Lezyon Sterilizasyonu ve Doku Onarımı
Özet
Lezyon Sterilizasyonu ve Doku Onarımı (LSDO), polimikrobiyal enfeksiyonlu süt dişlerinin yönetiminde mekanik preparasyonu içermeyen ya da minimal düzeyde sınırlayan, lokal antibiyotik kombinasyonuna dayalı bir tedavi yaklaşımıdır. Yaklaşımın temeli, enfekte kanal sisteminin kemomekanik dezenfeksiyon ile koronal sızdırmazlığın birlikte sağlanması ve böylelikle konak dokuların onarım yanıtının desteklenmesidir. Klinik uygulamada, propilen glikol/makrogol taşıyıcılı üçlü veya modifiye üçlü antibiyotik patı, sodyum hipoklorit ile irrigasyon ve EDTA ile smear tabakasının uzaklaştırılması sonrasında pulpa odasına yerleştirilir; restoratif sızdırmazlıkla tedavi tamamlanır. Kısa dönemde LSDO’nun klinik etkinliği yüksektir ve seçilmiş olgularda pulpektomi ile karşılaştırılabilir sonuçlar bildirilmiştir; ancak radyografik iyileşme protokole ve izlem süresine duyarlı olarak heterojen seyredebilir. Yöntemin başlıca üstünlükleri tek seans olanağı, kısa koltuk süresi ve iyatrojenik riskin görece düşüklüğüdür; sınırlılıkları arasında minosiklin ilişkili renklenme, medikamanın radyolüsent görünümü ve antibiyotik kullanımına yönelik direnç kaygıları yer alır. Sonuç olarak LSDO, çekime konservatif bir alternatif sunmakta; uzun dönem etkinliğin ve endikasyonların netleştirilmesi için metodolojik olarak güçlü, karşılaştırmalı çalışmalara gereksinim sürmektedir.
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