Management of Compromised First Permanent Molar with Triple Antibiotic Paste in a 12-year-old Child: A Case Report

Abstract

In teeth with pulpal and periapical infection, various group of microorganisms are present. Inhibition of the growth of these microorganisms and suppression of their antimicrobial activity play a crucial role in the success of the endodontic management. Triple antibiotic paste has been reported to have an excellent antimicrobial efficacy and it can be useful in management of teeth with severe infection. A 12-year-old female child reported with pain and swelling in relation with a lower left first permanent molar. Clinical examination of the tooth revealed deep occlusal caries and dentoalveolar abscess. Radiographically, the carious lesion was seen involving the pulp with periodontal ligament widening and inter-radicular bone loss was observed (endo-perio lesion). Considering the position of the tooth and its strategic importance, a conservative approach to salvage the tooth using Triple Antibiotic Paste (TAP) as a medicament was employed with complete radiographic healing by 12 weeks. Subsequent obturation using lateral condensation with gutta percha followed by composite restoration and preformed stainless steel crown was performed. This case report focuses on the endodontic management of perforated first permanent molar with compromised periodontal support and significant bone loss TAP as medicament and Mineral Trioxide Aggregate (MTA) as perforation repair material. Based on the results it can be concluded that Triple Anitibiotic Paste (TAP) can be effective in the disinfection and sterilization of the root canals and repair of complex lesions.