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. 2025 Nov 9.
doi: 10.1111/ipd.70046. Online ahead of print.

Comparative Evaluation of Clinical and Radiographic Success of Lesion Sterilization and Tissue Repair (LSTR), Modified LSTR With Triple Antibiotic Paste and Metapex Pulpectomy in Primary Molars: A Randomized Controlled Clinical Study

T P Ayisha Beevi  1 , Afroz Alam Ansari  1 , Rajeev Kumar Singh  1 , Richa Khanna  1
Affiliations

Comparative Evaluation of Clinical and Radiographic Success of Lesion Sterilization and Tissue Repair (LSTR), Modified LSTR With Triple Antibiotic Paste and Metapex Pulpectomy in Primary Molars: A Randomized Controlled Clinical Study

T P Ayisha Beevi et al. Int J Paediatr Dent. .

Abstract

Background: Managing necrotic primary molars is challenging due to complex root anatomy and resorption. While pulpectomy is standard, less invasive techniques like lesion sterilization and tissue repair (LSTR) are gaining interest. However, their comparative effectiveness remains uncertain.

Aim: To evaluate and compare the clinical and radiographic success of conventional LSTR, modified LSTR (with radicular pulp removal), and pulpectomy with Metapex in necrotic primary molars. Postoperative pain was also assessed.

Design: Sixty-three necrotic primary molars in children aged 3-8 years were randomly divided into three groups: (1) Group I: Conventional LSTR with triple antibiotic paste (3Mix MP). (2) Group II: Modified LSTR +3Mix MP. (3) Group III: Pulpectomy with Metapex. Clinical and radiographic assessments were done at 3, 6, 9, and 12 months. Postoperative pain was recorded immediately and after 24 h using a standard scale.

Results: A significant difference was observed after 12 months, with pulpectomy demonstrating superior outcomes compared to traditional LSTR (Table 4, p = 0.01). It also shows, radiographic success was lower in the LSTR group than the pulpectomy group when baseline radiolucency was present (p =0.047).

Conclusion: Pulpectomy showed significantly better overall radiographic results than conventional LSTR and was significantly better when there was a pre-treatment radiolucency. Pain outcomes were comparable.

Keywords: lesion sterilization and tissue repair therapy; noninstrumental endodontic treatment; primary molars; pulpectomy; pulpitis.

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References

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