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The infection of the root canal system is polymicrobial in nature, caused by both aerobic and anaerobic bacteria. Because of the persistent and recurrent feature of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin and minocycline) is thus used to eliminate target bacteria, which are the possible sources of root canal infection. Two case reports describe the nonsurgical endodontic treatment of teeth with large periapical lesions. A triple antibiotic paste was used for 3 months. After 3 months, teeth were asymptomatic and were obturated. The follow up radiograph of the two cases showed progressive healing of periapical lesions. The results of these cases show that when most commonly used medicaments fail to eliminate the symptom , a triple antibiotic paste could be used clinically for the treatment of teeth with large periapical lesions.

Non-Surgical Management of Periapical Lesions Using Triple Antibiotic Mixture: Two Case Reports