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

Jagzap, Janhavi Balasaheb; Patil, S. A.; Gade, Vandana; Chandhok, Deepika J; Upagade, Madhura A; Thakur, Deepa

doi:10.4103/ccd.ccd_524_17

Cited by 15 publications

(30 citation statements)

References 16 publications

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“…There was incomplete smear layer removal at the apical portion in group 2 and 3 which is in accordance with two studies which found that both 17% EDTA and 1% IP6 were unable to completely clean the apical portion of the root (11,26). A possible explanation for this could be a decrease in dentinal tubular density from coronal to apical direction and presence of more sclerosed dentinal tubules.…”

Section: Discussionsupporting

confidence: 89%

“…Results of this study demonstrated that 1% IP6 was moderately effective in removing smear layer and was less erosive than 17% EDTA. The results differ from the findings of Nassar et al (11) but are in accordance with Jagzap et al (26) in terms of smear layer removal. In addition, when erosion was evaluated, we found conflicting results with the findings of Kalcay and Tinaz (25).…”

Section: Discussionsupporting

confidence: 65%

“…Nassar et al reported equal or better smear removal of IP6 as compared to 17% EDTA (11). In contrast, Jagzap et al reported less effective smear removal by IP6 (26). This contrary evidence warrants a study on IP6 with known pH.…”

Section: Preparation Of 1% Ip6mentioning

confidence: 95%

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Erosive potential of 1% Phytic Acid on radicular dentine at different time intervals

et al. 2019

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The objective of this in-vitro study was to compare the erosive potential and smear layer removal ability of 1% Phytic acid (IP6) and 17% Ethylenediaminetetaacetic acid (EDTA). Methods: Canal preparation of 225 single rooted extracted human teeth was performed with Protaper NiTi rotary instruments. Teeth were divided into three groups according to the final irrigation protocol. Group 1: Saline irrigation (n=75), Group 2: 17% EDTA (n=75), Group 3: 1% Phytic Acid (n=75). Roots were splitted and observed under Scanning Electron Microscope (SEM) for erosion and smear layer removal. Mean differences between the groups for smear layer removal and erosion were assessed using the Kruskal Wallis and Mann Whitney U test. (P≤0.05) Friedman and Willcoxon Signed Rank tests were used to make comparisons within the groups. Results: Group 3 was significantly less erosive than Group 2 at all root portions (P<0.001). With regards to smear layer removal, group 2 (EDTA) removed more smear layer compared to group 3 (Phytic acid) at all root portions (P<0.001). Both 17% EDTA and 1% IP6 removed significantly less smear layer in the apical root portion. Intra group comparisons revealed no significant differences at any root level. There was a time dependent increase in erosion and smear layer removal in Group 2, with severe erosion at 5 minutes time interval. In Group 3, however, there was moderate erosion and smear removal at 3 and 5 minutes interval. Conclusion: IP6 at the concentration of 1% and pH 3 was less erosive than 17% EDTA. It exhibited moderate smear layer removal ability.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 65%

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Erosive potential of 1% Phytic Acid on radicular dentine at different time intervals

et al. 2019

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“…It is important to point out that, despite the statistically significant difference between groups with and without EDTA, it may lack clinical relevance, since its use as a final rinse at completion of root canal preparation has been proven indispensable. It allows smear layer removal, favoring the root canal cleaning, enhancing intracanal medicament diffusion through dentine, and also promoting better root canal sealing after filling (Violich & Chandler, ; Jagzap et al, ).…”

Section: Discussionmentioning

confidence: 99%

Effect of EDTA, sodium, and calcium hypochlorite on the inorganic component of root canal dentin: A SEM analysis

Cardoso

Baldasso

Delai

et al. 2018

Microscopy Res & Technique

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This study evaluated the influence of canal irrigation protocols with 5.25% calcium hypochlorite [Ca(OCl) 2 ], 5.25% sodium hypochlorite (NaOCl) and 17% EDTA solution on the inorganic component of root canal dentin. Sixty roots were randomly divided into six groups (n = 10): Saline solution (SS) (control); Saline solution (SSE) +17% EDTA; CH − 5.25% Ca(OCl) 2 ; CHE − 5.25% Ca(OCl) 2 + 17% EDTA; SH − 5.25% NaOCl; SHE − 5.25% NaOCl +17% EDTA. After canal irrigation, the specimens were longitudinally split and analyzed by scanning electron microscopy (SEM). Dentinal tubules were observed in transverse (middle and apical thirds) direction. The images were classified in scores, according to smear layer removal and peritubular dentin alteration, and data were analyzed by Kruskal-Wallis's test, followed by Dunn's test (α = 0.05). In the middle third, all groups with EDTA presented better removal of the smear layer with higher peritubular dentin alteration (p < .05). In the apical third, this happened only in SHE (p < .05).Ca(OCl) 2 and NaOCl exhibit similar performance to remove smear layer and alteration of the inorganic component in the middle third. In the apical third, NaOCl associated with EDTA showed better performance in smear layer removal.

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

Cited by 15 publications

References 16 publications

Erosive potential of 1% Phytic Acid on radicular dentine at different time intervals

Erosive potential of 1% Phytic Acid on radicular dentine at different time intervals

Effect of EDTA, sodium, and calcium hypochlorite on the inorganic component of root canal dentin: A SEM analysis

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

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