Effect of hemostatic agents on the outcome of pulpotomy in primary and permanent teeth: A systematic review.

Abstract

<h4>Aim</h4>The success of pulpotomy depends significantly on the choice of materials and techniques used, including hemostatic agents. Despite extensive research, there remains a lack of consensus on the most effective hemostatic agent for pulpotomy. This study aimed to systematically review the literature on the efficacy of hemostatic agents on the outcome of pulpotomy.<h4>Methods</h4>A comprehensive literature search was done in the different electronic databases namely PubMed, Scopus, EBSCO host. Supplementary search included grey literature The literature search performed included all the relevant articles published up to 31^st March 2025. The risk of Bias for the <i>in vivo</i> studies was evaluated by JBI critical appraisal tool and New Castle Ottawa scale for cohort study and retrospective studies and qualitative synthesis was evaluated using National Services Scotland guidelines Meta analysis could not be performed because of the heterogeneity of the studies.<h4>Results</h4>A total of eight studies were included in this review. Five studies concluded that sodium hypochlorite was more effective as a hemostatic agent in both primary teeth and permanent teeth. Two studies found potassium titanyl phosphate (KTP) laser treatment produced superior clinical and radiographic outcomes in permanent teeth. Another study showed better results with cryotherapy in the permanent teeth.<h4>Conclusion</h4>Sodium hypochlorite demonstrated superior hemostatic potential in primary teeth, whereas in permanent teeth, potassium titanyl phosphate (KTP) laser and cryotherapy yielded promising results in clinical and radiographic outcomes with no statistically significant results when compared to sodium hypochlorite.