Seminar 8 Smear Layer

SMEAR LAYER
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DETAILS OF PRESENTATION
 Total number of slides:100
 Total no of Text slides: 82
 Total no of llustrations: 24
 Time taken app -1 hr
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TEXT BOOK REFERENCES
 Smear Layer of Dentin - Operative Dentistry, Supplement 3,1984.
 Pathways of the Pulp- Cohen, 6th edition.
 Ingle’s Endodontics - 6th edition.
 Summit fundamentals of operative dentistry 3rd Edition
 Grossman’s Endodontic Practice - 12thedition.
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ARTICLE REFERENCES
 D. R.Violich et al., The smear layer in endodontics – a review. International

Endodontic Journal, 43, 2–15, 2010.
 Mahmoud Torabinejad et al., Clinical implications of the smear layer in

endodontics: A review. Oral Surgery Oral Medicine Oral Pathology,Volume
94, Number 6, December 2002.
 Paula Dechichi et al., Smear layer: A brief review of general concepts. Part
I. Characteristics, compounds, structure, bacteria and sealing. RFO UPF
2006; 11(2):96-9
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 Punit Bansal et al., Smear Layer In Endodontics - A review. Indian Journal
of Dental Sciences,Vol.1 Issue 2, November 2009.
 Aseem Shiromany et al., Smear Layer- A Matter of Controversy in

Endodontics– A Review. Journal of Advanced Medical and Dental Sciences
Research |Vol. 2| Issue 3| July-September 2014.
 Amarnath Shenoy et al., Effect of final irrigating solution on smear layer

removal and penetrability of the root canal sealer. J Conserv Dent. 2014
Jan-Feb; 17(1): 40–44.
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 Manuele Mancini et al., Smear Layer Removal and Canal Cleanliness
Using Different Irrigation Systems (EndoActivator, EndoVac, and Passive
Ultrasonic Irrigation): Field Emission Scanning Electron Microscopic
Evaluation in an In Vitro Study.JOE, November 2013Volume 39, Issue 11,
Pages 1456–1460
 Syed Mukhtar-Un-Nisar Andrabi et al., An In Vitro SEM Study on the

Effectiveness of Smear Layer Removal of Four Different Irrigations. Iran
Endod J. 2012 Autumn; 7(4): 171–176.
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 Andre Augusto Franco Marques et al., Smear layer removal and chelated
calcium ion quantification of three irrigating solutions. Braz. Dent. J.
vol.17 no.4 Ribeirão Preto 2006
 Senawongse P et al., Effect of dentine smear layer on the performance of

self- etching adhesive systems: A micro-tensile bond strength study. J
Biomed Mater Res B Appl Biomater. 2010 Jul;94(1):212-21.
 Stojicic S, Antibacterial and smear layer removal ability of a novel irrigant,

QMiX. Int Endod J. 2012 Apr;45(4):363-71.
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 Senem YİĞİT ÖZER et al., Removal of Debris and Smear Layer in Curved
Root Canals Using Self-Adjusting File with Different Operation Times – A
Scanning Electron Microscope Study. Int Dent Res 2011;1:1-6
 Chihiro C, Finger WJ.Effect of smear layer thickness on bond strength

mediated by three all-in-one self-etching priming adhesives. Oper Dent
2002;4:283-289.
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CONTENTS
 Introduction
 Definition
 History
 Components Of Smear Layer
 Contraversy in removing smear layer
 Bonding & Smear Layer
 Functional Implications
 Methods Of Removal
 Conclusion
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INTRODUCTION
Adhesive
Cavity liner
bonding
Beneficial and
detrimental
Identified using electron microprobe with SEM

First reported by EIEK et al
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DEFINITION
 According to Operative Dentistry Journal (1984)
Any debris produced iatrogenically by the cutting, not only of dentin, but
also of enamel, cementum and even the dentin of the root canal”.
 According to Cohen
“an amorphous, relatively smooth layer of microcrystalline debris whose

featureless surface cannot be seen with the naked eye”.
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The American Association of Endodontists
“surface film of debris retained on dentin or other tooth surfaces

like enamel, cementum after instrumentation with either rotary
instruments or endodontic files”.
 According to DCNA (1990)
“when tooth structure is cut, instead of being uniformly sheared, the

mineralised matrix shatters. Existing on the strategic interface of restorative
materials and the dentin matrix most of the debris is scattered over the
enamel and dentin surface to form what is known as smear layer” .
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HISTORY
Lammie and Draycott in 1952 and Stret (1953).
 The earliest studies on the effects of various instrumentson dental
tissues
 Limited principally to light microscope.
Charbeneou, Peyton and Anthony
 First to quantify and rank the differences between burs and abrasives by
using a profilometer to record the surface topography of cut and abraded
dental tissues
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In 1961 Scott and O’Neel
 Used transmission electron microscopy to study the nature of the

cut toothsurface.
Boyde, Switsur in 1963
 Advent of SEM - grinding debris was first referred to as the smear

layer
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Eick and others in 1970
Attempted to quantify and identify cutting debris on toothsurfaces.

 Surfaces abraded with diamonds were rougher than those cut with
tungsten carbide burs.
 Surfaces cut dry were rougher and more smeared than those in which
water was used as coolant.
 The smear layer is composed of an organic film less than 0.5 microns thick.
Included with in it were particles of opacity ranging from 0.5 – 15
microns.
 Such layers were present on all surfaces though they were not necessarily
continuous.
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In 1972, Jones, Lozdan and Boyde
 smear layers were common on enamel and dentin following the

use of instruments.
Erich and co-workers in 1976
 Discussed the role of friction and abrasion in the drilling of teeth.
 They accounted for the formation of smear layers, especially in

dentin by a brittle and ductile transition and alternating rupture and
transfer of apatite and collagen matrix into the surface.
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In 1982, Goldman and others
 Studied smear layers after the use of endodontic instrumentation.
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COMPOSITION OF SMEAR LAYER
INORGANIC ORGANIC
CAMERON PULP TISSUE DEBRIS

ODONTOBLASTIC PROCESSES
BACTERIA
BLOOD CELLS
Organic content high in early stage of
instrumentation
Due to presence of viable pulp tissue
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., The smear layer in endodontics – a review
Cameron (1983) madder (1984)
SMEAR –PACKED
SUPERFICIAL
INTO DENTINAL
LAYER
TUBULE
Loosely attached to
40 μm into dentinal tubules
dentinal walls
Granular or particulate in texture
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., The smear layer in endodontics – a review
SMEAR LAYER -CONTRAVERSY
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IN FAVOUR OF RETAINING SMEAR LAYER
Block dentinal Limit bacterial or toxin penetration by altering

tubules dentinal permeability
 The smear layer serves as a barrier to prevent bacterial migration into the
dentinal tubules (Drake et al. 1994, Galvan et al.)
Smear Layer- A Matter of Controversy in

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Love et al. 1996, Perez et al. 1996, Pashley 1985)
if the canals were inadequately disinfected
( or )
if bacterial contamination occurred after canal preparation
presence of a smear layer might stop bacterial invasion of the dentinal

tubules
IN FAVOUR OF REMOVING SMEAR LAYER
Loosely adherent structure- can harbour bacteria and provide an avenue

for leakage
Limit the effective disinfection of dentinal tubules
Substrate for bacteria, allowing their deeper penetration in the dentinal

tubules

Bacteria may be found deep within dentinal tubules and smear layer
may block the effects of disinfectants in them.
Contain bacteria and necrotic tissue .Bacteria may survive and multiply and
can proliferate into the dentinal tubules
Hinder the penetration of intracanal disinfectants and sealers into

dentinal tubules and can potentially compromise the seal of the root canal
filling

Beneficial to use lower concentrations and / or amounts of antibacterial agents
since all of these agents show some degree of toxicity of viable host
cells

SMEAR PHENOMENON
 Eirich (1976) stated that smearing occur when “ hydroxy apatite

within the tissue is either plucked out or broken or swept along
and resets in the smeared out matrix”.
 Temperature rises upto 600oC in dentin when it is cut without a

coolant.
 Thisvalue is significantly lower than the melting point of apatite

(1500-1800oC)
Smear layer: A brief review of general concepts. Part I.

Characteristics, compounds, structure, bacteria and
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 Smearing is a physico- chemical phenomenon rather than a thermal
transformation of apatite involving mechanical shearing and thermal
dehydration of the protein.
 Plastic flow of hydroxy apatite is believed to occur at lower

temperature than it melting point and may also be a contributing
factor to smearing.

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MORPHOLOGY OF SMEAR LAYER
Disc of human dentin cut with a fine-grit diamond blade on a

metallurgical saw. Note the uniformity and amorphous nature of the
smear layer. Scanning electron micrograph XT560.
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Scanning electron micrograph of dentine surface with typical amorphous
smear layer with granular appearance and moderate debris present
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Scanning electron micrograph of smeared surface of dentine.The crack shapes are
processing artefacts overlying dentinal tubules.
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Scanning electron micrograph of dentine surface showing smear plugs
occluding tubules.The surface has been treated for 60 s with Tubulicid Blue
Label
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 Clinically produced smear layers have and average depth of from 1-5
microns
 The depth entering the dentinal tubule may vary from a very few
microns to 40 microns.

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 Several factors may cause the depth of the smear layer to varyfrom
tooth to tooth:
 Dry or wet cutting of the dentin.
 The type of instrument used
 The amount and chemical make of the irrigation solution.

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 Filing a canal without irrigation or cutting without a water
spraywill produce a thicker layer of dentin debris
 The use of coarse diamond burs produces a thicker smear layer than
the use of carbide burs.

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TOPOGRAPHICAL DETAIL OF CUT DENTIN
 Steel and tungsten carbide burs produce an undulating pattern, the
trough of which run perpendicular with the direction of movement of the
hand piece.
Smear Layer of Dentin - Operative Dentistry,

Supplement 3,1984.
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 Finegrooves can be seen running perpendicular to the undulations
and parallel with the direction of rotation of the bur.
 Such a phenomenon is referred to as “galling ”.

Supplement 3,1984.
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Scanning electron micrograph showing the galling pattern on a dentin surface cut with
a water-cooled, tungsten carbide bur. X150.
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Scanning micrograph of the cutting anomalies on dentin following the use of
a cross-cut steel bur. Note the debris and evidence of smearing (arrow). X760
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 The galling phenomenon appears more masked with tungsten carbide
bursrun at high speed.
 An examination of both steel and tungsten carbide burs shows a

rapid deterioration of the cutting edges through what appears to be a
brittle fracture .
 Brittle significantly dminishes the cutting efficiencies of the bur -

increases frictional heat - causes smearing.

Supplement 3,1984.
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Scanning electron micrographs of the flutes of, tungsten carbide bur.At
higher magnification evidence of brittle fracture (arrow) of the cutting
edge is seen together with the formation of facets. X9, X1520.
Supplement 3,1984.
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 Steel and tungsten carbide burs - obliterate normal structural detail
of the tissue.
 Debris, irregular in shape and non-uniform in size and distribution,

remains on the surface even after thorough lavage with H2O.

Supplement 3,1984.
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 In the absence of coolant smeared debris does not form a continuous layer
but exists rather as localised islands with discontinuities exposing the
underlying dentin.
 Coolant of the water spray does not prevent smearing but appear to
significantly reduce the amount and distribution of it.

Supplement 3,1984.
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ADHESION STRATAGIES-INTERACTION WITH
SMEAR LAYER
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BASED ON INTERACTION WITH
SMEAR LAYER
MODIFY SMEAR REMOVE COMBINATION

LAYER SMEAR LAYER OF BOTH
1 AND 2 STEP 2 AND 3 STEP 1 AND 2 STEP
Summit fundamentals of operative dentistry 3rd

Edition
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SMEAR LAYER MODIFYING ADHESIVES
 Based on concept that smear layer provides a natural barrier to pulp
 Protect against bacterial invasion
 Limit the outflow of pulpal fluid
Efficient wetting and insitu polymerization of monomer infiltrated into

smear layer reinforce bonding of smear layer to underlying dentinal surface
 Form chemical bond to underlying dentin

Edition
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 Requires selective etching of enamel in separate step
 Primers applied before application of compomers
 Interaction of adhesives with dentin –very superficial
 Eg PROBOND

Edition
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SMEAR LAYER REMOVING ADHESIVES
 MECHANISM BASED ON
Combined effect of hybridization and formation of resin tags
 3 step smear layer removing adhesives reduced to 2 step by combining

primer and adhesive
 Eg:optibond solo(one bottle adhesive)
 Optibond FL(3 STEP)

Edition
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Edition
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Edition
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SMEAR LAYER DISSOLVING ADHESIVES
 Uses smear layer dissolving adhesives or self etching adhesives
 Primers –partially demineralize smear layer and underlying dentin
surface withour removing dissolved smear layer remnants or
unplugging tubule orifice
 Eg:ART Bond
 Ecusit primer mono
 Require selective enamel etching

Edition
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 2 step-provide simultaneous conditioning and priming of both enamel and
dentin

Edition
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FUNCTIONAL IMPLICATIONS
RESTORATIVE MATERIAL
 Masking of the underlying dentin matrix -interference with the

bonding of adhesive dental cements -polycarboxylates and GIC

Supplement 3,1984.
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Allowing cements to react chemically with the smear layer rather than with the
matrix of sound tubular dentin produces a weaker bond due to the fact that the
smear layer can be torn away from the underlying matrix.
 When cements are applied to dentin covered with a smear layer

and then tested for tensile strength, the failure can be adhesive (b/w
cement and smear layer) or cohesive (b/w constituents of smear
layer).

Supplement 3,1984.
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REMOVE SMEAR LAYER BY ETCHING WITH ACIDS
 6% Citric acid for 60 sec remove all smear layer

 tubules open -increased retention
 Surface collagen is exposed for possible covalent linkages
DISADVANTAGE OF REMOVING SMEAR LAYER

 No physical barrier to bacterial penetration of dentin al tubules.

Supplement 3,1984.
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 with nothing occluding the orifices of the tubules, the permeability of
dentin increases four- to ninefold depending upon the size of the
molecule
Brannstrom (1982) and others

 Prefer to remove the smear layer over and between the tubules without
removing the smear plugs.

Supplement 3,1984.
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RESTORATIVE DENTISTRY
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INFLUENCE OF CONDITIONING OF SMEAR LAYER ON
SENSITIVITY OF DENTIN
 Etching the dentin of roots, whether done therapeutically or by the

action of microorganisms of plaque can remove the thinlayer of
covering cementum or smear layer or both
 Conditioning withacids will remove the smear layer plugs exposing

patent dentinal tubules to the oral cavity.
This can lead to sensitivity of the dentin to the point where it interferes
with the oral hygiene

Supplement 3,1984.
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 Several studies indicate that most of the resistance to the flow of
fluid across dentin is due to the presence of smear layer.
 Etching dentin greatly increases the ease with which fluid can
move across dentin.
 Thisis accompanied clinically by increased sensitivity of dentin to

osmotic, thermal and tactile stimuli.

Supplement 3,1984.
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INFLUENCE ON PERMEABILITY OF DENTIN
 Substances diffuse across dentin at a rate that is proportional

to their concentration gradient and the surface available for diffusion
The removal of smear layer increases the dentin permeability by 5-6

times in vitro by diffusion but increases it by 25-36 times by filtration

Supplement 3,1984.
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BACTERIA UNDER SMEAR LAYER UNDER
RESTORATIONS
Water cleaned cavities with the smear layer remaining

Underneath the composite restoration showed the presence of
numerous bacteria, whereas in the antiseptically cleaned
cavities, bacteria wereabsent.
 Micro organisms get sufficient nourishment from the smear

layer and dentinal fluid.

Supplement 3,1984.
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 These considerations favour the opinion that most of the smear
layer should be removed and any smear layer remaining for
instance at the tubule should be antiseptically treated before the
application of lining or a luting cement.
 Bacteria -not present in freshly prepared smear layers.

Supplement 3,1984.
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 There is no evidence that common permanent restorative
materials aresufficiently antibacterial to kill bacteria entrapped within
thesmear layer, especially when a fluid filled contraction gap, 5-
20 microns wide separates the restoration from the smear
layer.

Supplement 3,1984.
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Bases of ZnOE and Ca(OH)2 may have good antiseptic effects but
unfortunately under permanent restorations, these bases cannot be placed on
all cavity walls.
 Pure Ca(OH)2 is an excellent antibacterial temporary dressing and

should be applied under temporary fillings.

Supplement 3,1984.
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 Ca(OH)2 may reinforce the remaining smear plugs in the outer
apertures of dentinal tubules

Supplement 3,1984.
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THE PROTECTIVE EFFECT OF SMEAR PLUGS IN TUBULE APERTURES AND THE
CONSEQUENCE OF REMOVING THE PLUGS
 Etching the cavity prior to the placement of composite resin resulted in a

massive invasion of bacteria in dentinal tubules (Vojinovic, Nyborg &
Brannstrom, 1973).
 The corresponding cavities, cleaned by water and with the smear layer left,
had a bacterial layer on cavity walls but practically no invasion into
the dentinal tubules.
 Obviously smear plugs in the apertures of the tubules had prevented

bacterial invasion

Supplement 3,1984.
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 From opened tubules, bacteria may easily reach the pulp and multiply
(Brannstrom, 1982).
 Therefore, removal of smear plugs should be avoided.
 Pashley(1984) has also demonstrated that smear plugs reduce permeability

of dentin.
Another important consequence- of etching and the removal of smear plugs and
peritubular dentin at the surface is that the area of wet tubules may increase from
about 10 to 25% of the total
., Clinical implications of the smear layer in

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IN ENDODONTICS
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ROLE OFSMEAR LAYER IN APICAL LEAKAGE
 The smear layer’s presence plays a significant part in an apical
leakage.
 Its absence makes the dentin more conducive to a better and

closer adaptation of the gutta percha to the canal wall.
With the smear layer intact, apical leakage will be significantly increased,
without the smear layer, the leakage will still occur but at a decreased
rate.

PULPAL IRRITATION DUE TO REMOVAL OF THE
SMEAR LAYER
 37% phosphoric acid or 50% citric acid applied for 15 seconds or one
minute does not result in any appreciable pulpal reaction, inflammation, or
necrosis.
 Acid etchants, detergents, a thin mix of phosphate cement, silicate, glass-

ionomer cement, and resins do not produce any appreciable damage and
inflammation to the pulp, not even when applied to exposed pulps

 Cut dentin should not be treated with acid or EDTA in such a way that the
tubules become open and widened.

EFFECT OF SMEAR LAYER ON SEALERS
 The type of sealer used has different implications once the
smear layer is removed.
 A powder liquid combination, the most of which is grossmans

sealer contains small particles in the powder that could enter the
orifices of the dentinal tubules and help create a reaction interface
between sealer and canal wall.

 Ca(OH)2 based sealers have the advantage of promoting the
apposition of cements at the canal apex and sealing it off
against microleakage.

POST CEMENTATION
 GICs are effective in post cementation after smear layer removal

because the glass ionomer has a better union with tooth
structure.

CHEMICAL
ULTRASONIC
LASER REMOVAL OF SMEAR
LAYER
ORGANIC CHELATING
ACIDS AGENTS
CHEMICAL REMOVAL
 The quantity of smear layer removed by a material is related to its pH and
the time of exposure (Morgan & Baumgartner 1997).
 According to Kaufman & Greenberg (1986),
WORKING SOLUTION IRRIGATION SOLUTION
clean the canal remove the debris and smear layer

created by the instrumentation process.

Chlorhexidine
 popular as an irrigant
 long lasting antibacterial effect through adherence to dentine
 Does not dissolve organic material or remove the smear layer.

SODIUM HYPOCHLORITE
 Dissolve organic tissues
 Goldman et al. 1982 -increases with rising temperature
 Capacity to remove smear layer from the instrumented root canal walls has
been found to be lacking.
 NaOCl during or after instrumentation produces superficially clean canal

walls with the smear layer present

CHELATING AGENTS
 Smear layer components include very small particles with a large surface :
mass ratio, which makes them soluble in acids (Pashley 1992).
EDTA
 Reacts with the calcium ions in dentine and forms soluble calcium chelates
 EDTA decalcified dentine to a depth of 20–30 lm in 5 min
 Fraser (1974) stated that the chelating effect was

almost negligible in the apical third of root canals

Erosion of the dentinal tubule after placement of EDTA in the root canal for 5
minutes. Original magnification 5000.
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RC PREP(EDTA ,UREA PEROXIDE)
 urea peroxide is added to encourage debris to float out of the root canal
 wax that left a residue on the root canal walls despite further
instrumentation and irrigation compromise the ability to obtain a hermetic
seal
 studies have shown that paste-type chelating agents, do not remove the
smear layer effectively when compared to LIQUID EDTA.

REDTA
A quaternary ammonium bromide (cetrimide) EDTA solutions
to reduce surface tension
increase penetrability of the solution
no smear layer remaining except in the apical part of the canal

EDTAC(EDTA &CETAVLON)
 Circumpulpal surface had a smooth structure and that the dentinal tubules
had a regular circular appearance
 The optimal working time of EDTAC was suggested to be 15 min in the

root canal
 no further chelating action could be expected after this
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BIS-DEQUALINIUM-ACETATE (BDA)
 remove the smear layer throughout the canal even in the apical third
 well tolerated by periodontal tissues
 low surface tension allowing good penetration.
 less toxic that NaOCl and can be used as a root canal dressing
TETRACYLINES
 low pH in concentrated solution
 can act as a calcium chelator
 Cause enamel and root surface demineralization

endodontics: A review
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MTAD
 MTAD to be an effective solution for the removal of the smear layer.
 It does not significantly change the structure of the dentinal tubules when
the canals are irrigated with sodium hypochlorite and followed with a
final rinse of MTAD.
This irrigant demineralizes dentine faster than 17% EDTA

The effectiveness of MTAD to completely remove the smear layer is enhanced
when a low concentration of NaOCl (1.3%) is used as an intracanal irrigant before
placing 1 ml of MTAD in a canal for 5 minutes and rinsing it with an additional 4
ml of MTAD as the final rinse.

ORGANIC ACIDS
 Citric acid removed smear layer better than polyacrylic acid, lactic acid and
phosphoric acid but not EDTA
 Wayman et al. (1979) showed that canal walls treated with 10%, 25% and
50% citric acid solution were generally free of the smeared appearance
Sequential use of 10% citric acid solution and 2.5% NaOCl solution, then
again followed by a 10% solution of citric acid

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After etching with 6% citric acid and for two minutes.The orifices of the patent
dentinal tubules are flared due to removal of peritubular dentin.
Scanning electron micrograph XT560.
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 25% citric acid–NaOCl group was not as effective as a 17% EDTA–
NaOCl combination.
 25% tannic acid solution

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SODIUM HYPOCHLORITE AND EDTA
 Goldman et.al. in 1982 - most effective working solution
 10 ml of 17% EDTA followed by 10 ml 5.25% NaOcl and the most

effective final flush
 NaOcl removes organic material including the collagenous matrix of dentin

and EDTA removes the mineralized dentin, thereby exposing more
collagen

AN IN VITRO SEM STUDY ON THE EFFECTIVENESS OF
SMEAR LAYER REMOVAL OF FOUR DIFFERENT
IRRIGATIONS
BioPure MTAD was the most effective agent for the purpose of smear layer
removal in the apical third of the root canals.
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SMEAR LAYER REMOVAL AND CANAL CLEANLINESS USING DIFFERENT
IRRIGATION SYSTEMS (ENDOACTIVATOR, ENDOVAC, AND PASSIVE
ULTRASONIC IRRIGATION): FIELD EMISSION SCANNING ELECTRON
MICROSCOPIC EVALUATION IN AN IN VITRO STUDY
The EndoActivator and EndoVac showed the best results at 3, 5, and 8 mm

(EndoActivator) and 1, 3, 5, and 8 mm (EndoVac) from the apex.
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Removal of Debris and Smear Layer in Curved Root Canals Using Self-
Adjusting File with Different Operation Times – A Scanning Electron
Microscope Study
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ULTRASONICS
 Used in conjunction with a solution of 2-4%NaOcl can eliminate the
smear layer
The apical region of the canal showed less debris and smear layer
than the coronal aspects depending on the acoustic streaming which was
more intense in magnitude and velocity at the apical region of the file .

LASERS
Takeda et al - lasers - vaporize tissues in the main canal, remove the smear layer,
and eliminate the residual tissue in the apical portion of the root canals
Effectiveness of lasers depends on - power level, the duration of exposure, the

absorption of light in the tissue, the geometry of the root canal, and the tip-to-
target distance.

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 Dederich et al and Tewfik et al used variants of the neodymium-yttrium-
aluminum-garnet laser - no change or disruption of the smear layer to
actual melting and recrystallization of the dentin
This pattern of dentin disruption was observed in other studies with various
lasers, including the carbon dioxide laser, the argon fluoride excimer laser, and
the argon laser.

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 Takeda et al, using the erbium-yttrium-aluminum-garnet (Er:YAG) laser,
demonstrated optimal removal of the smear layer without the melting,
charring, and recrystallization associated with other laser types.
Kimura et al demonstrated removal of the smear layer with an Er:YAG laser.

Although they showed removal of the smear layer, the photomicrograph showed
destruction of the peritubular dentin.

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 The main difficulty with laser removal of the smear layer continues to be
the access to small canal spaces with the relatively large probes that are
available for delivery of the laser beam.

07/25/2020 98
Effect of diode laser and ultrasonics with and without
ethylenediaminetetraacetic acid on smear layer removal from the
root canals: A scanning electron microscope study.
RESULTS:
 Ultrasonics with EDTA had the least smear layer scores.
CONCLUSION:
 Diode laser alone performed significantly better than ultrasonics.
07/25/2020 99
CONCLUSION
 There are widely varying results regarding the smear layer removal and
retention in the literature. smear layer in it self has varying advantages and
disadvantages which cannot be overlooked. Also with introduction of
thermoplasticised Gutta percha and various new methods of smear layer
removal, further studies are needed to open the facts of anatomical
complexities of the root canal system.
07/25/2020 100

Seminar 8 Smear Layer

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SMEAR LAYER

 Total number of slides:100

 Total no of Text slides: 82

 Time taken app -1 hr

 Pathways of the Pulp- Cohen, 6th edition.

 Ingle’s Endodontics - 6th edition.

 Summit fundamentals of operative dentistry 3rd Edition

 Grossman’s Endodontic Practice - 12thedition.

 D. R.Violich et al., The smear layer in endodontics – a review. International

 Mahmoud Torabinejad et al., Clinical implications of the smear layer in

 Aseem Shiromany et al., Smear Layer- A Matter of Controversy in

 Amarnath Shenoy et al., Effect of final irrigating solution on smear layer

 Syed Mukhtar-Un-Nisar Andrabi et al., An In Vitro SEM Study on the

 Senawongse P et al., Effect of dentine smear layer on the performance of

 Stojicic S, Antibacterial and smear layer removal ability of a novel irrigant,

 Chihiro C, Finger WJ.Effect of smear layer thickness on bond strength

Identified using electron microprobe with SEM

07/25/2020 ., The smear layer in endodontics – a review 10

“an amorphous, relatively smooth layer of microcrystalline debris whose

“surface film of debris retained on dentin or other tooth surfaces

 According to DCNA (1990)

“when tooth structure is cut, instead of being uniformly sheared, the

Charbeneou, Peyton and Anthony

 Used transmission electron microscopy to study the nature of the

Boyde, Switsur in 1963

 Advent of SEM - grinding debris was first referred to as the smear

Attempted to quantify and identify cutting debris on toothsurfaces.

 smear layers were common on enamel and dentin following the

Erich and co-workers in 1976

 Discussed the role of friction and abrasion in the drilling of teeth.

 They accounted for the formation of smear layers, especially in

 Studied smear layers after the use of endodontic instrumentation.

CAMERON PULP TISSUE DEBRIS

Granular or particulate in texture

Block dentinal Limit bacterial or toxin penetration by altering

Smear Layer- A Matter of Controversy in

if the canals were inadequately disinfected

if bacterial contamination occurred after canal preparation

presence of a smear layer might stop bacterial invasion of the dentinal

Loosely adherent structure- can harbour bacteria and provide an avenue

Limit the effective disinfection of dentinal tubules

Substrate for bacteria, allowing their deeper penetration in the dentinal

Smear Layer- A Matter of Controversy in

Hinder the penetration of intracanal disinfectants and sealers into

Smear Layer- A Matter of Controversy in

Smear Layer- A Matter of Controversy in

 Eirich (1976) stated that smearing occur when “ hydroxy apatite

 Temperature rises upto 600oC in dentin when it is cut without a

 Thisvalue is significantly lower than the melting point of apatite

Smear layer: A brief review of general concepts. Part I.

 Plastic flow of hydroxy apatite is believed to occur at lower

Smear layer: A brief review of general concepts. Part I.

Disc of human dentin cut with a fine-grit diamond blade on a

Smear layer: A brief review of general concepts. Part I.

 Dry or wet cutting of the dentin.

 The type of instrument used

 The amount and chemical make of the irrigation solution.

Smear layer: A brief review of general concepts. Part I.

Smear layer: A brief review of general concepts. Part I.