130 - Title: Triple Antibiotic Paste Pulpotomy (LSTR) to treat Necrotic Primary Molars

Abstract: Title: Triple Antibiotic Paste Pulpotomy (LSTR) to treat Necrotic Primary Molars

Authors: Khan F, Schwartz K, Clark R

Affiliation: St. Christopher’s Hospital for Children, Philadelphia, PA.

Purpose: The objective of this single‑arm clinical study was to assess the clinical success of the Lesion Sterilization and Tissue Repair (LSTR) technique for the management of necrotic primary molars in children in Pennsylvania, United States, over a 12‑month follow‑up period.

Methods: Children aged 4–10 years presenting with primary molars exhibiting signs of pulpal necrosis—including pain on mastication, spontaneous pain, draining sinus tract, fistula, or abscess—were recruited. Eligible teeth received LSTR therapy using a triple‑antibiotic paste pulpotomy. Clinical success was defined as tooth retention without pain at 12 months following treatment.

Results: Thirty‑three primary posterior teeth were included. Of these, 16 teeth demonstrated clinical success (48%). Twelve teeth (36%) were lost to follow‑up before the 12‑month evaluation, and five teeth (15%) were classified as treatment failures.

Conclusion: Given the anatomical and behavioral challenges associated with root canal therapy in primary dentition—including thin dentinal walls, root divergence, physiologic resorption, and limited patient cooperation—LSTR represents a viable alternative to traditional pulpectomy. For primary teeth exhibiting signs of irreversible pulpitis or necrosis, LSTR may offer a conservative treatment option that avoids premature extraction. Appropriate informed consent and careful management of parental expectations remain essential components of care.

Identify Supporting Agency and Grant Number: Research supported by Drexel University IRB - 1907007269