Intraosseous injection of clindamycin phosphate into the chronic apical lesion of lower molar--a case report.

Periapical disease is the result of bacteria, their product, and the host response to them. Early histological studies of diseased periapical tissue have not been able to demonstrate viable bacteria in the lesions studied. Recent reports indicate that many of periapical lesions are indeed infected before and after endodontic treatment. The validity and applicability of the microbial delivery overcome many disadvantages that we see with systemic drugs. In this case report we presented a novel approach of managing chronic diffuse periapical lesion of lower molar based on specific selection of intracanal medicament in combination with direct periapical injection. We used bacterial culturing and antibiotic sensitivity test to select specific intracanal medicament, in addition we presented an intraosseous injection technique to locally deliver the selected medicament directly into the periapical lesion. Our findings are encouraging and promising. The validity and applicability of the technique needs to be tested in a well controlled clinical trial.