An Oxymetazoline-based Hemostatic Solution Used with MTA for Pulpal Therapy: A Retrospective Study - Data Sharing Archive

Background/Objectives: Pulpotomies treated with mineral trioxide aggregate (MTA) have higher success rates as those treated with ferric sulfate (FS). The purpose of this study is to assess if the addition of an oxymetazoline (OXY) hemostatic solution, which can be used to manage pulpal bleeding hemostasis, maintains the higher MTA surviv-ability compared to pulpotomies treated with FS. Methods: In this retrospective cross-sectional study, patient data (n=75) was used to assess radiographic and clinical signs and symptoms of pathosis in primary molars receiving a pulpotomy and stain-less-steel crown. Pulpotomies treated with FS (Group 1) were compared to those treated MTA with OXY induced hemostasis (Group 2). Radiographic assessment was per-formed by a blinded reviewer. Cox proportional hazards regression analyzed the effects of patient and practice level covariates on radiographic and clinical pathosis. Restricted mean survival times (RMST) were calculated as the area under Kaplan-Meier survival curves 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 versus Group 1(P=0.02). The 36 month RMST for Group 2 was 30.1 months (95% CI: 26.5-33.7) compared to 24.7months (21.6-27.8) for Group 1 (P=0.025). Conclusions: OXY, can manage pulpal bleeding via temporary vasocon-striction of pulp tissue, and can be used prior to MTA placement. This method leads to higher pulpotomy survival than FS.