Success of additional irrigation procedure with qmix in teeth with periapical lesions: A Randomized controlled trial

The aim of this study was to compare the outcome of a root canal treatment with and without QMix irrigation. Sixty single-rooted teeth with periapical radiolucency of 60 patients were randomized into two groups using a randomized block design with block sizes of 10 patients each. Root canals were prepared with WaveOne Gold (WOG; Dentsply Sirona, Ballaigues, Switzerland) and during instrumentation, irrigation was performed with 5 ml 2.5% NaOCl using 28 side-vented needles (NaviTips, 30 gauge; Ultradent Products, Inc., South Jordan, UT, USA). Final irrigation protocol was performed using 5 ml 2.5% NaOCl (n= 30) or 5 ml QMix (n=30). Then the root canals were irrigated with 5 ml of saline and obturated with gutta-percha and AH Plus sealer, using cold lateral compaction technique. Eight patients were excluded due to pregnancy, systemic disease and use of medicament. The 52 patients were recalled and evaluated radiographically at 12 month according to PAI scores. In this stage, seven patients (7 teeth) were excluded from the follow-up schedule since they did not respond to the recall requests. Pre and post treatment PAI scores were compared and teeth were considered 'healthy' (PAI ≤ 2) or 'diseased' (PAI ≥ 3). Mann-Whitney U test was used to compare the differences between the post-operative and follow-up images of treatment groups. Wilcoxon signed rank test was conducted to examine the changes in PAI score from base line to the follow-up evaluation in each group. Forty five patients were reexamined 1 year after treatment. Overall, a statistically significant decrease in PAI score from the base line to the follow-up evaluation was seen in 43 of 45 teeth. Absence and reduction of the radiolucency together were observed in the QMix group in 23 of 25 teeth (92%) and 20 of 20 teeth (100%) in the NaOCl group. Two teeth were unhealed in QMix group. There was no significant difference between the results of decrease in PAI score was seen in both groups (p= .508). Root canal treatments with and without QMix irrigation contributed equally to periapical healing.