Non-instrumental endodontic treatment in primary tooth. Case report.

Abstract

Introduction: Lesion sterilization and tissue repair (LSTR) therapy is an endodontic procedure that involves no instrumentation or minimal instrumentation, followed by the placement of a mixture of antibacterial drugs. It emerges as an alternative treatment to traditional pulpectomies and extractions, mainly in non-vital teeth. The hypothesis of this therapy is based on the premise that a sterilization of the lesion will be able to achieve tissue repair. Clinical case: Male patient, 6 years-old, potentially cooperative, with anxiety and hyperactivity disorder. Clinical examination shows tooth 7.4 with glass ionomer filling. The radiographic examination shows deep obturation, internal root resorption, as well as interradicular injury, without compromising the germ of the permanent tooth. LSTR is performed in a single session, using a combination of metronidazole and ciprofloxacin together with propylene glycol. Radiographic control of the tooth is performed at the 3rd and 5th months after the therapy, observing a reduction of the interradicular lesion; and clinically the tooth remains asymptomatic. Conclusions: Although there is limited evidence on this pulp therapy technique for necrotic primary molars, published reports show encouraging results. The non-instrumental endodontic treatment technique is recommended in cases of teeth with doubtful prognosis, allowing to maintain it for up to 12 months, avoiding its extraction. On the other hand, it is a fast treatment, which is carried out in a single session and is very useful in non-cooperative patients.