Scanning electron microscopic evaluation of smear layer removal ability of novel irrigant qmix compared with others at apical third of the root

Abstract

Aim: The success of an endodontic treatment depends on the complete elimination of the microorganisms from the root canal system for which effective eradication of smear layer is crucial. Hence, various final irrigating solutions were introduced in endodontics. The aim of this in vitro study is to compare the smear layer removal efficacy of different final irrigating solutions at the apical third of the root canal through scanning electron microscopic (SEM) image analysis. Materials and methods: Forty human single-rooted mandibular premolar teeth were taken and decoronated to standardize the canal length. Each tooth was prepared endodontically with same chemomechanical technique and the teeth were randomly divided into four groups based on the final irrigation regimen. Group I: saline, group II: Tubulicid Plus, group III: BioPure MTAD, and group IV: QMix. After final irrigation, SEM evaluation was done for the assessment of removal of the smear layer at apical third, and data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test. Results: Intergroup comparison of the groups showed statistically significant differences in the smear layer removal efficacy of irrigating solutions tested. QMix is most effective in the removal of smear layer when compared with other tested irrigating solutions. Conclusion: QMix is the most effective final irrigating solution for smear layer removal followed by MTAD and Tubulicid Plus. Clinical significance: Final irrigating solution plays a major role in the elimination of smear layer, thereby enhancing the hermetic seal of obturating materials, resulting in greater success rate of root canal treatment. Further research is required regarding the use of QMix on smear layer removal and also its effect on ultrastructural changes in dentin.