Use of triple antibiotic paste in the treatment of large periradicular lesions

Microorganisms are the possible source of endodontic lesions. The polymicrobial infection makes the sterilization of the root canal difficult. The following case report describes the non-surgical endodontic treatment of teeth with a large periradicular lesion. First, an intracanal dressing of calcium hydroxide was given. Since the symptoms did not subside, the treatment protocol was changed. A triple antibiotic paste was used instead for 3 months. On follow up, teeth were clinically asymptomatic and radiographically showed healing of the periradicular lesion. The result of the case show that when most commonly-used medicaments fail in eliminating the symptoms, then a triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) can be used clinically in the treatment of teeth with large periradicular lesions.