Effect of different final irrigating solutions on smear layer removal in apical third of root canal: A scanning electron microscope study

Vemuri, Sayesh; Kolanu, Sreeha Kaluva; Sujana, Varri; Pabbati, Ravi Kumar; Penumaka, Ramesh; Bolla, Nagesh

doi:10.4103/0972-0707.173207

Cited by 21 publications

(17 citation statements)

References 17 publications

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“…In the apical third, QMix more effectively removes smear layer than 17% EDTA and similar to MTAD. These results are in accordance with recent studies of Ballal et al (2016) and Vemuri et al (2016) showing superior effect of QMix in removing the smear layer in the apical third than that of EDTA. Lower smear layer capability of 17% EDTA in the apical root third has been shown in previous studies (Ballal, Kandian, Mala, Bhat, & Acharya, 2009;Mancini, Armellin, Casaglia, Cerroni, & Cianconi, 2009;Torabinejad et al, 2003 NOGO-ŽIVANOVI C ET AL.…”

Section: Discussionsupporting

confidence: 93%

“…The difference in the efficiency of the removal of the smear layer between MTAD, QMix, and 17% EDTA was examined in several previous studies. However, obtained results have not yet reached a unified conclusion on which irrigant solution was the most efficient (Ali Mozayeni, Hossein Javaheri, Poorroosta, Asna Ashari, & Hossein Javaheri, 2009;Dai et al, 2011;Eliot et al, 2014;Jardine et al, 2016;Stojicic, Shen, Qian, Johnson, & Haapasalo, 2012;Ulusoy & Görgül, 2013;Vemuri et al, 2016).…”

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confidence: 95%

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The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin

Nogo-Živanović

Kanjevac

Bjelović

et al. 2019

Microscopy Res & Technique

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To compare the smear layer removal ability and mineral content of root canal dentine after initial irrigation with NaOCl and final irrigation with MTAD, QMix, and 17% EDTA. Forty extracted human maxillary incisors before root canal preparation and irrigation with NaOCl were randomly divided into four groups (n = 10) according to the type of final irrigants used: MTAD, QMix, 17% EDTA, and control (sterile distilled water). Scanning electron microscopy (SEM) was used to assess the presence of smear layer. SEM energy‐dispersive X‐ray spectroscopy was used to quantify dentin mineral composition in MTAD, QMix, 17% EDTA group, and in no‐treatment samples (no‐treatment group; n = 10). Among the various chelating agents, there were no significant differences in the smear layer removal in the middle and coronal thirds (p > .05). In the apical third, QMix removed significantly more smear layer than 17% EDTA (p < .05), but similarly to MTAD (p > .05). Final irrigation with MTAD resulted in a significant increase in the carbon (C) value compared to EDTA (p < .001). There was no significant difference in the mineral composition between the MTAD and the QMix group, although the values of the mineral elements were significantly altered in the MTAD group. QMix had smear layer removal capability similar to MTAD but better than EDTA in the apical third. MTAD yielded the most pronounced effect on mineral component of root dentin; however, differences were significant only for C level compared to 17% EDTA.

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Section: Discussionsupporting

confidence: 93%

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confidence: 95%

The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin

Nogo-Živanović

Kanjevac

Bjelović

et al. 2019

Microscopy Res & Technique

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“…[ 1 ] McComb and Smith were the first researchers to describe smear layer on the surface of instrumented root canal walls. [ 3 ] Smear layer from the dentinal tubules has the ability to protect the bacteria from irrigation or intracanal medicament thus avoiding complete disinfection of the infected canals and thorough sealing of the entire root canal system. [ 4 ] Thus, removal of smear layer from the root canal walls is highly necessary for long-standing endodontic success.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of three different irrigants - 17% ethylenediaminetetraacetic acid, Q-MIX, and phytic acid in smear layer removal: A comparative scanning electron microscope study

Jagzap¹,

Patil²,

Gade³

et al. 2017

Contemp Clin Dent

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Background:Removal of smear layer from the root canal walls is important for long-standing endodontic success.Aim:The aim of this study is to evaluate and compare smear layer removing ability among 17% ethylenediaminetetraacetic acid (EDTA), Q-MIX, and phytic acid by scanning electron microscopy (SEM).Materials and Methods:This in-vitro experimental study assessed smear layer removal using three different irrigants. Thirty single-rooted freshly extracted human permanent premolars were collected, disinfected, and decoronated to a standardized root length of 13 mm. Root canals were cleaned and shaped till F2 universal rotary protaper at working length 1 mm short of the apex. They were randomly divided into three groups, and final irrigation was done accordingly. Group 1 (n = 10): with 1 ml of 17% EDTA, Group 2 (n = 10): with 1 ml of Q-MIX, Group 3 (n = 10): with 1 ml of phytic acid. Samples were then longitudinally sectioned and evaluated under SEM at coronal, middle, and apical levels.Statistical Analysis:Two-way analysis of variance and Tukey's post hoc test were performed. The level of significance was set at 0.05.Results:Smear layer removing ability among irrigants and sections in descending order: 17 EDTA > Q-MIX > phytic acid; coronal > middle > apical.Conclusion:17% EDTA showed better and promising results followed by Q-MIX and then phytic acid.

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“…Eleven studies compared QMix to various irrigants like EDTA [ 23 24 25 26 27 28 29 30 31 33 35 ], 4 studies on MTAD [ 23 31 34 35 ], 5 studies on NaOCl [ 23 27 28 29 33 ], 2 studies on 7% EDTA (SmearClear) [ 30 32 ], 10% citric acid [ 29 33 ], one study on chitosan [ 32 ], glyde [ 32 ], 1% peracetic acid [ 33 ], Tubulicid Plus [ 34 ] and 7% maleic acid [ 28 ]. The effectiveness of smear layer removal was measured by different scoring systems.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies have shown that QMix removes smear layer more effectively than other irrigants whereas some results were contradictory. Thirteen studies have claimed that higher effectiveness was affected by the duration of QMix irrigation [ 23 24 25 26 27 28 29 30 31 32 33 34 35 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies

et al. 2020

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Objectives: To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. Materials and Methods: The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. Results: Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. Conclusions: QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.

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Effect of different final irrigating solutions on smear layer removal in apical third of root canal: A scanning electron microscope study

Cited by 21 publications

References 17 publications

The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin

The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin

Effectiveness of three different irrigants - 17% ethylenediaminetetraacetic acid, Q-MIX, and phytic acid in smear layer removal: A comparative scanning electron microscope study

Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies

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