Traditionally the treatment for teeth with infected root canals/periradicular tissue was extraction or endodontic pulpectomy therapy. These extractions may lead to undesirable tooth movements of primary and/or permanent teeth including loss of arch length.
Although the success rates of pulpectomies involving primary teeth are good, the technique can be very challenging due to the morphology of the canals. Research has shown that even after thorough mechanical and chemical cleaning of the canals, up to 40% of permanent teeth canals may still exhibit positive bacterial cultures, reducing long-term success rates of pulpectomies.
The first article explaining the use of Metronidazole, Ciprofloxacin and Minocycline was by Hoshino et al (1). Since then many endodontists and dentists have used the mixture with excellent results. The problem with this original mixture is that the antibiotic, Minocycline, causes a discoloration of the tooth and gums. To prevent this problem NuCARA has replaced Minocycline with Clindamycin.