• 1 School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
  • 2 Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
  • 3 Department of Developmental Dentistry, University of Texas Health School of Dentistry, San Antonio, TX, USA
  • 4 Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Alagoas, Maceió, AL, Brazil
Restor Dent Endod, 2020 Aug;45(3):e28.
PMID: 32839709 DOI: 10.5395/rde.2020.45.e28


Objectives: To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants.

Materials and Methods: The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains.

Results: Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute.

Conclusions: QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.