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

## TL;DR

Using oxymetazoline to control bleeding before MTA placement in children's teeth led to better long-term outcomes than using ferric sulfate.

## Contribution

The study shows oxymetazoline improves MTA pulpotomy success by controlling bleeding better than ferric sulfate.

## Key findings

- Oxymetazoline-based MTA pulpotomies had a 30.1-month survival time compared to 24.7 months for ferric sulfate.
- Younger children had lower chances of developing radiographic and clinical signs of pathosis.
- Age and treatment material significantly influenced pulpotomy success.

## Abstract

What are the main findings?
MTA-based pulpotomies pretreated with a hemostatic solution of 0.05% oxymetazoline were found to be more successful in preventing radiographic pathosis compared to 20% ferric sulfate (FS)-based pulpotomies.Younger children had lower chances of developing radiographic and clinical signs of pathosis compared to older children.

MTA-based pulpotomies pretreated with a hemostatic solution of 0.05% oxymetazoline were found to be more successful in preventing radiographic pathosis compared to 20% ferric sulfate (FS)-based pulpotomies.

Younger children had lower chances of developing radiographic and clinical signs of pathosis compared to older children.

What is the implication of the main finding?
Oxymetazoline controls pulpal bleeding prior to MTA placement in a primary tooth pulpotomy, resulting in a relatively high chance of survival compared to FS after 36 months.Pulpotomy success depends on both age and the materials used.

Oxymetazoline controls pulpal bleeding prior to MTA placement in a primary tooth pulpotomy, resulting in a relatively high chance of survival compared to FS after 36 months.

Pulpotomy success depends on both age and the materials used.

Background/Objectives: The purpose of this study is to assess whether the addition of an oxymetazoline (OXY) hemostatic solution, which can be used to manage pulpal bleeding, maintains higher MTA survivability than pulpotomies treated with FS. Methods: In this retrospective cross-sectional study, patient data (n = 75) were used to assess radiographic and clinical signs and symptoms of pathosis in primary molars treated with a pulpotomy and a stainless-steel crown. Pulpotomies treated with FS (Group 1) were compared to those treated with MTA with OXY-induced hemostasis (Group 2). Restricted mean survival times (RMSTs) were calculated for the two groups, and Cox proportional hazards regression was used to analyze the effects of patient and practice level covariates on radiographic and clinical pathosis. Results: Cox proportional-hazard regression identified three potential covariates (age, pulpotomy groups, and procedure location) that predicted radiographic pathosis. The adjusted hazard ratio for Group 2 was 0.30 (95% CI: 0.11–0.82), indicating improved radiographic outcomes compared with Group 1 (p = 0.02). The 36-month RMST for Group 2 was 30.1 months (95% CI: 26.5–33.7) compared to 24.7 months (21.6–27.8) for Group 1 (p = 0.025). Conclusions: A pulpotomy utilizing OXY hemostasis prior to MTA placement led to a higher chance of pulpotomy survival than FS.