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Pulp Therapy

113 - Hemostatic Techniques and Longterm Clinical Outcomes in Primary Tooth Pulpotomies

Friday, May 22, 2026
1:40 PM - 1:55 PM PST
Has Audio

    Presenting Author(s)

  • Calli C. Welker, DDS

    PGY-2 Resident
    Ohio State University, Nationwide Childrens Hospital
    Ohio State University
    Columbus, Ohio, United States

    • Co-Author(s)

  • Paul S. Casamassimo, DDS, MS

    Professor Emeritus
    The Ohio State University/ Nationwide Children's Hospital
    The Ohio State University
    Columbus, Ohio, United States

  • MD

    Melissa Drum, DDS, MS

    Ohio State University

  • Ann L. Griffen, DDS, MS

    Professor
    Ohio State University, Nationwide Children's Hospital
    Columbus, Ohio, United States

  • JP

    Jin R. Peng, MD, MS. PhD

    The Abigail Wexner Research Institute at Nationwide Children’s Hospital

    • Research Mentor(s)

  • AK

    Ashok Kumar, DDS, MS

    Associate Professor
    The Ohio State University, Columbus, OH
    Columbus, Ohio, United States

    • Program Director(s)

  • Kimberly J. Hammersmith, DDS, MPH, MS

    Associate Professor
    The Ohio State University/ Nationwide Children's Hospital
    The Ohio State University and Nationwide Children's Hospital
    Columbus, Ohio, United States

Abstract:


Background:
Pulpotomy is a vital pulp therapy commonly performed in primary teeth to maintain pulp vitality following carious exposure. Ferric sulfate (FS), cotton pellet (CP), and sodium hypochlorite (SH) are all routinely used for hemostasis prior to MTA placement and full coverage restoration. This study compared clinical success and failure rates of 3 hemostatic techniques in primary tooth pulpotomy.



Methods:
A retrospective chart review of 605 primary molars that underwent pulpotomy (FS = 399, CP = 100, SH = 106) used each tooth as the unit of analysis. Failure was defined as extraction of the treated tooth prior to natural exfoliation time. Failure rates at 12, 18, and >24 months post-treatment were compared using χ² or Fisher’s exact tests. A Firth penalized logistic regression model assessed association between technique and failure after adjusting for demographic and clinical covariates. Statistical significance was set at P < .05.



Results:
Overall failure rate was 5% (28/605; 95% CI, 3.1–6.6%). Failure rates were 5% (FS), 7% (CP), and 2% (SH), with no statistically significant differences among groups (P < .05). Multivariate analysis demonstrated no significant association between hemostatic technique and failure. Although follow-up duration varied across groups, no consistent technique-specific failure pattern emerged.



Conclusions:
All 3 hemostatic techniques showed comparable clinical success at 12, 18, and > 24 months. Clinicians can use any of the 3 hemostatic techniques if MTA is placed over radicular pulp followed by full coverage restorations. Future studies should focus on substantiating clinical success with radiographic success.

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