Optimizing Minimally Invasive Pediatric Endodontics: Evaluating a Time-Efficient LSTR Approach Utilizing a Modified Dual-Antibiotic-ZOE Complex vs Conventional ZOE

Abstract

Objectives: This clinical study aimed to evaluate the 12-month clinical and radiographic outcomes of lesion sterilisation and tissue repair (LSTR) using a novel modified two-drug combination with a zinc oxide-eugenol (ZOE) matrix (ZCM/MCZ paste), compared with conventional ZOE pulpectomy, in necrotic primary molars. Methods: A sample of 200 non-vital, multi-rooted primary teeth from paediatric patients aged 4-8 years was randomly allocated to two equal groups ( each). Group A received LSTR using ZCM/MCZ paste, whereas Group B received ZOE pulpectomy. Outcomes were assessed at 12 months using James’ criteria. Intergroup differences were analysed using the chi-squared test, with statistical significance set at . Results: At 12 months, the clinical success rates were 96% for ZOE pulpectomy and 93% for LSTR with ZCM/MCZ paste. Both groups demonstrated progressive or sustained radiographic improvement over time. The overall success rates were 84.3% for ZOE pulpectomy and 82.0% for MCZ/ZCM paste LSTR. Chi-squared analysis showed no statistically significant difference between the two groups. Conclusion: The minimally invasive approach achieved clinical and radiographic outcomes comparable to those of conventional ZOE pulpectomy while simplifying the clinical workflow. The novel ZCM/MCZ drug combination with a ZOE matrix may therefore represent a child-friendly alternative to traditional endodontic therapy. By avoiding complex root canal instrumentation, the approach may reduce chairside demands and the risk of mechanical procedural complications.