Which agent is used to achieve hemostasis of the pulp stump during vital pulp therapy?

Correct answer: D. Sodium hypochlorite

• A. ❌ Formocresol is a devitalizing/fixative agent historically used in primary tooth pulpotomy — it is not a hemostatic agent and its use has declined over carcinogenicity concerns.
• B. ❌ Calcium hydroxide is the capping material placed AFTER hemostasis (though MTA and bioceramics now outperform it).
• C. ❌ Epinephrine achieves hemostasis by vasoconstriction but does not disinfect, and it can mask an irreversibly inflamed pulp that would otherwise reveal itself by continued bleeding.
• D. ✅ CORRECT — A cotton pellet moistened with SODIUM HYPOCHLORITE (typically 1.5–6%) applied with light pressure for several minutes is the contemporary standard. It arrests bleeding, disinfects the exposure, and removes the fibrin clot and biofilm that would otherwise interfere with the seal. If bleeding will not stop within about 5 minutes, the remaining pulp is irreversibly inflamed and the treatment plan should change.

Note: The bleeding time is diagnostic: hemostasis within 5 minutes suggests a pulp healthy enough to cap. Persistent bleeding indicates irreversible pulpitis.