Alternative endodontic technique in pediatric dentistry: lesion sterilization and tissue repair

Primary teeth are necessary for mastication, phonation, esthetic, and maintaining the place for the permanent teeth. The success of endodontic treatment in primary teeth is actually based on eliminating microorganisms in the root canal system by adequate irrigation and obliteration. In the pediatric patient, it is not always possible to do perfect endodontic treatment; therefore, lesion sterilization and tissue repair becomes an alternative technique. Lesion sterilization and tissue repair is a non-instrumental endodontic technique developed in Japan in 1990 and used to treat abscesses, mobility, sinus tracts, radiolucency in the furcation area in primary teeth in pediatric patient. The technique is based on using triple antibiotic paste (including metronidazole, minocycline, and ciprofloxacin) for disinfecting the root canal system. Minocycline, a component of triple antibiotic paste has the ability to raise the interleukin-10 level while inhibiting collagenases and matrix metalloproteinases. Metronidazole and ciprofloxacin have the feature to repair tissue by the effect of generating fibroblasts. The aim of the article is to summarize the indications, contraindications, used materials and protocol of lesion sterilization and tissue repair in pediatric patient.