Annals and Essences of Dentistry
Open Access

Abstract

Lesion Sterilization and Tissue Repair (LSTR) Technique and its Clinical Application in Primary and Permanent Teeth: A Review

Triveni Mohan Nalawade*, Dhaval Parikh and Rachappa M Mallikarjuna

Lesion Sterilization and Tissue Repair (LSTR) is also called NIET OR Non-Instrumental Endodontic Treatment as it claims to be a “new biologic approach in the treatment of carious lesions with periapical involvement using a mixture of 3 antibiotics (3-Mix).” LSTR involves the use of three antibiotics / antibacterial drugs namely, Metronidazole, Ciprofloxacin and Minocycline. The 3 antibiotics are mixed together with propylene glycol. A fresh creamy consistency is prepared and placed in the pulp chamber which is subsequently sealed with a GIC restoration and stainless steel crown. This concept was developed by the cariology research unit at the Nigata University School of Dentistry in 1988. Several studies done using LSTR on deciduous teeth reported excellent clinical results which may be ascribed to the bactericidal effect of the 3-Mix. Some concerns include the inappropriate use of antibiotics, possible leakage of the antibiotic paste into the oral cavity and its effect on the oral microflora, etc. So this paper attempts to look in depth about the critical impact of LSTR in pulp therapy and also presents the newer concept of a 2-Mix instead of 3-Mix for treatment. Some uses of 3-Mix extend to cases of chronic periapical abscess, failure of pulpectomy in deciduous molars treated with zinc oxide eugenol (ZOE) obturation, revascularization endodontics, and reimplantation of avulsed teeth.

Published Date: 2019-03-21; Received Date: 2018-09-25