Non-surgical management of a large periapical lesion using triple antibiotic paste: A case report

Authors : Ashok Kumar Mohanty, Dhirendra Kumar

DOI : 10.18231/j.jooo.2022.010

Volume : 8

Issue : 1

Year : 2022

Page No : 49-52

Root canal infection is considered to be a polymicrobial infection, consisting of both aerobic and anaerobic bacteria. Because of the complexity of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline/doxycycline in this case) is used to eliminate bacteria, which are possible sources of endodontic lesions. Case report describes the nonsurgical endodontic treatment of maxillary right central and lateral incisor with large periapical lesion. A triple antibiotic paste was used for 4 months at monthly interval. After 4 months, teeth was asymptomatic and was obturated. 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. The results of the case show that when most commonly used medicaments fail in eliminating the symptoms, then a triple antibiotic paste can be used clinically in the treatment of teeth with large periapical lesion.


Keywords: Nonsurgical root canal treatment, Periapical lesion, Triple antibiotic paste (TAP)


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