Gültekin Didem Seda, Kont Çobankara Funda
Beyhekim Oral and Dental Health Center, Konya, Türkiye.
Department of Endodontics, Selcuk University, Faculty of Dentistry, Konya, Türkiye.
Eur Endod J. 2025 May;10(3):211-221. doi: 10.14744/eej.2025.27147.
This comprehensive study was aimed to compare the effectiveness of QMix and EDTA, activated by different techniques, in removing apical debris and the smear layer.
The crowns of 180 single-rooted mandibular premolar teeth were removed, and the root canals were shaped up to #X4 using the ProTaper-Next rotary file system. Samples were randomly divided into six main groups according to the activation protocols (n=30). These groups were as follows: Manuel activation with 30G NaviTip needle (MNA), manual dynamic activation with gutta-percha cone (MDA), passive ultrasonic activation (PUA), EndoActivator (EA), XP-Endo Finisher (XP) and Photon Induced Photoacoustic Streaming (PIPS). Each leading group was then divided into three subgroups for the final irrigation solution (distilled water, 17% EDTA and QMix) (n=10). While debris was examined in the randomly selected five roots in each subgroup, the smear layer was examined in the others. A stereomicroscope with x25 magnification was utilised to examine the debris, and the specimens were evaluated using a 4-grade system. To assess the smear layer, scanning electron microscope images were taken at x1000 magnification at the apical third of the root canals and scored using a 5-grade scoring system. The statistical analysis of the data was performed by using the Kruskal-Wallis test (p<0.05).
While XP and PIPS activation techniques were more effective than the other techniques at apical in terms of debris removal when using QMix (p<0.05), there was no statistically significant difference among the activation techniques when utilising EDTA (p>0.05). Regarding the removal of the apical smear layer, EDTA showed similar efficacy with all the tested activation techniques (p>0.05). Additionally, QMix was shown to be more effective when used in combination with MNA and PUA activation methods compared to MDA, EA, XP and PIPS techniques (p<0.05).
EDTA was found to be more effective than QMix in removing apical debris; however, OMix demonstrated its highest effectiveness when utilized with activation systems such as PIPS and XP. In addition, EDTA was found to be more effective than QMix in eliminating the apical smear layer. (EEJ-2024-08-139).
本综合研究旨在比较不同技术激活的QMix和乙二胺四乙酸（EDTA）在去除根尖碎屑和玷污层方面的有效性。
去除180颗单根下颌前磨牙的牙冠，使用ProTaper Next旋转锉系统将根管预备至#X4。根据激活方案将样本随机分为六个主要组（n = 30）。这些组如下：使用30G NaviTip针进行手动激活（MNA）、使用牙胶尖进行手动动态激活（MDA）、被动超声激活（PUA）、EndoActivator（EA）、XP-Endo Finisher（XP）和光子诱导光声流（PIPS）。然后将每个主要组再分为三个亚组，用于最终冲洗液（蒸馏水、17% EDTA和QMix）（n = 10）。在每个亚组中随机选择的五根牙根中检查碎屑，在其他牙根中检查玷污层。使用放大倍数为25倍的体视显微镜检查碎屑，并使用四级系统对标本进行评估。为了评估玷污层，在根管根尖三分之一处拍摄放大倍数为1000倍的扫描电子显微镜图像，并使用五级评分系统进行评分。使用Kruskal-Wallis检验对数据进行统计分析（p<0.05）。
当使用QMix时，XP和PIPS激活技术在根尖处去除碎屑方面比其他技术更有效（p<0.05），而在使用EDTA时，激活技术之间没有统计学上的显著差异（p>0.05）。关于根尖玷污层的去除，EDTA与所有测试的激活技术显示出相似的效果（p>0.05）。此外，与MDA、EA、XP和PIPS技术相比，QMix与MNA和PUA激活方法联合使用时显示出更有效的效果（p<0.05）。
发现EDTA在去除根尖碎屑方面比QMix更有效；然而，QMix在与PIPS和XP等激活系统一起使用时显示出最高的有效性。此外，发现EDTA在消除根尖玷污层方面比QMix更有效。（EEJ - 2024 - 08 - 139）
