LSTR therapy for tooth fracture and periapical abscess of deciduous tooth.

Abstract

Introduction: The management of pulp infections in primary teeth with immature roots represents a clinical challenge in infants. Traumatic dental injuries in children with severe early childhood caries and periapical tissue involvement, require a therapeutic approach that ensures effective infection control, preservation of the tooth, and minimization of the emotional and functional impacts on the child.  Case report: A two-year-old male patient presented with definitively negative behavior, high caries risk, and a recent history of facial trauma. Clinical examination revealed an uncomplicated crown fracture in an upper incisor, periapical abscess without fistula, and multiple carious lesions. Radiographic evaluation revealed a deep carious lesion, open apex, thin radicular walls, and signs of apical pathology. Conservative treatment was carried out under conscious sedation. In the presence of vital pulp, controlled removal of pulp tissue was performed, followed by irrigation with antiseptic solutions, placement of Hoshino paste, and curettage of the periapical abscess with local application of the same medicament. Symptoms resolved immediately, and at the three-month clinical and radiographic follow-up, no signs of inflammation were detected. Dental esthetics were restored, and an individualized preventive protocol was instituted. Conclusions: This case demonstrates that adopting a conservative and personalized approach can yield satisfactory results even in highly complex clinical situations, contributing to the preservation of primary teeth, the promotion of oral health, harmonious craniofacial development, and improved overall child well-being.