Healing of a large periapical lesion using triple antibiotic paste and intracanal aspiration in nonsurgical endodontic retreatment

Abstract

A patient with a large periapical lesion in relation to the maxillary right central and lateral incisors is presented here. During the conservative root canal treatment, aspiration of the fluid was done through the root canal, followed by placement of triple antibiotic paste for two weeks. Complete periapical healing was observed at the 24-month recall. This report confirms that for treatment of a large periapical lesion it is not always necessary to do surgical treatment and even cyst-like periapical lesions heal following conservative endodontic therapy.

A Comparative Evaluation of the Effectiveness of Three Different Irrigating Solution on Microorganisms in the Root Canal: An Invivo Study

“…Various studies on triple antibiotic paste have demonstrated successful elimination of microbial pathogens [6][7][8]16]. Windley et al, assessed the efficacy of a triple antibiotic paste in the disinfection of immature dog teeth with apical periodontitis [16].…”

“…Even though there are studies available regarding the antibacterial efficacy of individual antibiotics as an endodontic irrigant, there are no studies existing in the literature regarding the use and efficacy of the combination of tetracycline, ciprofloxacin and ornidazole as an endodontic irrigant but some studies have used antibiotics in paste form as an intracanal medicament [6][7][8]. Hence, this study was undertaken to suggest triple antibiotic solution containing tetracycline, ornidazole and ciprofloxacin as a new endodontic irrigant that may possess superior antibacterial activity in comparison with chlorhexidine solution.…”

Triple antibiotic paste: momentous roles and applications in endodontics: a review

“…Zain et al [ 70 ] reported that the presence of a large size periapical radiolucency is more likely to be a peri-radicular cyst. Various treatment approaches to manage a large periapical lesion can be classified as either surgical or non-surgical endodontic therapies [ 71 ]. Since surgical endodontics has its own problems, it is advisable to initially treat periradicular lesions in a conservative manner by a non-surgical endodontic therapy, usually with the use of an antimicrobial intracanal medicament [ 71 72 ].…”

Nonsurgical Clinical Management of Periapical Lesions Using Calcium Hydroxide-Iodoform-Silicon-Oil Paste

“…The healing time in the studied cases was between 40 and 120 days ( Figure 4(a) ). Thereby, the nonsurgical procedure is one-sixth to one-fourth of the time reported for the conventional treatment of 12 months [ 7 , 13 ] and 24 months [ 1 ], respectively.…”

“…Periapical lesion results from serious inflammatory response to microorganisms around the tooth root and the root canal [ 1 ]. Periapical lesions could perforate into the oral cavity affecting hard tissue or maxillary sinus.…”