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Abstract This in vitro study was conducted to compare the influence of Q-Mix, apple vinegar, and 17% ethylenediaminetetraacetic acid (EDTA) on removal of smear layer through assessing Alizarin dye penetration into the dentinal tubules using confocal laser scanning microscopic analysis (CLSM). Thirty single‑canaled extracted human mandibular premolars with mature apices were selected for this study. Teeth were decoronated to a standardized root length of 15 mm. Access cavity and root canal preparation were performed. Roots were randomly divided into three groups based on the final rinse: group I: 10 ml of Q-Mix for 1 min, group II: 10 ml of apple vinegar for 1 min and group III:10 ml of 17% EDTA for 1 min. Each sample was irrigated with 5 ml of NaOCl labeled with Alizarin red dye for 1 min then dried using absorbent paper points. Samples were transversely sectioned into coronal, middle and apical thirds to be evaluated under confocal laser scanning microscopy. Data were then recorded and statistically analyzed. The results showed that no statistically significant difference was found among Q-Mix, apple cider vinegar, and EDTA in smear layer removal from canal walls. Better cleaning ability was recorded in the coronal and middle thirds of the canal walls within all groups compared to the apical thirds. It was concluded that apple cider vinegar is a promising natural product to remove the smear layer from canal walls. Q-Mix promoted a great effect on the cleaning ability of root canal system especially from the coronal and middle thirds of the canal. 84 6.2 Conclusion Based on the results presented and within the limitations of this study, the following can be concluded: 1. Q-Mix, apple vinegar, and EDTA promoted the cleaning ability of the root canal system. 2. The cleaning ability of the three irrigants in the coronal and middle sections are superior to that in the apical section. 3. Apple vinegar is a promising natural product since it is cost-effective and a biocompatible substance which produces an effective elimination of smear layer in vitro. 4. Q-Mix as a novel irrigating solution exhibited a great effect on removal of the smear layer from the canal walls. 5. Confocal laser scanning microscopy is considered an easy and convenient method during specimens’ preparation for examination of smear layer removal from the canal walls through penetration of fluorescent dye through the dentinal tubules. |