LESION STERILIZATION AND TISSUE REPAIR (LSTR) TECHNIQUE (original) (raw)

Despite improved awareness and advanced caries prevention methods, the prevalence of dental caries remains high. In dental practices, endodontic treatment of primary teeth with necrotic pulps is common. Due to the anatomy of the root canal in primary and permanent teeth, delayed presentation of patients for treatment due to financial constraints, dental neglect, and lack of cooperation in pediatric patients, successful pulp therapy is always a challenge for the dentist. Factors like extensive root resorption, inadequate bone and periodontal support, a child in the pre-cooperative age group, and others can make pulp therapy contraindicated or compromised[1]. Instrumentation techniques, irrigation regimes, and intracanal medicaments have all been mentioned as ways to limit the number of bacteria. In today's world, a novel approach that is less intrusive and time-consuming could be a ray of hope for both the pediatric patient and the pedodontist. In such a clinical scenario, the LSTR asserts its importance. The Cariology Research Unit of Niigata University School of Dentistry invented the concept of Lesion Sterilization and Tissue Repair (LSTR) therapy, which involves non-instrumentation or minimal instrumentation followed by the placement of an antibiotic mixture in a propylene glycol vehicle to disinfect root canal systems and periapical lesions[2]. In 1990, Hoshino et al. utilized a 1:1:1 ratio of antibiotics such as metronidazole 500 mg, ciprofloxacin 200 mg, and minocycline 100 mg[3]. Takushige et al. employed the aforesaid antibiotics in 1:3:3 ratios in 1998[2]. Metronidazole is a member of the nitroimidazole family of antibiotics that binds to DNA and kills both gram-positive and gram-negative anaerobes. Ciprofloxacin is a fluoroquinolone antibiotic that works by inhibiting DNA Gyrase, enabling it to destroy gram-negative bacteria. Minocycline is a broad-spectrum antibiotic that kills grampositive and gram-negative bacteria, as well as Spirochetes, by inhibiting protein synthesis,