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PubMed2001

Antimicrobial activity of Ca(OH)2 containing pastes with Enterococcus faecalis in vitro.

Sixty-eight standardized human root specimens were infected with Enterococcus faecalis for 3 wk after removal of the smear layer. After 3 wk of infection, the smear layer was reformed and in half of the specimens, the smear layer was again removed. Aqueous Ca(OH)2 paste and silicone oil based Ca(OH)2 paste were used as the test medications. The specimens were divided into four groups (i.e. (a) nonsmeared aqueous calcium hydroxide group, (b) nonsmeared silicon oil-based calcium hydroxide group, (c) smeared aqueous calcium hydroxide group, and (d) smeared silicon oil-based calcium hydroxide group. Medications were placed in the canals for 7 days. After removal of medications dentin chips were collected and incubated. The quantity of bacteria present was assessed. All calcium hydroxide pastes were effective in the elimination of bacteria in the dentinal tubules, except in the smeared group with silicone oil-based calcium hydroxide.

Calcium Hydroxide↗
PubMed2005

Comparative study of the sealing ability of a polydimethylsiloxane-based root canal sealer.

The purpose of this study was to compare the sealing ability of three root canal sealers, RSA (polydimethylsiloxane sealer), Endion (glass-ionomer sealer) and Topseal (epoxy resin sealer), with and without smear layer removal. Ninety extracted human teeth were selected and assigned to 6 groups (n=15), according to the following protocols: in 3 groups, the smear layer was left intact and the root canals were obturated with gutta-percha points and RSA, Endion and Topseal, respectively; in the other 3 groups, the smear layer was removed and the root canals were obturated in the same way as described above. Microleakage was measured at 7 days, 1 month and 2 months, using the fluid transport model. The results were expressed in microL/24 h. Data were analyzed statistically by Kruskall-Wallis and Mann-Whitney non-parametric tests. The results showed that the Topseal group without smear layer leaked significantly less (p<0.05) than the RSA group without smear layer, at all experimental periods. No statistically significant differences (p>0.05) were found among the other groups, at the established evaluation intervals. The findings of this study showed that the polydimethylsiloxane sealer (RSA) did not yield better sealing ability than the other sealers, either in the presence or in the absence of smear layer. Topseal had the least microleakage from the root canal sealers evaluated.

Chelating Agents↗
PubMed2002

A comparison of techniques for assessment of coronal dye leakage.

This study was designed to compare different techniques for coronal dye leakage testing. One hundred and fifty extracted human anterior teeth were fully instrumented and randomly divided into two experimental groups of 60 teeth each, plus two groups of 15 teeth each for positive and negative controls. One group was rinsed with 5.25% NaOCl (smear layer intact), whereas the other group was flushed with 17% EDTA and 5.25% NaOCl (smear layer removed). Roots were obturated with gutta-percha using lateral condensation and AH Plus as root canal sealer. Each experimental group was divided into three subgroups of 20 teeth each for three methods of testing coronal dye leakage: passive dye penetration, penetration with vacuum applied, and fluid filtration methods. The teeth were left in 100% humidity at 37 degrees C for 5 days before being immersed in Indian ink for 2 days and cleared. The linear extent of dye penetration was measured. Mean depth of leakage for the groups with the smear layer intact was 2.5 +/- 1.0 mm for passive dye penetration, 6.7 +/- 2.8 mm for vacuum dye penetration, and 3.0 +/- 1.1 mm for fluid filtration dye penetration. In the group in which the smear layer was removed, the mean depths of leakage were: 3.2 +/- 2.1 mm for passive dye penetration, 5.8 +/- 2.8 mm for vacuum dye penetration, and 3.4 +/- 2.1 mm for fluid filtration. The vacuum method resulted in significantly (p < 0.05) more dye penetration than fluid filtration and passive dye penetration. The presence or absence of smear layer had no statistically significant effect (p > 0.05) on any of the leakage testing techniques.

Analysis of Variance↗
PubMed1993

Quantitative contribution of resin infiltration/hybridization to dentin bonding.

This study determined, quantitatively, the role of resin infiltration in dentin bonding. Four groups contained 10 molar teeth. Thirty were sectioned in the mid-coronal region and the dentin ground flat with 600 grit silicon carbide paper. Group 1: smear layer intact; Group 2: smear layer removed with a Prophy Jet; Group 3: conditioned with 10% H3PO4 for 20 seconds; Group 4: comprised dentin exposed by a transverse, mid-coronal fracture. Dentin surfaces were treated with All-Bond 2, its companion bonding agent, followed by P50 resin composite, polymerized in 1 mm increments. After storage in water at 37 degrees C for 24 hours, the assemblies were tested to failure in a shear mode at a crosshead speed of 5 mm/minute. Surface and interfacial morphology was characterized using SEM. Values in MPa were: Group 1: 10.24 +/- 2.98; Group 2: 20.37 +/- 4.62; Group 3: 32.68 +/- 7.12; and Group 4: 26.77 +/- 4.85. ANOVA and student t-test showed the means statistically different (P < 0.05). Since resin penetration was only found appreciably in dentin tubules in Group 4 and tubular and intertubular penetration in Group 3, it was concluded that resin infiltration can contribute approximately one third of the shear bond strength of this total etch system.

Acid Etching, Dental↗
PubMed1994

Assessment of coronal leakage in teeth root filled with gutta-percha and a glass of ionomer root canal sealer.

The effect on coronal leakage of the use of either a single gutta-percha cone or cold lateral condensation of gutta-percha, with a glass ionomer sealer cement was studied. In addition, the effect of the removal of the smear layer was also determined. Eighty-eight single-rooted teeth were prepared chemomechanically using hand files, with the balanced force technique. Lubrication was provided by either Hibiscrub (maintaining the smear layer) or an EDTA-containing paste (to remove the smear layer). Copious irrigation was carried out with 2.2% sodium hypochlorite. The teeth were allocated randomly to four groups of 20 teeth each, the remaining eight teeth served as controls. Two groups of teeth, one with and one without smear layer, were obturated with either a single gutta-percha cone or cold laterally condensed gutta-percha, with Ketac Endo as the sealer. The teeth were stored for 6 weeks, thermocycled, and the extent of coronal leakage determined for each group after immersion in India ink for 90 h. The teeth were demineralized, dehydrated and immersed in methyl salicylate, which rendered them transparent. Linear measurement of maximum dye penetration was recorded. The mean depth (+SD) of leakage for the groups in which the smear layer was left intact was 1.68 mm (+0.38) for the single cone (A1) and 2.29 mm (+1.58) for lateral condensation (B1). When the smear layer was removed the mean depth of leakage for the single cone group (A2) was 2.04 mm (+0.73) and 2.37 mm (+1.70) for the laterally condensed group (B2). There was no significant difference in coronal leakage between the groups (P > 0.05).

Dental Leakage↗
PubMed1993

In vitro cleaning ability of root canal irrigants with and without endosonics.

A variety of methods have been used to evaluate the cleanliness of root canals after endodontic preparation and irrigation. Few irrigation agents other than sodium hypochlorite (NaOCl) have been tested in conjunction with endosonics. The purpose of this study was to examine the cleaning ability of water, NaOCl, Hibiscrub and a biological washing liquid when used as intracanal irrigants, with and without endosonics. Two methods of evaluation were employed to assess the root canal cleanliness after endodontic preparation. A total of 56 teeth, divided into eight groups, were prepared manually using the step-down technique. Each irrigating agent was used in two experimental groups, with and without endosonics. Two additional teeth which received neither instrumentation nor irrigation served as the controls. The teeth were split longitudinally and the state of cleanliness of the root canal was assessed by scoring the amount of stained organic debris and smear layer. It was demonstrated that the results of debris and smear layer scoring were significantly influenced by the type of irrigant and whether endosonics had been used. All agents exhibited similar cleaning ability when introduced manually. With endosonics, NaOCl yielded significantly less stainable debris (P < 0.05) than the other groups which showed no significant difference. The ability to remove the smear layer was enhanced, but at some distance short of the working length, by endosonics for all irrigants tested. None of the solutions tested was able to produce a canal wall that was free of smear layer.

Chi-Square Distribution↗
PubMed2004

Lactic acid root canal irrigation for dowel and core treatment: a pilot study.

STATEMENT OF PROBLEM: Various solutions used to irrigate root canals and remove the smear layer prior to obturation of a root canal affect surface topography and may influence the sealing ability of endodontic therapy, retention of endodontic dowels, and restoration survival. PURPOSE: This study microscopically evaluated the effects of varying dilutions of lactic acid on the removal of the smear layer created by hand instrumentation in the coronal, middle, and apical thirds of root canals. Lactic acid solution was compared with other solutions deemed to be suitable root canal irrigants. MATERIAL AND METHODS: Thirty-five extracted human single-rooted teeth were manually shaped with files (K-flex) using the step-back technique. ISO size 50 files were used as master apical files. The teeth were equally divided into 7 test groups according to the canal irrigant used. While the teeth were cleaned and shaped, the root canals were irrigated with 3 mL of 1 of the following irrigants between each file size and as a final flush: no irrigant (control), 5% hydrogen peroxide, 5% sodium hypochlorite, a combination of 5% hydrogen peroxide and 5% sodium hypochlorite, 15% ethylenediaminotetraacetic acid (EDTA), 10% lactic acid, or 20% lactic acid. Specimens were critical-point dried and freeze-fractured for scanning electron microscope analysis at 3 sites (cervical, middle, and apical). RESULTS: Scanning electron micrographs showed no differences between the cervical, middle, and apical levels of the specimens tested with any of the irrigants used. Also, no difference was found within individual groups. The surface of the control specimens had a smear layer that contained smear plug material. Hydrogen peroxide and sodium hypochlorite used separately and in combination consistently produced surfaces with a smear layer. Lactic acid solutions and EDTA, however, removed the dentinal smear layer but left remnants of smear plugs in the dentinal tubules. CONCLUSIONS: Within the limitations of this study, differences related to the type of irrigant used were found in the characteristics of the pulpal dentin surface. Although lactic acid effectively cleaned and smoothed the dentin walls of root canals of endodontically prepared teeth, further study is needed before this procedure can be recommended for routine clinical use.

Chelating Agents↗
PubMed2001

Effectiveness of oxidative potential water as a root canal irrigant.

AIM: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigant, based on its ability to remove the smear layer and/or debris from instrumented root canals. METHODOLOGY: One hundred and twenty root canals from extracted human maxillary incisors were instrumented using a conventional step-back technique with irrigation from sodium hypochlorite (NaOCl) or oxidative potential water (OPW). After instrumentation, the canals were irrigated by syringe or ultrasound using 15% EDTA or OPW as an irrigant. The volume of each irrigant used for syringe irrigation was 10, 20, and 30 mL, respectively, whilst the duration for ultrasonic irrigation was 1, 3, and 5 min, respectively. After irrigation, each root was split longitudinally in two with cutting pliers, and the specimens were prepared for SEM observation. The presence of debris and smear layer on each canal wall was assessed using a three-point scale for each parameter. RESULTS: Smear layer was effectively removed with EDTA both introduced via syringe and via ultrasonic irrigation. A similar effect was observed with OPW via syringe irrigation following instrumentation with 5% NaOCl. The canal walls in any of these cases showed open and patent dentinal tubules following smear layer removal. Some specimens irrigated with EDTA exhibited the effect of demineralization on the dentine resulting in funnelling of tubule orifices. Syringe irrigation was more effective in smear layer removal, except for ultrasonic irrigation with 15% EDTA, whilst ultrasonic irrigation was more effective in debris removal including the use of OPW as irrigant following instrumentation with 5% NaOCl. Neither syringe nor ultrasonic irrigation with OPW following instrumentation with OPW removed smear layer or debris effectively. CONCLUSIONS: The most effective irrigation technique for smear removal was 15% EDTA irrigation by means of syringe following instrumentation with 5% NaOCl solution. However, the most effective irrigation technique for debris removal was ultrasonic irrigation regardless of irrigant used. OPW irrigation by means of syringe following instrumentation with 5% NaOCl showed a similar effect to that of 15% EDTA irrigation for removal of smear layer and debris.

Anti-Infective Agents, Local↗
PubMed2006

The effectiveness of different acid irrigating solutions in root canal cleaning after hand and rotary instrumentation.

The goal of this study was to evaluate the cleaning ability of three acid irrigating solutions after hand and rotary instrumentation. Eighty human teeth were randomly divided in eight groups. Four groups were prepared with hand instrumentation and other four with ProTaper. The irrigating solutions were 15% citric acid plus 2.5% NaOCl; 15% EDTA plus 2.5% NaOCl; 5% orthophosphoric acid plus 2.5% NaOCl; and 2.5% NaOCl alone as control. Canal walls were observed with scanning electron microscopy, and photomicrographs were taken in apical, middle, and coronal thirds. A scoring system for debris and smear layer was used. Acid solutions with 2.5% NaOCl were effective in the elimination of smear layer or debris, and no significant differences were showed in smear layer removal between techniques. However, 2.5% NaOCl did not remove smear layer or debris, and no significant differences in debris were observed between manual and rotary techniques.

Acids↗
PubMed1994

Bonding to ground dentin by a phenyl-P self-etching primer.

Increasingly higher concentrations of Phenyl-P in 30% HEMA were used as dentin conditioners to improve the bonding of adhesive resins to smear layers. The maximum bond strength (10.4 MPa) was obtained at a concentration of 20% Phenyl-P. Transmission electron microscopy of fractured, lightly smeared, and compactly smeared dentin demonstrated that 20% Phenyl-P in 30% HEMA demineralized the dentin surface by partially dissolving mineral crystals from around collagen. When applied to smear layers, this resin system demineralized the smear layer and incorporated it into the applied resin which penetrated a short distance into the underlying dentin, thereby creating a hybrid layer that contained the original smear layer. This single-step conditioner/primer offers several advantages over previous bonding systems by permitting a single solution to serve as both a conditioner and a primer.

Animals↗
PubMedDate not supplied

Influence of adhesive systems on interfacial dentin gap formation in vitro.

PURPOSE: This study measured: 1) the interfacial dentin gap formation (IGW) of 2 etch & rinse and 3 self-etch systems with different degrees of acidity and determined the correlation between the smear layer thickness and interfacial gap formation after 1 day and 6 months water storage; 2) the hybrid layer thickness (HLT) produced by the adhesives applied under different smear layer thicknesses. METHODS AND MATERIALS: Three self-etch adhesives, a mild (Clearfil SE Bond; SE), a moderate (Optibond Solo Plus Self-Etch Primer; SO) and a strong (Tyrian Self Priming Etchant + One Step Plus; TY), and 2 etch & rinse systems (Single Bond; SB and Scotchbond Multi-Purpose Plus; SBMP) were studied. After flat grinding of the occlusal surfaces, 30 molars were sectioned longitudinally in 2 halves. Dentin surfaces with thick and thin smear layers were obtained for each tooth after polishing different sections on 60- and 600-grit SiC paper, respectively. A resin composite (Z250) build-up was made on each tooth section after randomized application of the adhesives. After 24-hour storage in water, resin-dentin bonded sticks (0.8 mm2) were prepared and divided for 1-day and 6-month measurements. The IGW was measured in a stereomicroscope under 400x. SEM micrographs were also made in order to measure the HLT provided by each adhesive. RESULTS: The thickness of the smear layer did not influence the mean gap width (p>0.05). The etch & rinse systems showed the lowest mean IGW in the 1-day group. Their IGW remained unchanged after 6 months. The self-etch systems showed wider initial IGW, which diminished after 6 months water storage, to sizes similar to the etch & rinse systems. The hybrid layer was thicker when bonded to #60 SiC-treated dentin; however, this difference was only statistically different for the 3-step etch & rinse system (p=0.001). The thickest hybrid layers were observed for the 2 etch & rinse adhesive systems and the thinnest for the mild self-etch. A negative and strong correlation between IGW and HLT was observed for the self-etching adhesive systems tested (r=80.2, p=0.01).

Bisphenol A-Glycidyl Methacrylate↗
PubMed2004

The influence of vinegars on exposure of dentinal tubules: a SEM evaluation.

Dentin hypersensitivity is a common painful condition observed in clinics. Dietary habits have been much associated with its development and persistence during and following periodontal treatment. The aim of this in vitro study was to evaluate the influence of vinegars on the removal of smear layer and exposure of dentinal tubules. Extracted human teeth were submitted to manual scaling with Gracey curettes in order to remove the cementum as well as to form a smear layer. Dentin samples with 3 mm(2) were obtained and distributed into six experimental groups: one control and five types of vinegars (alcohol, apple, rice, white wine and balsamic). Each group included two methods of vinegar application: topical and friction. After routine preparation for SEM analysis, photomicrographs were assessed by a calibrated and blind examiner using an appropriate index system. Kruskal-Wallis test indicated a significant influence of vinegars on smear layer removal. There was a statistically significant difference between groups treated with apple, white and rice vinegars and the control group (p < 0.05). Nevertheless, Mann-Whitney test indicated that removal of smear layer did not vary with the method of application (topical versus friction) for any of the tested substances. We can conclude that the contact of vinegar may remove smear layer and expose dentinal tubules, regardless of the type of application. However, balsamic vinegar was associated with less removal of smear layer after both methods of application.

Acetic Acid↗
PubMed2004

Appearance of the root canal walls after preparation with NiTi rotary instruments: a comparative SEM investigation.

The aim of this study was to evaluate, in vitro, with scanning electron microscope (SEM), the appearance of root canal walls shaped by three different rotary NiTi techniques and one conventional manual technique in human extracted teeth. Four different instruments were used: K3, Hero 642, RaCe and K-file. Each sample was irrigated with 5 ml of 5% NaOCl and 5 ml of 3% H2O2 and EDTA, Rc-Prep (1 ml). Each sample was prepared for SEM observation and analyzed in the coronal, middle and apical third, comparing its aspect with a predefined scale of four different parameters: presence of smear layer, pulpal debris, inorganic debris and surface profile. The apical third showed significantly more pulpal and inorganic debris, smear layer and a high number of surface profile irregularities. No significant difference was found at the coronal, middle and apical thirds between manual and rotary techniques for inorganic debris, smear layer and surface profile. Much pulpal debris were found in the apical third for K3 and RaCe compared with Hero 642 and K-file. In conclusion, mechanical rotary techniques with NiTi instruments produced quite similar results compared with a conventional manual technique using K-files. The present study demonstrated that dentin and pulpal debris, the morphology of smear layer and surface profile were only partially influenced by the type of endodontic instruments. The apical third was the anatomical area with greater amount of debris and smear layer.

Analysis of Variance↗
PubMed1989

The relationship between dentin bond strengths and dentin permeability.

The relationship between dentin permeability and the shear bond strength of Scotchbond/Silux was investigated. In the presence of a smear layer, there was no correlation between dentin permeability and dentin bond strengths. After removal of the smear layer with acids, there was an inverse relationship between dentin permeability and dentin bond strength. The bond strengths were high when dentin permeability was low and decreased as dentin permeability increased. Creation of smear layers with abrasive paper or dental burs reduced permeability by 80-85%. When Scotchbond/Silux bonds were made to such smear layers and then broken, the permeability of the dentin remained low. If the smear layer was removed by acid-etching prior to bonding, the permeability increased. When these bonds were broken, the permeability of the dentin remained elevated.

Adolescent↗
PubMed1997

Demineralization of resected root-ends with methylene blue dye.

OBJECTIVES: This study evaluated the ability of methylene blue solutions of different concentration, pH, and time exposure to remove the smear layer from resected root-ends. STUDY DESIGN: Resected root-ends were treated with either 2% methylene blue dye for intervals of 5 to 11 minutes or 1% methylene blue for 7 to 9 minutes and examined with a scanning electron microscope for smear layer removal. Two minute applications of saline solution and 50% citric acid served as controls. RESULTS: All methylene blue solutions were found to be ineffective in removing the smear layer at all time intervals tested. An experimental solution of 1% methylene blue in 50% citric acid was found to predictably remove the smear layer during a 2 minute application and retained all the favorable staining characteristics of the dye. Fifty percent citric acid solutions applied for 3 minutes appeared to overdemineralize the root-end and gave poorer results than 2 minute applications. CONCLUSIONS: Smear layer removal was pH dependent. Methylene blue solutions are clinically unsuitable for smear layer removal.

Adult↗
PubMed1996

Morphological field emission-SEM study of the effect of six phosphoric acid etching agents on human dentin.

OBJECTIVES: This study evaluated the effects of six phosphoric acid-etching agents on dentin, the independent variables being two acid concentrations (10% and 32%-37%) and three thickener conditions (no thickener, silica, and polymer). The tested hypothesis was that the use of different etchants with similar concentrations of phosphoric acid would result in similar depths of dentin demineralization. METHODS: Thirty dentin disks were obtained from extracted human teeth by microtome sectioning. The dentin surfaces were etched with one of the etching agents, fixed, dehydrated and dried. The specimens were observed using a FE-SEM. The mean deepest demineralization of intertubular dentin was measured from fracture surfaces of the disks. These values were analyzed by ANOVA and Duncan's Test. The morphological appearance of the dentin surfaces was compared using the following observation criteria: 1) Presence of a cuff of peritubular dentin; 2) Relative thickness of the layer containing residual collagen or smear layer particles; and 3) Formation of a submicron hiatus at the bottom of the exposed collagen network. The pH of each of the etching agents was measured. A correlation analysis was made of the pH vs. the depth of dentin demineralization. RESULTS: Silica-thickened etchants did not demineralize dentin as deeply as did polymer-thickened etchants and unthickened etchants. High magnifications revealed three distinct zones within the demineralized dentin layer; an upper porous zone of residual smear layer or denatured collagen and residual silica particles (in groups etched with silica-thickened etchants), an intermediate area with randomly oriented collagen fibers, and a lower zone with submicron hiatus, few collagen fibers, and scattered hydroxyapatite inclusions. This hiatus was observable in all the specimens etched with the polymer-thickened etchants, in 90% of the specimens etched with the unthickened phosphoric acid liquids, and in 60% of the specimens etched with the silica-thickened gels. SIGNIFICANCE: The results obtained suggest that similar concentrations of phosphoric acid etchants containing distinct thickeners result in different demineralization depths as well as different morphology of etched dentin.

Acid Etching, Dental↗
PubMed1986

The effects of calcium hydroxide on dentin permeability.

Calcium hydroxide paste was applied to human dentin in vitro to determine its effects on dentin permeability. Discs of dentin were acid-etched on both sides to permit determination of their maximum permeability. Smear layers were then applied to the enamel sides of the discs, thereby reducing dentin permeability 99%. Topical application of Ca(OH)2 paste to the smear layer reduced dentin permeability further, to levels 48% below that of untreated smear layers. When the Ca(OH)2-treated smear layers were exposed to 6% citric acid for two min, dentin permeability returned to the initial acid-etched value, demonstrating that Ca(OH)2 offers little protection to acid challenge. Treatment of acid-etched dentin with Ca(OH)2 produced a similar reduction in dentin permeability, which was restored to normal following acid challenge. Thus, Ca(OH)2 is effective at reducing the permeability of both the smear layer and of acid-etched dentin, in vitro.

Acid Etching, Dental↗
PubMed1993

An in vitro study of dentinal tubule occlusion by ferric oxalate.

This study examined ferric oxalate's ability to occlude dentinal tubules both in the presence of a smear layer and after its removal. Radicular dentinal chips were prepared with a smear layer created from a high speed carbide bur. The dentinal chips were then grouped as follows: 1) those with the smear layer remaining intact; 2) those sonicated for 7 minutes; 3) those treated with 10% tetracycline HCl; 4) those treated with 0.5M EDTA; 5) those treated with 20% citric acid; or 6) those treated with saturated citric acid. Six percent ferric oxalate was applied for 1 minute to the dentinal chips under blinded conditions. The chips were examined under SEM and the number of small and large crystals formed were counted. The results indicate that a decrease in the number of small crystals occurs following pretreatment of the smear layer by chemical means. An increased variability in size and shape of the crystals is also observed when no chemical pretreatment is used. Thus, relative to the number of crystals that form, no chemical pretreatment of radicular dentin is indicated prior to application of ferric oxalate in the treatment of root sensitivity.

Analysis of Variance↗