175 - Lesion Sterilization Tissue Repair Implementation Challenges in a Residency Program

Purpose: To assess the implementation of a Lesion Sterilization Tissue Repair (LSTR) protocol at a hospital based pediatric dental residency program.

Methods: A chart review was completed for patients who received LSTR therapy as per normal Division of Dentistry protocols. A LSTR 3 Mix-MP preparation was utilized for treatment. Commercially prepared chemotherapeutic agents including metronidazole, ciprofloxacin, and clindamycin were obtained from the Dental Clinic's Pyxis machine. Each drug was combined in a 1:1:1 ratio. Iodoform (triiodomethane) USP was added to make the 3 Mix-MP paste radiopaque to verify its placement radiographically. Dental treatment was completed using previously accepted LSTR protocols. Reasons for planning LSTR were reviewed. 

Results: Data was collected from twelve subjects. LSTR was completed on ten patients. Two were planned for LSTR but extraction was chosen day of procedure due to poor restorability after caries excavation. Of the ten LSTR subjects, two were seen at four-month recall, one was seen at six-month recall, and two were seen at twelve-month recall. Of the LSTR treated teeth, two exfoliated successfully, one showed no changes and is still present, one showed boney refill and is still present, and one abscessed requiring extraction.

Conclusions: Currently, LSTR is a difficult non-vital pulp therapy to introduce in an educational hospital pediatric dental clinic. Recall basis, resident treatment planning, care continuity, and the acute symptomatic clinical presentation of potential candidates have presented as obstacles in selecting LSTR as a novel non-vital pulp therapy in an educational setting.