SMEAR LAYER :

Introduction :
Unknown and unrecognized for years, the smear layer has become a
force to be reckoned with during the last decade. Most dentists know now it
exists but are often puzzled as to whether or not they should cope with it.
Since the smear layer has been recognized, dentist have come to realize that
they must renew their acquaintance with the science of dental materials so
they can understand the relationships of the products they work with to the
smear layer.
History :
Boyde et al (1963) were the first to describe and demonstrate the
presence of a smear layer! on surfaces of cut enamel such a layer was
readily removed with sodium hypochlorite, leading them to conclude that
an organic layer containing apatite particles was deposited or smeared on
the enamel surface, through functional heat generated during cutting.
"hey believed that the heterogenous nature of enamel was the source of
the smeared components.
ro!en"a and Sardana (1996) evaluated means of removing debris
from enamel and dentin after the use of steel burs, diamond stones and
hand instruments. "hey reported variations in the degree to which debris
was removed. #etergents were relatively ineffective, $#"% left behind a
film, &.'( hydrochloric acid was considered too destructive in its action,
hydrogen peroxide appeared to be most effective.
#elsen and $is%an (1966) described the dynamics of cutting dental
tissues and appeared to imply the existence of an altered surface layer
due to elastic and plastic deformation of the tissue.
Eic& et al (19'() found that surfaces cut dry are rougher and more
smeared than those in which water is used as a coolant. )n the absence of
coolant, smeared debris does not form a continuous layer but exists
rather as localized islands with discontinuities exposing the underlying
dentin. )f the diamond is allowed to clog with cutting debris, the smear
layer appears to cover a wider area. *ater coolant does not prevent
smearing but significantly reduces the amount and distribution of it.
Boyde et al (1963) attributed smearing of enamel to melting of the
tissue by functional heat. Studies have shown that temperatures will rise
upto +&&
&
, in dentin when it is cut without a coolant. "his value is
significantly lower than the melting point of apatite -i.e. '.&& / '0&&
&
,1
and has led to the conclusion that smearing is a physiochemical
phenomenon rather than a thermal transformation of apatite involving
mechanical shearing and thermal degradation of the protein. 2lastic flow
of hydroxyapatite is believed to occur at lower temperatures than its
melting point and may also be a contributing factor to smearing.
Eic& et al (19'() found the smear layer to be composed of an organic
film less than &.. m thick, included within it were particles of apatite
ranging from &.. / '. m. "hey also found that coarse diamond burs
produced more smearing than tungsten carbide bur.
Eiric) and *o+lit" (19'6) 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 onto the
surface. #entin, comprising approximately 3.4 collagen matrix and
water, is a more abundant source of protein than enamel, which contains
approximately 54 protein matrix and water.
6esearchers become aware of the endodontic smear layer by about
'78.. )t was first reported by 9aker.
,id%ars) in 19'-. treated instrumented teeth with .&4 citric acid
and found the dentin clear of smear layer and the dentinal tubules wide
open.
/old%an in 19'9. demonstrated that the smear layer was tenacious
regardless of flushing with both a conventional and a perforated needle.
"wo years, later, he tested various solutions individually and in
combination and concluded that chelating agent $#"% and sodium
hypochlorite was the best to remove the debris when used as a final
flush.
9aumgartner showed similar results with citric acid and sodium
hypochlorite.
:ennedy used warmed solution of sodium hypochlorite.
,ameron, used ultrasonics to produce a smear layer, found that the
layer was composed of two separate layers, each having a different effect
on the tubules and dependent on the time the ultrasonic was used.
*hite et al found that plastic filling material could penetrate dentinal
tubule when smear layer was removed.
;oldman discovered that smear layer removal improved the tensile
strength of post retention when the posts were cemented with a 9)S /
;M% resin.
Mader, by S$M investigation measured thickness of the smear layer
and the depth of its penetration into the dentinal tubules.
$vans, in<ected thermoplasticized gutta=percha into canals after smear
layer removal and concluded that the presence or absence of the smear
layer had no significant effect on the apical seal.
0e1inition o1 s%ear layer :
Accordin2 to S)3art" / %ny debris, calcific in nature, produced by
reduction or instrumentation of dentin, enamel or cementum or as a
contaminant that precludes interaction with the underlying pure tooth
tissue!.
4)at is s%ear layer 5
*hen tooth structure is cut, instead of being uniformly sheared, the
mineralized matrix shatters and considerable quantities of cutting debris
made of small particles of mineralized collagen matrix are produced that
is scattered over the enamel and dentin surfaces at the interface of
restorative materials and dentin matrix and is known as the Smear
layer!.
)n endodontics, the smear layer results directly from the instrumentation
used to prepare the canal wall and is found only where the wall is
instrumented and not in uninstrumented areas.
9ecause it is a very thin layer and is soluble in acid it is not very
apparent. )t cannot be seen in demineralized teeth as it dissolves in the
process of demineralization. )t is only visible under S$M or "$M.
"he smear layer has an amorphous, irregular and granular appearance
when viewed under the scanning electron microscope. "his appearance
may be formed by translocating and burnishing the superficial
components of the dentin walls during endodontic instrumentation.
"he smear layer consists of two separate layers>
'1 % superficial layer.
51 ?oosely attached layer to dentin.
#entin debris enters the orifices of the dentinal tubules and acts as a
plug -smear plug1 to occlude the ends of the tubules.
"he smear layer is made up of tooth particles ranging from less than
&.. m to '. m. "he particles are composed of globular subunits
approximately &.&. / &.' m in diameter which originated from mineralized
fibers. "he thickness of this layer is '=. m. "he depth entering the tubules
may be from a few m upto @&m. "his tubular packing phenomenon is due
to action of burs and endodontic instruments. Aowever ,engiz et al
proposed that the penetration of smear material into dentinal tubules could
be caused by capillary action as a result of adhesive forces between the
dentinal tubules and the smear layer. "his hypothesis of capillary action
may explain the packing phenomenon observed by %ktener et al who
showed that this penetration was increased upto ''&m.by the use of
surface achieve reagents as a working solution during endodontic
instrumentation.
Bne can conclude that a smear layer is present on all restoratively or
endodontically prepared teeth unless the dentin surface was treated with an
acid or a chelating agent.
Several factors may cause the depth of the smear layer to vary from
tooth to tooth / i.e. >
'1 #ry or wet cutting of the dentin.
51 "he size is shape of the cavity or root canal.
31 "he type and sharpness of instrument used.
@1 "he amount and chemical make up of the irrigating solution.
.1 )ncreased centrifugal forces resulting from the movement and the
proximity of the instrument to the dentin wall form a thicker and
more resistant smear layer.
+1 "he amount produced during automatic preparation as with gates /
glidden or post drills will be greater in volume than that produced by
hand filing. )nstrumentation with : files and reamers and giromatic
files created similar surfaces.
)f there is a difference in the rate of flow of fluid across dentin before
and after removal of the smear layer, the magnitude of rate change is an
indication of the thickness or density of the smear layer.
Ciling a canal without irrigation or cutting without water spray will
produce thicker debris than otherwise similarly coarse diamond burs
produce thicker debris than carbide burs.
#entin is composed of 5 different layers>
'1 Superficial dentin -near the enamel1.
51 #eep dentin -near pulp1.
Smear layer on deep dentin contains more organic material than
superficial dentin. "his is because of greater number of proteoglycans lining
the tubules or the greater number of odontoblastic processes near the pulp.
"he adhesive strength of all cements is always .&4 greater in
superficial dentin. "his may indicate that the quality or quantity of the
smear layer found on superficial dentin may be greater than that produced in
deep dentin.
"he movement of fluid across dentin meets a resistance directly
proportional to the quantity and quality of smear layer present. )n vital teeth
the smear layer restricts the dentinal fluid from flushing the dentin surface.
)t also hinders the chemical process that produces marginal seal. "he
presence of smear layer, however, does not appear to restrict the adaptation
of freshly condensed amalgam to cavity surface.
)n non=vital teeth, marginal seals are improved because of the lack of
moisture within the dentinal tubules. *hen the acid etch technique is used
the retention of the smear layer is not an important factor in the
development of a marginal seal around composite resin restorations. "he
initial sealing process occurring under amalgam restorations may be
compromised because of the instability of the smear layer and its penchant
for leaching under the amalgam. "his leaching process will produce a
widening of the amalgam / tooth micro crevice and ultimately weaken the
sealing mechanism.
Dodaikin proposed a conflicting theory about the smear layer in the
sealing mechanism of a restoration. Ae believed that a chemical effect was
in force that provided a substrate that interacted with the restoration
substrates or other substances that might find their may into the micro
crevices at the restoration / tooth interface. Ae theorized that the smear
layers presence provided an environment that was conducive to the
initiation and progression of the sealing mechanism. 9y restricting the
dentinal fluid from flushing the molecules that affected the seal from the
restoration / tooth interface, the smear layer may also play a physical as
well as chemical role in margin sealing.
%ccording to some investigators, after a canal is instrumented the
smear layer produced can harbour bacteria and bacterial products that can be
a reservoir of potential irritants. "he smear layer is a separate structure from
the underlying dentin and may crack open and pull away from the
underlying dentinal tubules. % situation like this could be harmful to the
foundation of gutta=percha obturated over the smear layer. Aence they
thought it best to remove the smear layer, though controversy still remains.
67M7#E#,S 78 ,HE SMEAR LAYER :
"hough the exact proportion of the composition is not certain.
)s composed of
i1 Brganic component.
ii1 )norganic component.
)norganic component is made up of tooth structure and some non=
specific inorganic components.
Brganic component consists of heated coagulated proteins -gelatin
formed by the deterioration of collagen heated by cutting temperatures1,
necrotic or viable pulp tissue, odontoblastic processes, Saliva, blood cells
and micro=organisms.
Ad!anta2es o1 s%ear layer :
'1 6eduction of dentin permeability to toxins and oral fluids.
51 6eduction of diffusion -usually inwards by convection and outwards
by hydrostatic pressure1 of fluids and prevents wetness of cut dentin
surface.
31 9acterial penetration of dentinal tubules is prevented.
0isad!anta2es o1 s%ear layer :
'1 )t may harbour bacteria, either from original carious lesion or saliva,
which may multiply taking nourishment from smear layer or dentinal
fluid.
51 Smear layer is permeable to bacterial toxins.
31 "he smear layer may prevent the adhesion of composite resin system,
bonding agents, ;), and polycarboxylate cements.
HYSI6AL BARRIER 87R BA6,ERIA A#0 0ISI#8E6,A#,S :
*hen pathologic changes occur in the dental pulp, the root canal
system can harbour several species of bacteria, their toxins and by products.
"hese bacteria are predominantly gram=negative anaerobes. "he
morphology of the root canals is very complex therefore the mechanically
prepared canals contain areas not accessible by endodontic instruments and
bacteria will be found more in number in these areas.
%vailable evidence shows that bacteria and its by products present in
infected root canals may invade the dentinal tubules. )nvestigators have
reported the presence of bacteria in the dentinal tubules of infected teeth at
approximately half the distance between the root canal walls and the
cemento=dentinal <unction. 9acterial penetration into the dentinal tubules is
seen upto '.& m. in the apical 5E3
rd
of the root. "hus even after
chemomechanical instrumentation of the root canal, some bacteria still
remain in the canal and dentinal tubules, for this reason, chemomechanical
cleansing is often supported by the use of disinfectants.
#rake et al showed that removal of the smear layer opened the
tubules, allowing bacteria to colonize in the tubules to a much higher degree
-'& fold1 compared with roots with an intact smear layer, removal of smear
layer facilitates passive penetration of bacteria. )t was shown that smear
layer delayed the penetration of proteus vulgaris but it was also found that
pseudomonas aeruginosa penetrated even thicker dentin slices by removing
the smear layer it self and by opening the orifices of dentinal tubules after
possible collagenase production. %. Fiscosus, corynebacterium spp. and S.
sanguis also digested the smear layer and facilitated their penetration. Smear
layer is permeable even to large molecules such as albumin. "herefore this
layer is not a strict barrier to bacteria.
%ccording to some authors the presence of smear layer may block the
antimicrobial effects of intracanal disinfectants into the tubules, various
medicaments have been proposed for disinfection of root canals, they are>
'1 "raditional phenolic or fixative agents like camphorated mono
chlorophenol -,M,21, formacresol and cresatin.
51 (on / phenolic compounds like iodine potassium iodide G calcium
hydroxide.
6esearchers found that in absence of smear layer, liquid camphorated
monochlorophenol disinfected the dentinal tubules rapidly and completely
but calcium hydroxide failed to eliminate enterococcus faccalis even after 8
days of incubation and hence concluded that smear layer did delay but not
abolish the action of the disinfectants. Aowever following removal of smear
layer, bacteria in dentinal tubules can be easily destroyed and in this way, it
may be beneficial to use lower concentrations of antibacterial agents since
all these agents show some degree of toxicity to viable host cells.
S%ear layer and %icrolea&a2e :
%n important consideration in endodontics is the ultimate seal of root
canals in order to prevent possible microleakage which may be the cause of
future failure of the root filling. 2repared dentin surfaces should be very
clean to increase the sealing efficiency of obturation. Smear layer on root
canal walls acts as an intermediate physical barrier and may interfere with
adhesion and penetration of sealers into dentinal tubules.
)nvestigators observed that plastic filling materials and sealers
penetrated into the dentinal tubules after removal of smear layer, and its
presence obstructed their penetration. "he penetration in smear free groups
ranged from @&=+&m."hey concluded that tubular penetration may increase
the interface between the filling and the dentinal structures and thus may
prevent leakage. Aowever there is no strong evidence to this statement.
2ashley et al observed extensive reticular network of micro=channels
with thickness of '=5&m around restorations that had been placed in
cavities with intact smear layer and this provided a passage for
microleakage to occur. "hey concluded that removal of smear layer
decreased microleakage but increased dentin permeability.
)n a recent study it was definitely shown that coronal leakage of root
canal filling was less in smear free groups than those with smear layer.
Microleakage in root canal is very complicated and many variables
may contribute to it like anatomy and instrumented size of the root canal,
irrigating solutions, root filling techniques, physical and chemical properties
of the sealers and the infectious state of the canal etc.
A9ical lea&a2e :
%ccording to $van et al, the use of in<ected thermoplasticized gutta=
percha should be accompanied by the use of sealer regardless of whether or
not the smear layer has been removed. 9ut :ennedy stated that an absence
of the smear layer causes less apical leakage than gutta=percha filled canal
with the smear layer intact. Ae also stated that the use of chelating agents on
the smear layer would increase apical leakage. Ae concluded that removal
of smear layer would improve gutta=percha seals if the master cones are
softened with chloroform and used with a sealer and lateral condensation,
technique.
"he greater the degree of canal preparation, the smaller the amount of
apical leakage.
)t is still inconclusive whether the presence of dentinal fillings or
plugs will enhance the seal of root canal filling as the dentinal plugs were
porous and permeable and apical leakage existed in some situations.
Sealers :
$ndodontic sealers act as a glue to ensure good adaptation of gutta=
percha to the canal walls. )f the smear layer is not removed then the gutta=
percha is not firmly attached to the dentin and the smear layer may laminate
off the canal wall and create a false seal, voids in the fill and an
environment for microleakage.
"he type of sealer used has different implications once the smear
layer has been removed. Cor example ;rossman sealer which is a powder
liquid combination, contains small particles in the powder that enter the
dentinal tubule orifices and create a secure interface between sealer and
canal wall, after the removal of smear layer, calcium hydroxide based
sealers promote the apposition of the cementum at the canal apex and seal it
off against microleakage by the formation of osteoid or dentoid type
material. ,irculation of blood is needed for the calcium ion to promote new
tissue thus the calcium hydroxide sealers are effective for sealing only at the
root apex. )f more cementum is going to form to create a better apical seal,
dentin chips at the apex of a root canal acts as a nidus for formation of hard
tissue. 9acterial contamination by the presence of a smear layer can prevent
this.
"here is no practical advantage to the use of auto cure unfilled resin
as a seal over the tubules before gutta=percha oburation, as the resin would
be susceptible to moisture though lateral canals and the apex and upon
polymerization the resin would shrink creating a gap between the fill and
the canal wall.
"he use of some dentin bonding agents to harden the smear layer to
the canal wall and to harden the apical plug is a sub<ect of research and is
doubtful that the bonding agent would be antimicrobial to the bacteria in the
smear layer.
ost ce%entation :
6emoval of smear layer increases the cementation bond and the
tensile strength of the cementing medium for post cementation.
;lass ionomer cements are effective in post cementation after smear
layer removal because the glass ionomer has better union with tooth
structure.
*hen the smear layer was removed by flushing with $#"% and
sodium hypochlorite rinse, the unfilled 9)S. ;M% resin -cementing media1
flowed into the exposed dentinal tubules and into serrations on the post,
improving retention vastly, and with the removal of smear layer and an
unfilled resin bonding agent, shorter posts can be used.
8unctional i%9lications :
1) 0ental %aterials :
"he presence of smear layer masks the underlying dentin matrix and
may interfere with the bonding of adhesive dental cements such as
polycarboxylates and glass ionomer that reacts chemically with the dentin
matrix. Hinc phosphate require dentin matrix for mechanical roughness to
aid in retention.
"he cements that react chemically to smear layer rather than the
matrix of sound intertubular dentin produce a weaker bond as the smear
layer can be torn away from the underlying matrix, and when these cements
are tested for tensile strength, the failure can be either adhesive -between
cement and smear layer1 or cohesive -between constituents of smear layer1.
"o increase the tensile strength of a cement dentin interface there are several
approaches>
'1 6emove the smear layer by etching with acids. "his procedure does
not in<ure the pulp if dilute acids are used for shorter periods of time ex>
etching dentin with +4 citric acid for +&secs removes all the smear layer
as does '.secs of etching with 384 phosphoric acid. "he advantages are
that the smear layer is entirely removed, the tubules are open and
available for increased retention and the surface collagen is exposed for
covalent linkage with new experimental primers for cavities.
"he disadvantage is that there is a physical barrier for bacterial
penetration and the permeability of dentin increases.
51 %nother approach would be to use a resin that would infiltrate
through the entire thickness of the smear layer and either bond to the
underlying matrix or penetrate into the tubules. "he impressive tensile
strength of Scotch bond is due to this process. "he bond is stronger
between resin and pumiced dentin that between resin and etched dentin.
6emoving smear layer with acid etching exposes surface collagen and
removes peritubular dentin from the top .='& m. of the tubules, yielding
a tubule with a funnel shaped orifice. )f the resin penetrates only into the
funneled portion of tubule rather than where the tubules are normal and
of uniform diameter then retention would be less due to diverging tubule
walls rather than normal parallel walls of unetched tubules. %dditionally,
acid etching demineralizes the surface which lowers the adhesive bond
between cement and minieralized dentin.
"he adhesive strength of clearfil resin to dentin with a smear layer
present was as high as polycarboxylate and glass / ionomer cement. $tching
dentin doubled the adhesion of clearfil resin to etched superficial dentin.
%cid etching and removal of smear layer increases the adhesive
strength of composite resin to superficial dentin by 0&& / '&&&4 over that
of deep dentin even though far more tubules are available for penetration of
resin. "his indicates that composite resins probably do not derive their
adhesiveness from penetration of resin into the tubules but rather by
interacting with mineralized intertubular dentin.
31 %nother approach is to fix the smear layer with gluteraldehyde or
tanning agents such as tannic acid or ferric chloride. "his increases the
cross linking of exposed collagen fibers within the smear layer and
between it and the matrix of the underlying dentin to improve its
cohesion.
@1 % fourth and most convenient approach is to remove the smear layer
by etching with acid and replace it with an artificial smear layer
composed of a crystalline precipitate. 9owen used this approach by
treating dentin with .4 ferric oxalate which replaces the original smear
layer with a new complex permitting extremely high bond strength to be
produced between resin and dentin.
E#0707#,I6S :
Smear layer might provide a reservoir of potential irritants. %lternate
use of sodium hypochlorite and $#"% is employed to remove smear layer.
"he sodium hypochlorite removes organic material and collagenous matrix
of dentin and $#"% removes mineralized dentin thereby exposing more
collagen.
6emoval of smear layer results in better adaptation of obturating
materials and sealers to dentin. ;oldman also demonstrated increased
tensile strength of plastic posts after smear layer removal as these is more
penetration of resin into the open dentinal tubules.
Restorati!e dentistry :
*hen cementing a casting or condensing amalgam and during normal
mastication there is considerable force or pressure applied to the tooth. "his
pressure is transferred to dentin which causes movement of dentinal fluid
and displacement of fluid into the pulp that might cause pain. "he presence
of smear layer can prevent this phenomenon to a certain extent.
In1luence on sensiti!ity and 9er%ea+ility o1 dentin :
Sensitivity of dentin is due to movement of fluid -hydrodynamic
theory of pain1 most of the resistance to the flow of fluid across dentin -0+4
of total resistance1 is due to the presence of smear layer. $tching dentin to
remove the smear layer greatly increases the ease with which fluid can
move across dentin. "his is accompanied by increased sensitivity of dentin
to osmotic, thermal and tactile stimuli.
"hough the smear layer is permeable to bacterial toxins and its by
products to a certain extent but it still reduces the permeability of bacteria as
compared to smear layer free area. "ransport of material across dentin can
be by 5 ways >
'1 #iffusion.
51 ,onvection.
)n diffusion, there is movement of substance from higher to lower
concentration and the concentration of the substance is dissipated over a
distance.
)n convection, movement of substance is due to a pressure gradient
but no dissipation of concentration occurs.
)t is shown that removal of smear layer increases dentin permeability
by diffusion by about .=+ times and convection by 5.=3+ times.
0i11erent treat%ent %odalities on s%ear layer :
'1 (o treatment of the smear layer at all eg= 26)SM%.
51 (o removal of smear layer, <ust partial demineralization.
31 ,omplete removal of smear layer.
@1 Modification of smear layer by keeping smear plugs intact.
.1 6emoval of natural smear layer and replacement by artificial smear
layer. eg / ferric oxalate.
Re%o!al o1 s%ear layer :
)rrigating solutions have been used during and after instrumentation
to increase cutting efficiency and flush away debris. "he efficacy of the
irrigating solution is not only dependent on the chemical nature of the
solution but also on the quantity and temperature, the contact time, depth of
penetration of the irrigating needle, type and gauge of the needle, surface
tension of the irrigating solution and age of the solution.
Sodiu% )y9oc)lorite :
"he organic tissue dissolving activity of (aocl is well known and its
increases with rising temperatures. Aowever, the capacity to remove smear
layer from instrumented canal has been found to be insufficient. )t produces
a superficially ,lean canal wall with smear layer present.
%lternating use of hydrogen peroxide and (aocl solutions that was
advocated in the past was no more effective than (aocl used alone. )t was
seen that the effect produced by (aocl was similar to that produced by
water. %dding surface active reagents also did not improve the situation.
6)elatin2 a2ents :
"he most common chelating solutions are based on ethylene diamine
tetra acetic acid -$#"%1 which reacts with calcium ions in dentin and forms
soluble calcium chelates.
)t was shown that $#"% decalcified dentin to a depth of 5& / 3& m.
in . min, but its chelating effect was almost negligible in the apical third of
root canals.
%nother preparation i.e. $#"% in combination with urea peroxide
-6,=prep1 was used to float the dentinal debris from the root canal but
despite further instrumentation and irrigation a residue of this mixture was
left on the canal walls which was a disadvantage in hermetic sealing of the
root canal.
% quarternary ammonium bromide -utrimide1 has been added to
$#"% -6$#"%1 solutions to reduce surface tension and increase
penetrability of the solution. *hen this combination was used during
instrumentation, there was no smear layer left except in the apical third of
the canal.
%nother combination used was $#"%, i.e. $#"% with cetavlon. )t
was seen that optimal working time of $#"%, is '.mins after which no
more chelating action takes place.
%nother root canal chelating agent is Salvizol / based on amino
quinaldinum diacetate. )t has surface acting properties similar to materials of
the quaternary ammonium group and possess the combined action of
chelation and organic debridement.
)t was shown that 6$#"% was the most efficient irrigating solution
in removing smear layer.
7r2anic acids :
,itric acid appeared to be an effective root canal irrigant and was
more effective than (aocl alone in removing the smear layer, it was also
better than polyacrylic acid, lactic acid and phosphoric acid but not $#"%.
)t was shown that canal walls treated with '&4, 5.4 and .&4 citric
acid solutions were free of smear layer, but the best results were with
sequential use of '&4 citric acid and 5..4 (aocl solution then again
followed by '&4 citric acid. )t was however observed that 5.4 citric acid /
(aocl group was not as effective as '84 $#"% / (aocl combination,
besides citric acid left precipitated crystals in the root canals which was a
hinderence during root canal obturation, with .&4 lactic acid, the canal
walls were generally clean but the dentinal tubules openings were not
completely patent.
%nother root canal irrigant cleanser used was 5.4 tannic acid. )t was
demonstrated that the canal walls irrigated with this solution appeared
significantly cleaner and smoother than the wall treated with a combination
of (aocl and hydrogen peroxide and that the smear layer was removed.
"he use of 5&4 polyacrylic acid was found as better than 6$#"%.
.4 and '&4 polyacrylic acids also removed smear layer but only in
accessible regions.
Sodiu% )y9oc)lorite and E0,A : (%et)od o1 c)oice)
"he purpose of irrigation is two folds>
a1 "o remove gross debris originating from pulp tissue and
bacteria =organic component.
b1 "o remove smear layer / inorganic component.
9ecause there is no single solution which has the ability to dissolve
organic tissues and to demineralize the smear layer, a sequential use of
organic and inorganic solvents have been recommended. Cor example the
alternate use of $#"% and (aocl for removal of smear layer and soft tissue
debris.
%ccording to a study it was found that the most effective working
solution was ..5.4 (aocl and the most effective final flush was '& ml of
'84 $#"% followed by '& ml of ..5.4 (aocl.
:ltrasonics :
%ccording to Matrin and ,unningham, a continuous flow of sodium
hypochlorite solution -5.@41 activated by ultrasound delivery system that
was used for preparation and irrigation of the root canal also produced
smear free root canal surfaces.
%hmad et al showed that with modified ultrasonic instrumentation
and '4 (aocl, smear layer could be removed.
)t was observed that the apical region of the canals 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. )t was seen that a 3=.min. )rrigation produced smear free
canal walls.
)n contrast to these results. )t has been found by other investigators,
that ultrasonic preparation was not able to remove the smear layer. "his
contradiction may be due to physical contact of the file with the canal wall
that reduced the acoustic streaming.
Lasers :
"akeda et al found that lasers can be used to vapourize tissues in the
main canal, remove the smear layer and eliminate residual tissue in the
apical portion of the root canals. $ffectiveness of lasers depends on many
factors including the power level, the duration of exposure, the absorption of
light in the tissues, the geometry of the root canal and the tip target distance.
"akeda et al using the erbium / yttrium / aluminium / garnet -$r>
I%;1 laser demonstrated optimal removal of smear layer without the
melting, charring and recrystallization associated with other laser types like
neodymium / yttrium / aluminium garnet -(d>I%;1 laser, carbon dioxide
laser, organ fluoride excimer laser and organ laser. %lthough there was
removal of smear layer it showed destruction of peritubular dentin. "he
main difficulties with lasers is the access to small canals as only large
probes are available for delivery of laser beam.
,B(,?US)B( >
"he problem of smear layer is yet a controversy. "o keep it or
remove it is still a problem , the solution of which still eludes us. )t is upto
the dentists <udgement , knowledge and understanding to treat the smear
layer or not.


Introduction :
History
0e1inition o1 s%ear layer :
4)at is s%ear layer 5
,BM2B($("S BC "A$ SM$%6
?%I$6 >
Ad!anta2es o1 s%ear layer :
0isad!anta2es o1 s%ear layer :
HYSI6AL BARRIER 87R BA6,ERIA A#0 0ISI#8E6,A#,S
S%ear layer and %icrolea&a2e
A9ical lea&a2e
Sealers :
ost ce%entation
8unctional i%9lications :
1) 0ental %aterials
E#0707#,I6S :
Restorati!e dentistry :
In1luence on sensiti!ity and 9er%ea+ility o1 dentin :
0i11erent treat%ent %odalities on s%ear layer
6emoval of smear layer
,B(,?US)B( >