Effect of QMix as final irrigation protocol on periapical healing after single-visit root canal treatment: A randomised controlled clinical trial
Cemre Sapmaz Ucan DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorCorresponding Author
Aysin Dumani DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Correspondence
Aysin Dumani, Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey.
Email: [email protected]
Search for more papers by this authorIlker Unal DDS, PhD
Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
Search for more papers by this authorSehnaz Yilmaz DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorOguz Yoldas DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorCemre Sapmaz Ucan DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorCorresponding Author
Aysin Dumani DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Correspondence
Aysin Dumani, Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey.
Email: [email protected]
Search for more papers by this authorIlker Unal DDS, PhD
Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
Search for more papers by this authorSehnaz Yilmaz DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorOguz Yoldas DDS, PhD
Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Search for more papers by this authorAbstract
The aim of this study was to evaluate radiographic periapical repair after endodontic treatment using QMix or NaOCl irrigation in single-rooted teeth with apical periodontitis. In this randomised clinical trial, 60 patients were selected and randomised into two groups (n = 30). After instrumentation of root canals, QMix or NaOCl was used as a final irrigation and the canals obturated with gutta-percha and AH Plus sealer. All the participants were recalled after 12 months and 15 patients were lost to the study so 45 patients were evaluated radiographically according to periapical index (PAI) scores. A significant decrease was seen in PAI scores after 1 year in all patients (p < 0.001). In the QMix and NaOCl group, absence or reduction of radiolucency was observed in 23 of 25 teeth (92%) and 20 of 20 teeth (100%), respectively. There was no significant difference between two groups according to the decrease in PAI score (p = 0.508). Root canal treatments with or without QMix irrigation contributed equally to periapical healing.
CONFLICT OF INTEREST
The authors deny any conflict of interest related to this study.
REFERENCES
- 1Plotino G, Cortese T, Grande NM, Leonardi DP, di Giorgio G, Testarelli L, et al. New technologies to improve root canal disinfection. Braz Dent J. 2016; 27(1): 3–8.
- 2Pérez AR, Ricucci D, Vieira GCS, Provenzano JC, Alves FRF, Marceliano-Alves MF, et al. Cleaning, shaping, and disinfecting abilities of 2 instrument systems as evaluated by a correlative micro-computed tomographic and Histobacteriologic approach. J Endod. 2020; 46(6): 846–57.
- 3Nair P. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol. 2004; 15(6): 348–81.
- 4Gawdat SI, Bedier MM. Influence of dual rinse irrigation on dentinal penetration of a bioceramic root canal sealer: a Conofocal microscopic analysis. Aust Endod J. 2021. https://doi.org/10.1111/aej.12599
- 5Siqueira JF, Paiva SS, Rocas IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod. 2007; 33: 541–7.
- 6Rahmati A, Karkehabadi H, Rostami G, Karami M, Najafi R, Rezaei-Soufi L. Comparative effects of Er:YAG laser, and EDTA, MTAD, and QMix irrigants on adhesion of stem cells from the apical papilla to dentin: a scanning electron microscopic study. J Clin Exp Dent. 2022; 14(4): e310–5.
- 7Chandrasekhar V, Amulya V, Rani VS, Prakash TJ, Ranjani AS, Gayathri C. Evaluation of biocompatibility of a new root canal irrigant Q mix™ 2 in 1- an in vivo study. J Conserv Dent. 2013; 16(1): 36–40.
- 8Rodríguez-Benítez S, StambolskyGuelfand C, Martín-Jiménez M, Segura-Egea JJ. Root canal disinfection of immature dog teeth with apical periodontitis: comparison of three different protocols. J Clin Exp Dent. 2014; 6(4): 357–63.
10.4317/jced.51475 Google Scholar
- 9Chia MSY, Parolia A, Lim BSH, Jayaraman J, Porto ICCM. Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies. Restor Dent Endod. 2020; 45(3):e28.
- 10Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant. QMiX Int Endod J. 2012; 45(4): 363–71.
- 11Matos FS, Khoury RD, Carvalho CAT, Martinho FC, Bresciani E, Valera MC. Effect of EDTA and QMix ultrasonic activation on the reduction of microorganisms and endotoxins in ex vivo human root canals. Braz Dent J. 2019; 30: 220–6.
- 12Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A. Effect of different apical preparation sizes on outcome of primary endodontic treatment: a randomized controlled trial. J Endod. 2012; 38: 1309–15.
- 13Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986; 2(1): 20–34.
- 14Peters LB, Lindeboom JA, Elst ME, Wesselink PR. Prevalence of apical periodontitis relative to endodontic treatment in an adult Dutch population: a repeated cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111(4): 523–8.
- 15Jiménez-Pinzón A, Segura-Egea JJ, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV. Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population. Int Endod J. 2004; 37: 167–73.
- 16Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of our common root canal irrigants and two new irrigants containing antibiotic. J Endod. 2006; 32: 1091–3.
- 17Goldsmith M, Gulabivala K, Knowles JC. The effect of sodium hypochlorite irrigant concentration on tooth surface strain. J Endod. 2002; 28: 575–9.
- 18Trepagnier CM, Madden RM, Lazzari EP. Quantitative study of sodium hypochlorite as an in vitro endodontic irrigant. J Endod. 1977; 3: 194–6.
- 19Ballal NV, Tweeny A, Khechen K, Prabhu KN, Satyanarayan TFR. Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions. J Dent. 2013; 41: 556–60.
- 20Arslan D, Guneser MB, Kustarci A, Er K, Siso SH. Pulp tissue dissolution capacity of QMix 2 in1 irrigation solution. Europe J of Dent. 2015; 9(3): 423–7.
- 21Aksel H, Serper A. Concentration and time-dependent effect of initial sodium hypochlorite on the ability of QMix and ethylenediaminetetraacetic acid to remove smear layer. J Conserv Dent. 2017; 20(3): 185–9.
- 22Aksel H, Serper A, Kalayci S, Somer G, Erisken C. Effects of QMix and ethylenediaminetetraacetic acid on decalcification and erosion of root canal dentin. Microsc Res Tech. 2016; 79(11): 1056–61.
- 23Elnaghy A. Effect of QMix irrigant on bond strength of glass fibre posts to root dentine. Int Endod J. 2014; 47: 280–9.
- 24Nogo-Živanović D, Kanjevac T, Bjelović L, Ristić V, Tanasković I. The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin. Microsc Res Tech. 2019; 82(6): 923–30.
- 25Küçük M, Kermeoğlu F. Efficacy of different irrigation methods on dentinal tubule penetration of chlorhexidine, QMix and Irritrol: a confocal laser scanning microscopy study. Aust Endod J. 2019; 45(2): 202–8.
- 26Paredes-Vieyra J, Enriquez FJ. Success rate of single-versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial. J Endod. 2012; 38: 1164–9.
- 27Boubaris M, Chan KL, Zhao W, Cameron A, Sun J, Love R, et al. A volume-based novel cone-beam computed tomographic periapical index. J Endod. 2021; 47(8): 1308–13.
- 28Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008; 34(11): 1325–31.
- 29Forsberg J. A comparison of the paralleling and bisecting-angle radiographic techniques in endodontics. Int Endod J. 1987; 20: 177–82.
- 30Strindberg LZ. The dependence of the results of pulp therapy on certain factors-an analytical study based on radiographic and clinical follow-up examination. Acta Odontol Scand. 1956; 14: 1–175.
- 31Friedman S, Mor C. The success of endodontic therapy–healing and functionality. CDA J. 2004; 32: 493–503.
- 32Holland R, Filho GJE, Cintra LTA, Queiroz ÍOA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci. 2017; 25(5): 465–76.
Citing Literature
