Lesion sterilization tissue repair as adjunct to conventional root canal treatment of combined periodontic-endodontic cases

Abstract

Background: Treatment of perio-endo lesions is challenging for the clinician. A combination of root canal treatment and periodontal treatment is needed in order to provide good results. There is a high failure rate due to the difficulty in eliminating the microflora that colonizes and complicates the lesion. Conventional root canal treatment (RCT) sometimes is not enough to prevent failure in such lesions. Hence the Aim of this study was to evaluate of use of LSTR (Lesion Sterilization Tisssue Repair) therapy in conjunction with, periodontal therapy and RCT in management of combined perio-endo lesions. Materials and methods: This study was conducted on 26 patients with perio-endo lesions, The affected teeth were tender to percussion, presented no mobility, and meticulous periodontal probing revealed all pockets to be more than 6 mm in depth. Periapical radiographs of the teeth confirmed the extensive coronal carious lesion involving the pulp and revealed large periapical lesion. The patients were classified into two groups, each of 14 patients, control group (A) RCT done by using conventional sealer, and group (B), RCT done by mixing sealer with LSTR material in equal proportions. All teeth were treated by open flap debridement. Results: In group B patients, after follow-up for 3, 6, 9 and 12 months, we found excellent prognosis (98%), with no symptoms of pain and there was marked improvement in periodontal parameters for all teeth. However, on the other hand, in group A patients, the prognosis was found to be 90%. Conclusion: According to results of this study, we highly recommend the use of LSTR with sealer in RCT together with periodontal treatment in management of perio-endo lesions to decrease the rate of failure and improve the periodontal condition.