Clinical and Radiographic Success of Modified LSTR Techniques in Primary Second Molars

This study was conducted to evaluate and compare the clinical and radiographic success of different antibiotic and vehicle modifications of the Lesion Sterilization and Tissue Repair (LSTR) technique in infected mandibular primary second molars.

A total of 64 systemically healthy children aged 4-11 years were included in the study. The cases were assigned to four treatment groups according to the antibiotic combination (3Mix or 2Mix) and the vehicle used [Macrogol-Propylene Glycol (MP) or Normal saline (NS)]. The four treatment groups were 3Mix-MP, 3Mix-NS, 2Mix-MP, and 2Mix-NS.

Following LSTR treatment, clinical evaluations were performed at 3, 6, and 12 months, while radiographic evaluations were performed at 6 and 12 months. Clinical and radiographic findings were assessed at the specified follow-up periods to determine treatment success and to compare the outcomes of the four LSTR modifications over a 12-month follow-up period.

Inclusion criteria

• Children aged 4-11 years. Systemically healthy children. Presence of deep caries, pulp necrosis, or irreversible pulpitis in a mandibular primary second molar indicated for LSTR treatment.

Patients unsuitable for conventional pulpectomy due to poor cooperation. At least 6 months remaining before physiological exfoliation of the affected tooth.

Root resorption not exceeding one-third of the root length. No furcation perforation. Furcation radiolucency not extending to the permanent tooth germ. Sufficient remaining tooth structure for restoration. Parent/legal guardian willing to provide informed consent.

Exclusion criteria

• Risk of infective endocarditis. Known allergy to any antibiotic used in the study. Root resorption exceeding one-third of the root length. Extensive furcation involvement extending toward the permanent tooth germ. Insufficient remaining tooth structure for restoration. Parent/legal guardian declining informed consent.