Comparison of Smear Layer Removal Ability of QMix with Different Activation Techniques.
BACKGROUND
To evaluate the effectiveness of QMix solution (Dentsply Tulsa Dental Specialties, Tulsa, OK) on the smear layer using the following irrigation activation techniques: the EndoActivator (EA) system (Dentsply Tulsa Dental Specialties), photon-initiated photoacoustic streaming (PIPS), and an Er:YAG laser with an endodontic fiber tip.


METHODS
Sixty-four extracted single-rooted human teeth were decoronated and the canals instrumented with ProTaper (Denstply Maillefer, Ballagues, Switzerland) up to size F4. The canals were irrigated with 5.25% sodium hypochlorite and a saline solution for 1 minute each. The specimens were then divided randomly into 4 experimental and 4 control groups (n = 8) according to the final irrigation activation technique. These groups included group 1, 2.5 mL QMix; group 2, QMix + EA; group 3, QMix + PIPS; and group 4: QMix + Er:YAG. Laser activated distilled water was used as control groups 5, 6, 7, and 8. Teeth were split longitudinally, and specimens were observed under a scanning electron microscope. Images were taken at the coronal, middle, and apical thirds of the teeth at a magnification of 1000× and were scored in the presence of the smear layer. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests.


RESULTS
The highest scores were found in the apical third of all groups (P < .05). The QMix + Er:YAG group removed the smear layer more effectively than the nonactivated QMix group in the apical third (P < .05). The QMix + EA group removed the smear layer significantly in all thirds of the teeth when compared with the nonactivated QMix group (P < .05). The QMix + PIPS group showed a significantly better effect than the QMix group in the coronal third (P < .05).


CONCLUSIONS
The EA and Er:YAG laser enhanced the smear layer removal ability of QMix in the apical thirds of the canals. QMix removed more smear layer in the coronal thirds when activated with the PIPS technique.
Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey. Electronic address: dilaraendo@hotmail.com.
Dilara
D
Arslan
Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
Mehmet Burak
MB
Guneser
Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
Asiye Nur
AN
Dincer
Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
Alper
A
Kustarci
Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
Kursat
K
Er
Department of Restorative Dentistry, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
Seyda Herguner
SH
Siso
D001641:Bicuspid; D001645:Biguanides / Q000494:pharmacology*; D003786:Dental Pulp Cavity / Q000648:ultrastructure; D006801:Humans; D066298:In Vitro Techniques; D053844:Lasers, Solid-State; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D061088:Photoacoustic Techniques; D011108:Polymers / Q000494:pharmacology*; D012388:Root Canal Irrigants / Q000494:pharmacology*; D018915:Root Canal Preparation / Q000379:methods*; D016369:Smear Layer / Q000517:prevention & control*
D001645:Biguanides; D011108:Polymers; C557698:QMix root canal irrigant; D012388:Root Canal Irrigants
EndoActivator; Er:YAG laser; QMix; photon-initiated photoacoustic streaming; smear layer