infections, by critically assessing previous study findings. It also emphasizes LSTR's ability to preserve vital tooth pulp, obviating the need for invasive and frequently uncomfortable endodontic operations. The review advocates for integrating LSTR into contemporary dental practices, showcasing its potential to transform the landscape of oral healthcare. By providing a comprehensive overview of this innovative technique, this review encourages further research and clinical implementation, heralding a new era in dentistry focused on preservation, regeneration, and enhanced patient well-being.

Lesion sterilization and tissue repair (LSTR) method in irreversible dental pulp changes of primary teeth

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period.

Treatment of pulpally involved primary molars utilizing LSTR: Report of two cases

The purpose of this report was to review an emerging alternative treatment to pulpectomies and extractions for nonvital primary teeth called lesion sterilization and tissue repair (LSTR) and provide the results of two clinical case reports. LSTR is a noninstrumentotion endodont treatment (NIET) that involves a triple antibiotic mixture in a suitable vehicle, which is used to disinfect root canol systems. This type of treatment is develop by the coriology research unit of the School of Dentistry. Niigata University. Japan. This article describes clinical procedures required for the technique, two clinical applications and radiographic documentation and follow-up.

Lesion sterilization and tissue repair therapy using GAM antibiotic paste

Despite the efforts to prevent dental caries among children, premature loss of primary teeth due to pulp and periapical diseases is a common problem. The effect of this premature loss on the development of dentition is a matter of great interest. Importantly, the primary teeth are considered as natural space maintainers and therefore should be retained until their natural exfoliation. Based on these issues and concerns, the concept of “Lesion sterilization and tissue repair (LSTR)” therapy proposed by the Cariology Research Unit of the Niigata University School of Dentistry, would be preferable to current endodontic treatments.

Triple Antibiotic Paste in Primary Teeth- A Review

In primary teeth the foremost goal of endodontic treatment is to eliminate all bacterial infection by endodontic instrumentation. Lesion sterilization and tissue repair (LSTR) therapy is an unconventional endodontic technique which requires less instrumentation succeeded by placement of a triple antibiotic paste on the floor of the pulpal cavity. Antibacterial drugs have proven to be successful in eliminating microorganisms from root canal, thereby resulting in successful endodontic treatment.

LSTR AND ITS POTENTIAL ROLE IN CONSERVATIVE MANAGEMENT OF NON-VITAL PRIMARY MOLAR: A CASE REPORT.

Lesion sterilization and tissue repair (LSTR) treatment is very effective in disinfecting the root canal using triple antibiotic mixed in a suitable vehicle. This report is highlighting a case where LSTR therapy was done using triple antibiotic paste in primary molar showing peri-radicular pathosis and root resorption. On one-year follow-up, the tooth was asymptomatic with reduction in peri-radicular pathosis and root resorption. Thus, LSTR can be successful for nonvital pulp therapy in primary teeth with peri-radicular pathosis and root resorption. And also, LSTR therapy can be used as an alternative option to extraction in treating primary teeth with peri-radicular pathosis.

Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses.

To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth. Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE. Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6months (RR = 0.99, 95% CI, 0.94-1.04, p= 0.67; I2= 0%), 12months (RR = 0.97, 95% CI, 0.90-1.04, p= 0.34; I2= 0%), and 18months (RR = 0.89, 95% CI, 0.77-1.04, p= 0.14; I2= 0%) and radiographic findings at 6months (RR = 0.91, 95% CI, 0.78-1.06, p= 0.23; I2= 9%), 12months (RR = 0.87, 95% CI, 0.65-1.18, p= 0.38; I2= 64%), and 18months (RR = 0.84, 95% CI, 0.69-1.02, p= 0.08; I2= 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low. No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low. The present meta-analyses could not demonstrate the superiority of one treatment over the other.

Clinical, microbiological, and radiographic evaluation of sealed carious dentin after minimal intervention in primary molars.

In continuation with the ultraconservative minimal intervention approach for carious lesions treatment, lesion sterilization and tissue repair (LSTR) is a novel concept of using antibacterial drugs to disinfect dentinal, pulpal, and periapical lesions. The purpose of this study is to evaluate the clinical, radiographic, and microbiologic success rate of indirect pulp treatment (IPT) using a new technique minimal excavation and LSTR with triple antibiotic paste (TAP), for primary molars. This was randomized controlled trial design. Forty-two healthy cooperative children aged 5-10 years having deep carious lesion in primary molars were randomly assigned to receive either traditional IPT with calcium hydroxide or minimal excavation and LSTR with TAP. Follow-up was done at 6 weeks, 3, 6, and 15-18 months intervals, and treatment success or failure was determined by a combination of clinical, microbiological, and radiographic findings. Qualitative data were analyzed using Pearson's Chi-square test. Mann-Whitney U nonparametric test was used for statistically significant differences between the bacterial counts (median values and percent reduction) between the two groups and the Wilcoxon sign rank test for the intragroup evaluation of bacterial counts. LSTR with TAP was found to be as effective as traditional indirect pulp treatment (P < 0.05). Minimal excavation and LSTR with TAP can be an effective treatment methodology for the management of deep carious lesions in primary molars.

Efficacy of lesion sterilization and tissue repair using different materials in primary molars: A case series

The concept of lesion sterilization and tissue repair (LSTR) therapy involves the use of a triple antibiotic mixture in a suitable vehicle, which is used to disinfect the root canal systems. This series highlights three cases where pulp therapy using modified 3 Mix antibiotic paste and chloramphenicol, tetracycline, and zinc oxide-eugenol paste was attempted in primary molars with or without pulpal and periapical involvement. Successful clinical and radiographic assessment after 6 months advocates LSTR therapy as an alternative option to conventional pulp therapy.

Pulp therapy of primary molars using lesion sterilization tissue repair and traditional endodontic treatment

Aim: This study aimed to compare the clinical and radiographic success of lesion sterilization and tissue repair (LSTR) therapy and traditional endodontic treatment for pulp therapy of primary molars over a period of 6 months. Materials and Methods: Fifty primary mandibular molars from children aged 3–8 years in need of pulp therapy presenting with signs of irreversible pulpitis and those meeting our inclusion criteria were selected for the study. The teeth were randomly divided into two groups: Group 1 individuals received intervention by LSTR therapy and Group 2 individuals were treated with the principles of traditional pulpectomy procedures using a mixture of zinc oxide (ZnO) and calcium hydroxide (Ca(OH)2) as the obturating material. Patients were reviewed clinically and radiographically at 1, 3, and 6 months. Results: At the end of 1 and 3 months, both the study groups were comparable in their overall success rates. At 6 months, the clinical success was comparable between the two study groups. Radiographic success rate of the two study groups achieved statistically significant difference, with Group 2 faring better than Group 1. Conclusion: Primary mandibular molars showing signs of irreversible pulpitis, particularly those which were destined to have a poor prognosis, were successfully treated in Group 1 using LSTR and in Group 2 with traditional endodontics using a mixture of Ca(OH)2and ZnO as obturating material.

Antimicrobial activity of antibiotic pastes used in pulp therapy through direct contact with a multispecies biofilm: a pilot study

Objective: To evaluate the antimicrobial activity of antibiotic pastes used in lesion sterilization and tissue repair (LSTR) technique, through a novel membrane direct contact methodology against a multispecies biofilm and to establish appropriate dilutions for this method. Methods: CTZ (chloramphenicol, tetracycline, zinc oxide) and two formulations of 3Mix pastes (ciprofloxacin, metronidazole, and minocycline), 3Mix1 and 3Mix3, were evaluated with negative (0.9% saline) and positive (chlorhexidine 0.2%) control groups. Candida albicans and Enterococcus faecalis (24-hour) biofilms (n=10) grown on cellulose membranes were directlyexposed to standardized amounts of fresh pastes and control solutions (n=2) for 24h. Membranes were immersed in 900 μl of saline solution, and seven serial dilutions were made for each sample. Plating for each dilution (n=2) was performed on culture media for microbial colony-forming unit (CFU) counting of totalmicroorganisms, Candida spp. and Enterococcus spp. Aiming the comparison between groups, CFU quantification data were transformed into log10 CFU / mL and the Mann-Whitney test was applied (p<0.05). Results: Inhibition of CFU was observed for all pastes, with greatest effects for CTZ paste in medium selective for Candida spp. (p<0.001) and 3Mix1 in non-selective (p<0.000) and selective for Enterococcus spp. (p<0.004). Conclusion: The pastes showed antimicrobial activity against the tested multispecies biofilm, and the proposed direct contact methodology was efficient. Moreover, the dilutions used proved to be appropriatefor this methodology.

LSTR 3mix-MP Important Efficacy Particularly Antibacterial and Periapical Lesions during Conservative Treatment in the Dentistry like RCT and Others Endodontics Management: Case Studies

Local sterilization and tissue repair which generally termed as LSTR, brings a radicular change in the field of conservative dentistry. Efficacy against antibacterial environment and non-surgical healing of periapical lesions much better than calcium hydroxide. LSTR 3Mix-MP, Using an antibacterial drug combination, therapy is a novel caries, pulpal treatment of primary tooth and root canal treatment. LSTR 3Mix-MP aims to eliminate causative bacteria from lesions and after sterilization, the host’s natural tissue recovery process usually the lesions are repaired or resolved. LSTR 3Mix MP where TAP (triple antibiotics paste) such as: Metronidazole, Ciprofloxacin, Minocycline and Vehicle MP Macrogol/polyethylene glycol and propylene glycol used to prepare. TAP has great antibacterial efficacy particularly against enterococci which remains after successful root canal treatment, effective eradication of the causative microorganisms during root canal treatment procedures. Residual infection in Root canal therapy has always been an area of interdermind or vague for a treating dental surgeon. Lesion sterilization and tissue repair (LSTR) therapy is a non-surgical or non-conventional endodontic treatment procedure that involves non-instrumentation or minimal instrumentation followed by placement of a triple antibiotic paste in a medication along with Macrogol and Propylene glycol.

Evaluation of Success Rate of Lesion Sterilization and Tissue Repair Compared to Vitapex in Pulpally Involved Primary Teeth: A Systematic Review.

Background:Vitapex has been a popular obturating material for several decades. In recent times, lesion sterilization and tissue repair (LSTR) has shown promising results. This technique uses a mixture of 3 antibiotics for sterilization of the root canals and healing of periradicular tissues.Objective:The objective of this systematic review was to compile all the literature comparing Vitapex and LSTR for pulpally involved primary teeth and evaluate the success rate in terms of clinical and radiographic outcomes.Materials and Methods:This review is based on PRISMA guidelines. The electronic search on MEDLINE via PubMed database and Google scholar, cross-referencing and hand search of journals was carried out for articles from January 1, 2000 to December 31, 2019. Articles only in the English language were selected. Out of the 17 articles, 3 unique articles were identified for the review, of which 2 were randomized controlled trials and 1 was a retrospective study.Results:All the three articles were assessed for their quality and all had a low risk of bias. It was found that LSTR and Vitapex had a high clinical success after 12 months. The radiographic success after 6 months was high but decreased after 12 months in both the groups.Conclusion:There is no difference in the success rate of LSTR as compared to Vitapex for the treatment of pulpally involved primary teeth.

Lesion Sterilization and Tissue Repair in Nonvital Primary Teeth: An In vivo Study.

Aim and Objective:The aim of this study is to evaluate the clinical and radiographic success of endodontic treatment of nonvital primary teeth using lesion sterilization and tissue repair (LSTR) therapy.Materials and Methods:A sample size of 40 primary molars from 34 children of 3–10 years of age were selected for the study. Nonvital primary molars were treated using LSTR technique with a combination of antibacterial drugs comprising ciprofloxacin, metronidazole, and doxycycline with propylene glycol as vehicle. The procedure was completed in a single appointment. Only analgesics were prescribed postoperatively. Postoperative evaluation was done after 1, 3, 6, and 12 months.Results:Clinical signs and symptoms got resolved in the 1st-month follow-up itself and continued in the subsequent visits. Radiographic evaluation showed a gradual improvement in success rates through the 12-month follow-up period.Conclusion:LSTR technique can be considered as an alternative treatment option for nonvital primary teeth avoiding a course of systemic antibiotics to the children. Doxycycline can be used in the drug combination instead of minocycline which also gives higher clinical and radiographic success.

Lesion Sterilization and Tissue Repair-Current Concepts and Practices.

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.

Lesion Sterilization and Tissue Repair-A Review

AIM: To review the technique of lesion sterilization and tissue repair and its significance as an alternative to pulpectomy and extraction in primary tooth. BACKGROUND: Lesion sterilization and tissue repair (LSTR) therapy is an endodontic treatment procedure that involves non-instrumentation or minimal instrumentation which is followed by the placement of antibiotic mixture to disinfect root canal systems. OBJECTIVE: In general, treatment for teeth with infected root canals or periradicular tissue is endodontic pulpectomy therapy, other than extraction. Although success rates of endodontic root canal procedures are good, the technique can be very challenging in primary tooth due to morphology of the canals. Thus, lesion sterilization and tissue repair technique using antibiotic paste is introduced as an alternative to pulpectomies and extractions in primary teeth. REASON: The article reviews the nature of the technique, its indications, uses and clinical procedures required in performing the technique. LSTR technique aims at eliminating the causative bacteria from lesions by sterilizing the lesions promoting tissue repair and regeneration by natural tissue recovery process.

An in vivo study evaluating lesion sterilization and tissue repair 3 MIX-MP noninstrumentation endodontic treatment as an alternative to conventional endodontic retreatment

Aim: To alleviate the patient's symptoms and promote periapical healing in teeth with failure of root canal treatment, without the removal of previous obturating material using lesion sterilization and tissue repair (LSTR) 3 MIX-MP noninstrumentation endodontic treatment (NIET). Materials and Methods: Fifteen single-rooted teeth with a history of root canal treatment 1–2 years previously, requiring retreatment, with pain, sinus tract, swelling and periapical lesions, and having acceptable obturation were included in the study. The previous coronal restoration was removed, and a medication cavity was prepared for placement of 3MIX MP; this was followed by lining with Glass ionomer cement and a coronal restoration with composite resin. Results: At 8 weeks, all patients did not have either pain, tenderness on vertical percussion, pain on biting, or swelling (asymptomatic). Radiographically, the periapical lesions had reduced by 1 mm in five cases. In six patients, the lesion size remained unchanged. Conclusion: LSTR NIET is an excellent, inexpensive, less traumatic, and least time-consuming alternative to treat symptomatic teeth requiring endodontic retreatment.

The application of lesion sterilization and tissue repair 3Mix-MP for treating rat's dental pulp tissue

Background: Lesion sterilization and tissue repair (LSTR) 3Mix-MP are three broad-spectrum antibiotics, including metronidazole, ciprofloxacin and minocycline are mixed with propylene glycol or macrogol. There is the possibility ofthe healing process that marked proliferation ofnew blood vessels and proliferation offibroblasts in the treatment ofirreversible pulpitis by pulp capping LSTR 3MixMP because of the principle of the method LSTR 3Mix-MP is to kill bacteria. Purpose: The purpose of this study to prove the effect of LSTR 3Mix-MP on chronic inflammation and the healing process in rat dental pulp tissue in vivo. Methods: Rattus norvegicus anaesthetized by using ketamine and xylazine dissolved in sterile isotonic saline solution (0.2 ml/50gr mm) on the upper right thigh. Cavity preparation class I to perforation by using a low speed tapered diamond round bur. In the treatment group, rats were treated 3Mix-MP at a dose of10 mg and then covered with glass ionomer cement for 7 days on the pulp that has been opened for 3 days. The control group treated with saline irrigation on the pulp that has been opened for 3 days. Rats were killed after seven days, and then made preparations pulp tissue to count the number oflymphocytes, macrophages, plasma cells, blood vessels, and fibroblasts Results: There is an increase in the average number ofmacrophage cells, plasma, and fibroblasts; and decreased lymphocytes and blood vessels in the treated group exposure LSTR 3Mix-MP. Conclusion: LSTR 3Mix-MP can reduce chronic inflammation process and enhance the healing process in rat dental pulp tissue.

Nonsurgical Root Canal Therapy of Large Cystic Periapical Lesions Using Simple Aspiration and LSTR (Lesion Sterilization and Tissue Repair) Technique: Case Reports and Review

Introduction: This review and case report presents the treatment of two large cystic periapical lesions using simple aspiration technique for decompression and triple antibiotic paste for disinfection of the root canal system. Methods: A non-surgical approach was followed for the two large cystic periapical lesions. Simple aspiration irrigation technique along with lesion sterilization therapy with triple antibiotic paste was used without any surgical intervention. Results: Complete periapical healing of both the cyst like periapical lesions occurred without any surgical intervention. A 1 year follow-up radiograph showed complete healing of the lesion. Conclusion: Pathogenesis, histology, and molecular cell biology of inflammatory apical true cysts are not different from pocket cysts. Therefore, inflammatory apical true cysts might regress after nonsurgical root canal therapy by the mechanism of apoptosis or programmed cell death, similar to inflammatory pocket cysts. Non-surgical approach using a combination of Simple Aspiration technique and LSTR (lesion sterilization and tissue repair) technique was successful in healing large cyst-like periradicular lesions.