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

Abstract

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.

Keywords: EDS; SEM; dentin mineral composition; irrigation; smear layer.