Pulp Therapy
Ghazaleh Peiravani, DDS
Resident
Cohen Children’s Medical Center of Long Island Jewish Hospital, Queens, NY
Cohen Children's Medical Center
great neck, New York, United States
Ritu Shah, DMD, MS
Cohen Children's Medical Center
Comparing LSTR therapy and Pulpectomy: Literature Review and Case Report
Peiravani, G, Shah, R
Cohen Children’s Medical Center
New Hyde Park, NY
Background: Dental caries are the most common cause of premature tooth loss in primary dentition. This can lead to changes in eruption sequence, ectopic eruption, habit development, space loss, functional and speech impairment. The most promising space maintainers are successfully disinfected and restored primary teeth. Primary teeth typically have curved root canals, multiple accessory canals, and abundant medullary bone spaces that help spread infection. Obstacles in endodontic therapy for primary teeth include the proximity of the developing permanent tooth bud and difficulty in obtaining a perfect seal. Lesion sterilization and tissue repair (LSTR) is a procedure for necrotic primary teeth that requires no instrumentation or filling of the root canals. Rather, it involves placement of an antibiotic mixture in the pulp chamber to disinfect the root canals. The principle behind LSTR is supported by the host’s natural defense mechanisms. Sterilizing the canals and pulp chamber can decrease the bacterial load and if successful, tissue repair can be anticipated, and the tooth can be retained.
Methods: Databases were searched between the years 2020-2022 for randomized controlled trials, cohorts, and case summaries. Eight articles were selected to review and the success rate of traditional pulpectomy treatment and LSTR were compared.
Results/
Conclusion: Overall, the difference between LSTR and pulpectomy success rates was not significant amongst different studies. However, LSTR had a higher success rate than pulpectomies in teeth with preoperative root resorption and pulpectomy results were improved when roots were intact.