The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 23 , ISSUE 3 ( March, 2022 ) > List of Articles


Comparative Assessment of Qmix as Endodontic Irrigant on Reversal of Bond Strength in Teeth Subjected to Irradiation: An Scanning Electron Microscope Study

Bharath Naga Reddy, Sabari Murugesan, Savadamoorthi Kamatchi Subramani, Ohm Nijandhan Kumar, Sujith Raj Mohan, Parthiban Saket

Keywords : Adhesive failure, Bond strength, Chitosan, Cohesive failure, Qmix, Radiation

Citation Information : Reddy BN, Murugesan S, Subramani SK, Kumar ON, Mohan SR, Saket P. Comparative Assessment of Qmix as Endodontic Irrigant on Reversal of Bond Strength in Teeth Subjected to Irradiation: An Scanning Electron Microscope Study. J Contemp Dent Pract 2022; 23 (3):331-336.

DOI: 10.5005/jp-journals-10024-3283

License: CC BY-NC 4.0

Published Online: 24-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: The aim of this current study was to compare and evaluate the reversal efficacy of Qmix and chitosan-based irrigation materials quantitatively through the assessment of the push-out bond strength of bioceramic sealer employing universal testing machine and to qualitatively analyze the sealer/dentin interface by scanning electron microscope (SEM) in the teeth subjected to fractioned radiation. Materials and methods: Ninety single-rooted straight human maxillary central incisors were randomly divided into six groups (n = 15) where in three groups comprise Chitosan, Qmix, and EDTA/sodium hypochlorite which were not exposed to irradiation while other three groups were challenged with irradiation protocols. Root canals were prepared with ProTaper universal system and all the samples were irrigated according to the final irrigation protocols and obturated with bioceramic sealers. Dentin slices were prepared with 1 mm thickness from each root third for the estimation of bond strength of sealers to dentin. Qualitative assessment of the sealer–dentin interface was done by scanning electron microscopy. Bond strength data were scrutinized by independent t-test and failure modes using the Chi-square test. Results: Significantly lower bond strength (p <0.05) was recorded after irradiation compared with nonirradiated group. To quantify the results irrigation protocols, Qmix had highest bond strength followed by chitosan and EDTA/sodium hypochlorite group irrespective of irradiation status. Bond strength values reduced after irradiation in all root thirds irrespective of the irrigation materials. Scanning electron microscope images revealed traces of repair process for Qmix-based irrigation materials than the chitosan-based materials for both irradiated and nonirradiated specimens. Conclusion: All the irrigation materials employed in this study had good bond strength. The specimen irrigated with Qmix had comparatively higher bond strength than the chitosan-based materials. The teeth subjected to irradiation challenge were associated with a decrease in the push-out bond strength of sealers to intraradicular dentin with formation of more gaps and fewer tags at the sealer/dentin interface. Clinical significance: Selection of ideal irrigation protocols still remains a challenge for the clinical practitioners, and this study explored the utilization of novel materials used for irrigation, especially in the teeth subjected to radiation.

PDF Share
  1. Rao SV, Mejia G, Roberts-Thomson K, et al. Epidemiology of oral cancer in Asia in the past decade-an update (2000-2012). Asian Pac J Cancer Prev 2013;14(10):5567–5577. DOI: 10.7314/apjcp.2013.14.10.5567.
  2. Falk AT, Hébert C, Tran A, et al. Radiotherapy for elderly patients and cetuximab, a monocentric study. Eur Arch Oto-Rhino-Laryngol 2017;274(2):1061–1065. DOI: 10.1007/s00405-016-4336-3.
  3. Ferguson HW, Stevens MR. Advances in head and neck radiotherapy to the mandible. Oral Maxillofac Surg Clin North Am 2007;19(4): 553–563. DOI: 10.1016/j.coms.2007.07.005.
  4. Neelakantan P, Varughese AA, Sharma S, et al. Continuous chelation irrigation improves the adhesion of epoxy resin-based root canal sealer to root dentine. Int Endod J 2012;45(12):1097–1102. DOI: 10.1111/j.1365-2591.2012.02073.x.
  5. Dobroś K, Hajto-Bryk J, Wróblewska M, et al. Radiation-induced caries as the late effect of radiation therapy in the head and neck region. Contemp Oncol 2016;20(4):287. DOI: 10.5114/wo.2015.54081.
  6. Gonçalves LM, Palma-Dibb RG, Paula-Silva FW, et al. Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teeth. J Dent 2014;42(8):986–992. DOI: 10.1016/j.jdent.2014.05.011.
  7. Costa JA, Rached-Júnior FA, Souza-Gabriel AE, et al. Push-out strength of methacrylate resin-based sealers to root canal walls. Int Endod J 2010;43(8):698–706. DOI: 10.1111/j.1365-2591.2010.01766.x.
  8. Fisher MA, Berzins DW, Bahcall JK. An in vitro comparison of bond strength of various obturation materials to root canal dentin using a push-out test design. J Endod 2007;33(7):856–858. DOI: 10.1016/j.joen.2007.02.011.
  9. Lieshout HF, Bots CP. The effect of radiotherapy on dental hard tissue—a systematic review. Clin Oral Investig 2014;18(1):17–24. DOI: 10.1007/s00784-013-1034-z.
  10. Arslan D, Guneser MB, Dincer AN, et al. Comparison of smear layer removal ability of QMix with different activation techniques. J Endod 2016;42(8):1279–1285. DOI: 10.1016/j.joen.2016.04.022.
  11. Springer IN, Niehoff P, Warnke PH, et al. Radiation caries—radiogenic destruction of dental collagen. Oral Oncol 2005;41(7):723–728. DOI: 10.1016/j.oraloncology.2005.03.011.
  12. Pashley DH, Carvalho RM. Dentine permeability and dentine adhesion. J Dent 1997;25(5):355–372. DOI: 10.1016/s0300-5712(96)00057-7.
  13. Knott L, Bailey AJ. Collagen cross-links in mineralizing tissues: a review of their chemistry, function, and clinical relevance. Bone 1998;22(3):181–187. DOI: 10.1016/s8756-3282(97)00279-2.
  14. Orstavik D. Physical properties of root canal sealers: measurement of flow, working time, and compressive strength. Int Endod J 1983;16(3):99–107. DOI: 10.1111/j.1365-2591.1983.tb01307.x.
  15. Martins CV, Leoni GB, Oliveira HF, et al. Influence of therapeutic cancer radiation on the bond strength of an epoxy-or an MTA-based sealer to root dentine. Int Endod J 2016;49(11):1065–1072. DOI: 10.1111/iej.12556.
  16. McGuire JD, Mousa AA, Zhang BJ, et al. Extracts of irradiated mature human tooth crowns contain MMP-20 protein and activity. J Dent 2014;42(5):626–635. DOI: 10.1016/j.jdent.2014.02.013.
  17. Soares CJ, Castro CG, Neiva NA, et al. Effect of gamma irradiation on ultimate tensile strength of enamel and dentin. J Dent Res 2010;89(2):159–164. DOI: 10.1177/0022034509351251.
  18. Tao L, Pashley DH. Shear bond strengths to dentin: effects of surface treatments, depth and position. Dent Mater 1988;4(6):371–378. DOI: 10.1016/S0109-5641(88)80052-6.
  19. Amade ES, Novais VR, Roscoe MG, et al. Root dentin strain and temperature rise during endodontic treatment and post rehabilitation. Braz Dent J 2013;24(6):591–598. DOI: 10.1590/0103-6440201302268.
  20. Ames JM, Loushine RJ, Babb BR, et al. Contemporary methacrylate resin–based root canal sealers exhibit different degrees of ex vivo cytotoxicity when cured in their self-cured mode. J Endod 2009;35(2):225–228. DOI: 10.1016/j.joen.2008.11.008.
  21. Saleh IM, Ruyter IE, Haapasalo MP, et al. Adhesion of endodontic sealers: scanning electron microscopy and energy dispersive spectroscopy. J Endod 2003;29(9):595–601. DOI: 10.1097/00004770-200309000-00013.
  22. Pameijer CH, Zmener O. Resin materials for root canal obturation. Dent Clin 2010;54(2):325–344. DOI: 10.1016/j.cden.2009.12.004.
  23. Patil SA, Dodwad PK, Patil AA. An in vitro comparison of bond strengths of Gutta-percha/AH Plus, Resilon/Epiphany self-etch and EndoREZ obturation system to intraradicular dentin using a push-out test design. J Conserv Dent JCD 2013;16(3):238. DOI: 10.4103/0972-0707.111323.
  24. Carneiro SM, Sousa-Neto MD, Rached-Júnior FA, et al. Push-out strength of root fillings with or without thermomechanical compaction. Int Endod J 2012;45(9):821–828. DOI: 10.1111/j.1365-2591.2012.02039.x.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.