CMC Gel for Lesion Sterilization and Tissue Repair Pulpectomy in Primary Tooth - A Case Series

Dental caries in primary teeth progress rapidly due to thinner enamel and dentin, often resulting in early pulpal and periapical involvement. Premature loss of primary teeth can lead to space loss, altered eruption sequence, and functional disturbances. Conventional pulp therapy in primary teeth is challenging because of complex root canal anatomy, physiological root resorption, and limited child cooperation. Lesion Sterilization and Tissue Repair (LSTR) therapy offers a minimally invasive biological alternative using locally delivered antimicrobial agents. Aim: To assess the clinical effectiveness of Clindamycin gel-based modified triple antibiotic paste (CMC-TAP) as a lesion sterilization and tissue repair technique in pulpally involved primary molars. Methodology: Two pediatric patients aged 5 and 6 years presenting with dentoalveolar abscesses in primary molars were treated using LSTR therapy. Following clinical and radiographic diagnosis, access opening and pulp extirpation were performed. A modified triple antibiotic paste composed of ciprofloxacin and metronidazole powders mixed with Clindamycin gel was placed in the pulp chamber. Coronal sealing was achieved using glass ionomer cement, followed by stainless steel crown placement when indicated. Clinical evaluation was performed at one-month follow-up. Results: Both cases showed complete resolution of pain and swelling with no clinical signs of infection. The treated teeth remained functional and asymptomatic, indicating effective lesion sterilization and tissue repair. Conclusion: Clindamycin gel?based LSTR therapy is a simple, effective, and child-friendly alternative to conventional pulp therapy in primary teeth, providing sustained antimicrobial action, reduced chair time, and preservation of primary teeth as natural space maintainers.