An Oxymetazoline-Based Hemostatic Solution Used with MTA for Pulpal Therapy: A Retrospective Study

Area of Science:

• Pediatric Dentistry
• Dental Materials Science
• Endodontics

Background:

• Pulpotomy is a common dental procedure for primary molars.
• Managing pulpal bleeding is crucial for successful treatment outcomes.
• Traditional hemostatic agents like Formocresol (FS) have potential toxicity concerns.

Purpose of the Study:

• To compare the efficacy of oxymetazoline (OXY) as a hemostatic agent versus FS in maintaining MTA (Mineral Trioxide Aggregate) survivability.
• To evaluate the long-term radiographic and clinical success rates of pulpotomies using OXY-induced hemostasis with MTA.

Main Methods:

• Retrospective cross-sectional study of 75 primary molars treated with pulpotomy and stainless-steel crowns.
• Comparison of pulpotomies treated with FS (Group 1) versus MTA with OXY hemostasis (Group 2).
• Analysis using Restricted Mean Survival Times (RMST) and Cox proportional hazards regression.

Main Results:

• Oxymetazoline (OXY) group showed significantly improved radiographic outcomes (adjusted hazard ratio 0.30, p=0.02).
• The 36-month RMST was higher for the OXY group (30.1 months) compared to the FS group (24.7 months, p=0.025).
• Cox regression identified age, pulpotomy group, and procedure location as predictors of radiographic pathosis.

Conclusions:

• Pulpotomy utilizing OXY hemostasis prior to MTA placement significantly enhances pulpotomy survival.
• OXY offers a safer and more effective alternative to FS for managing pulpal bleeding in MTA pulpotomies.
• This approach leads to better long-term radiographic success in primary molar pulpotomies.