Clinical and radiographic outcomes of lesion sterilization and tissue repair in primary molars: the role of patient cooperation in a retrospective study.

objectiveThe aim is to evaluate the effect of lesion sterilization and tissue repair (LSTR) treatment on the clinical and radiographic symptoms of necrotic primary molar teeth. MATERIALS AND

methodsThis retrospective study analyzed clinical and radiographic records of 36 necrotic primary molars from 26 pediatric patients who underwent LSTR therapy. Data from pre-operative, 3-month, and 6-month follow-ups were extracted from medical archives, with outcomes assessed based on symptom resolution and radiographic changes. A single-session LSTR treatment was performed on 36 pediatric patients aged 4–8 years with necrotic primary molars. Carious tissue was completely removed, and the endodontic cavity was prepared to facilitate proper placement of the medicament. While the necrotic pulp within the root canals was left intact, only the necrotic pulp tissue in the pulp chamber was removed using a sharp excavator. The pulp chamber was then irrigated with 1% NaOCl, and 3Mix-MP—comprising metronidazole, ciprofloxacin, and clindamycin in powder form combined with macrogol and propylene glycol in liquid form—was placed into the cavity to cover the canal orifices. The teeth were subsequently restored with glass ionomer cement. Clinical and radiographic evaluations were performed pre-operatively, and at 3 and 6 months post-operatively. Statistical analyses, including Cochran’s Q test and the Marginal Homogeneity test, were used to evaluate the outcomes. For the statistical analysis, a significance level of p < 0.05 was applied.

resultsThe overall success rate, defined as the absence of pain, abscess, and fistula with no worsening of mobility or furcation lesions, was 91.7% at the 6-month follow-up. Statistically significant reductions were observed in pain, abscess, fistula formation and sensitivity to percussion/palpation at both 3- and 6-month follow-ups (p < 0.05). By the 6-month evaluation, all treated teeth were completely free of pain and fistula. In addition, 97.2% of the teeth showed no abscess, and 88.9% exhibited no palpation/ percussion sensitivity. While changes in furcation lesions were not statistically significant at 3 months (p > 0.05), a meaningful reduction became evident by 6 months (p < 0.05). Tooth mobility, however, showed a significant decline as early as the 3-month follow-up (p < 0.05).

conclusionLSTR represents a viable alternative to conventional root canal therapy for necrotic primary molars. Its success appears independent of patient cooperation levels, making it particularly advantageous for managing uncooperative children where conventional endodontic procedures might be challenging.