Lesion Sterilization Tissue Repair (LSTR) is a therapeutic approach used in dentistry for the treatment of oral infectious lesions, including dentinal, pulpal, and periradicular lesions (Vijayaraghavan et al., 2012). It involves the use of a combination of antibacterial drugs to disinfect the affected pulp and periapical tissues (Tedesco et al., 2021). The concept of LSTR was developed by the Cariology Research Unit of Niigata University School of Dentistry in Japan (Sain et al., 2018).

The antibacterial drugs used in LSTR therapy may vary, but commonly used combinations include metronidazole, ciprofloxacin, and minocycline (Vijayaraghavan et al., 2012). These drugs have been shown to have bactericidal activity against selected microorganisms (Nalawade et al., 2015). The mixture of three antibacterial drugs, known as 3Mix, has been found to effectively sterilize carious lesions, necrotic pulps, and infected root dentine of primary teeth (Nakornchai et al., 2010). The use of 3Mix in LSTR therapy has been shown to promote tissue repair and regeneration (Nanda et al., 2014).

LSTR therapy is considered a non-instrumentation endodontic treatment, as it does not involve mechanical instrumentation of the root canal system (Duanduan et al., 2013). This approach helps prevent over-enlargement of the root canal and unnecessary irritation of periapical tissue (Duanduan et al., 2013). Instead, LSTR therapy focuses on disinfecting the affected pulp and periapical tissues with an antibacterial paste (Tedesco et al., 2021). The antibacterial paste is typically applied to the lesion and left in place for a certain period to allow for disinfection and tissue repair (Doneria et al., 2017).

The success of LSTR therapy has been demonstrated in various studies. It has been shown to be effective in the treatment of infected primary molars (Nakornchai et al., 2010), pulpotomies of infected primary molars (Daher et al., 2015), and non-vital pulp treatment in primary teeth (Duanduan et al., 2013). LSTR therapy has been found to increase the longevity of deciduous teeth in young children (Sain et al., 2018). It has also been shown to be a suitable alternative to conventional pulpectomy in primary molars (Agarwal et al., 2011).

In addition to its effectiveness, LSTR therapy offers several advantages. It preserves tooth structure by avoiding excessive instrumentation of root canals (Singhal et al., 2021). It also promotes tissue repair and regeneration through the host’s natural tissue responses (Sain et al., 2018). LSTR therapy has been found to have a high success rate and can be considered a reliable treatment option (Malu & Khubchandani, 2022).

However, it is important to note that LSTR therapy may be associated with some limitations. Discoloration of the treated tooth has been reported as a potential side effect of LSTR therapy (Prasad et al., 2017). Antibiotic resistance can also decrease the efficacy of endodontic filling pastes used in LSTR therapy (Rivera-Albarrán et al., 2021). Further research is needed to explore the clinical applications and long-term outcomes of LSTR therapy (Garrocho-Rangel et al., 2021).

In conclusion, Lesion Sterilization Tissue Repair (LSTR) is a therapeutic approach used in dentistry for the treatment of oral infectious lesions. It involves the use of a combination of antibacterial drugs to disinfect the affected pulp and periapical tissues. LSTR therapy has been shown to be effective in various dental conditions, including infected primary molars and non-vital pulp treatment in primary teeth. It offers advantages such as preserving tooth structure and promoting tissue repair and regeneration. However, it may be associated with limitations such as tooth discoloration and antibiotic resistance. Further research is needed to explore the clinical applications and long-term outcomes of LSTR therapy.

References:

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