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A comparative SEM study of smear layer removal by detergents and EDTA on the root surface.

The present study performed an SEM evaluation of the efficiency of the following detergents on smear layer removal on the root surface: sodium lauryl sulphate, Plax, castor oil, and EDTA 24%. Sodium lauryl sulphate did not remove the smear layer and showed the worst results of all detergents tested. Plax and castor-oil detergents showed similar results represented by partial removal of the smear layer; these results were better than those obtained in the control (physiologic serum) and sodium lauryl sulphate groups. Neutral EDTA 24% was the most efficient detergent for smear layer removal.

Benzoates↗

The influence of the dentin smear layer on adhesion: a self-etching primer vs. a total-etch system.

OBJECTIVE: To determine the effect of dentin smear layers created by various abrasives on the adhesion of a self-etching primer (SE) and total-etch (SB) bonding systems. METHODS: Polished human dentin disks were further abraded with 0.05 micro m alumina slurry, 240-, 320- or 600-grit abrasive papers, # 245 carbide, # 250.9 F diamond or # 250.9 C diamond burs. Shear bond strength (SBS) was evaluated by single-plane lap shear, after bonding with SE or SB and with a restorative composite. Smear layers were characterized by thickness, using SEM; surface roughness using AFM; and reaction to the conditioners, based on the percentage of open tubules, using SEM. RESULTS: Overall, SBS was lower when SB was used than when SE was used. SBS decreased with increasing coarseness of the abrasive in the SE group. Among burs, the carbide group had the highest SBS, and 320- and 240-grit papers had SBS close to the carbide group. Surface roughness and smear layer thickness varied strongly with coarseness. After conditioning with SE primer, the tubule openness of specimens abraded by carbide bur did not differ from 240- or 320-grit paper, but did differ from the 600-grit. SIGNIFICANCE: Even though affected by different surface preparation methods, SE yielded higher SBS than SB. The higher SBS and thin smear layer of the carbide bur group, suggests its use when self-etching materials are used in vivo. Overall, the 320-grit abrasive paper surface finish yielded results closer to that of the carbide bur and its use is recommended in vitro as a clinical simulator when using the SE material.

Aluminum Oxide↗

A new solution for the removal of the smear layer.

Various organic acids, ultrasonic instruments, and lasers have been used to remove the smear layer from the surface of instrumented root canals. The purpose of this study was to investigate the effect of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) as a final rinse on the surface of instrumented root canals. Forty-eight extracted maxillary and mandibular single-rooted human teeth were prepared by using a combination of passive step-back and rotary 0.04 taper nickel-titanium files. Sterile distilled water or 5.25% sodium hypochlorite was used as intracanal irrigant. The canals were then treated with 5 ml of one of the following solutions as a final rinse: sterile distilled water, 5.25% sodium hypochlorite, 17% EDTA, or a new solution, MTAD. The presence or absence of smear layer and the amount of erosion on the surface of the root canal walls at the coronal, middle, and apical portion of each canal were examined under a scanning electron microscope. The results show that MTAD is an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when canals are irrigated with sodium hypochlorite and followed with a final rinse of MTAD.

Chelating Agents↗

A new method for studying the adhesion of Candida albicans to dentin in the presence or absence of smear layer.

OBJECTIVES: The purpose of this study was to develop a reproducible, quantitative model of Candida albicans adhesion to human dentin through the use of a colorimetric method and to evaluate the effect of smear layer on candidal adhesion. STUDY DESIGN: Dentin disks with or without smear layer were incubated with C albicans (10(8) cells/mL) for 4 hours. After incubation, the disks were exposed to an (2,3)-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl]-2H-tetrazolium hydroxide-coenzyme Q solution for 2 hours. The color of (2,3)-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl]-2H-tetrazolium hydroxide formazan in the supernatant was determined spectrophotometrically at 492 nm. To relate formazan formation to cell numbers, standard curves were generated with known numbers of yeast cells without dentin. The number of adherent cells per square millimeter was then calculated. RESULTS: The number of attached C albicans cells was 2.4 x 10(4) per square millimeter in dentin with smear layer and 1.5 x 10(4) in dentin without smear layer (P <.05). CONCLUSION: (2,3)-Bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl]-2H-tetrazolium hydroxide assay is a potential microbiologic tool for the quantitative determination of Candida adhesion to human dentin.

Candida albicans↗

The effects of acid application on the dentine surface smear layer: an S.E.M. study.

In this study, the effect of citric acid and LIV CENERA Liquid (40% poly-acrylic acid) on the smear layer of the dentine surface was investigated. Twelve freshly extracted, non-carious human molar teeth were used and approximately 25 mm2 flat occlusal dentine surfaces were prepared. Citric acid and LIV CENERA Liquid were applied for 10 and 30 seconds to the dentine surfaces. The results of our study indicated that: 1. Conditioning with LIV CENERA Liquid for 10 seconds was not effective in removing the smear layer on the dentinal tubules but application for 30 seconds was partially effective. 2. Although 10 seconds application of citric acid was not effective in removing the smear layer, 30 seconds application removed it completely, but harmful effects were observed on the dentinal tubules. 3. Conditioning with citric acid is more effective than the application of LIV CENERA Liquid in removing the smear layer, but LIV CENERA Liquid in contrast to citric acid application, did not enlarge the dentinal tubules.

Acid Etching, Dental↗

Effect of smear layer on coronal microleakage.

The purpose of this study was to examine the effect of smear layer on coronal microleakage. Fifty-two single-rooted extracted human teeth with a straight root canal were chemomechanically prepared and equally divided into experimental groups A and B. The teeth in group B were treated with ethylenediamine tetraacetic acid and sodium hypochlorite to remove the smear layer. All teeth in the experimental groups were next obturated with gutta-percha and sealer. Finally they were tested for dye leakage with methylene blue. Linear and volumetric measurement of dye penetration was used to assess leakage. The results of this study suggest that the removal of smear layer significantly improves the tightness of the sealing in the coronal area.

Coloring Agents↗

Effect of smear layer and direction of dentinal tubules on osteoblast adhesion to human dentin tissue.

The purpose of this study was to investigate the effect of smear layer and direction of dentinal tubules on osteoblast adhesion to human dentin tissue in vitro. Dentin disks were made from human premolars extracted for orthodontic reasons. Dentin disks were cut either perpendicularly to the long axis of the tooth or at 45 degrees to the long axis of tooth. The smear layer was removed by 34% phosphoric acid gel from half of the dentin disk surface. Human osteoblast-like Saos-2 cells were grown in RPMI medium with 10% fetal bovine serum and 1% antibiotic/antimycotic cocktail under standard cell culture conditions. Cells were seeded into Nunc four-well culture plates at 1.5 x 10(5) cells per well with dentin disks in the bottom of each well. After 1 day in culture the dentin disks along with cells grown on their surface were examined with a scanning electron microscopy. Osteoblasts attached and spread on the dentin surface and formed a monolayer in the presence and absence of a smear layer. Cells spread over the dentinal tubules despite their direction. These results suggest that cell adhesion and spreading of osteoblasts is not influenced either by the existence of a smear layer or the direction of the dentinal tubules on the dentin surface.

Acid Etching, Dental↗

Smear layer production by 3 rotary reamers with different cutting blade designs in straight root canals: a scanning electron microscopic study.

OBJECTIVES: The design of the cutting blade of rotary instruments may affect the outcome of root canal instrumentation in terms of cleanliness. The aim of this scanning electron microscopic study was to compare the quality and amount of smear layer generated in the apical third of straight root canals by 2 rotary nickel-titanium reamers and 1 rotary steel reamer with different cutting blade designs. STUDY DESIGN: Seventy intact, single-rooted human mandibular premolars with straight, fully developed roots were selected for this study. Before instrumentation, the cervical portion of all teeth was removed by using a microtome (Isomet), leaving 13-mm-long roots. Automated preparation was performed with ProFile (n = 20) and Hero 642 (n = 20) reamers by using the crown-down technique and with a stainless steel engine reamer (Mani; n = 20) by using a reaming motion. All root canals were instrumented to No. 40. A control group (pulp extirpation with barbed broaches; n = 10) was also included. Irrigation with 3 mL of a 1% sodium hypochlorite (NaOCl) solution was performed after each instrumentation. After the instrumentation, each root was split longitudinally, and a scanning electron microscope was used to examine the selected areas of the canal walls at the apical third from 2 different perspectives. A 4-category scoring system for smear layer was used, and the resulting scores were statistically analyzed. RESULTS: The least smear layer remained in the Hero 642 group at the selected apical third of straight root canals (P < .05). However, all instruments left a smear layer. The surface texture of the smear layer, in addition to the depth and the frequency of packed materials into the dentinal tubules, varied with instrument type. CONCLUSION: These data revealed that the design of the cutting blade of rotary instruments can affect root canal cleanliness in straight root canals. This information may be useful in the selection of nickel-titanium rotary reamers.

Dental Alloys↗

[Clinico-pathological studies on the effects of pulp protection (lining) under the condition with and without smear layers].

Many studies have been made of pulpal reactions to pulp protection (lining) materials have always employed a smear layer between the dentin wall and the lining materials. In this study, the author has attempted to evaluate pulpal response without a smear layer and compared effects of pulp protection (lining) with and without smear layers. Materials and methods. The experiment employed 84 vital human teeth ranging in age from 14 to 54 years. The experimental teeth were divided into 4 groups for the purposes of histopathological studies and scanning electron microscope (SEM) observation. Group C: No EDTA-treatment and lining with gutta-percha temporary material, 10 cases for histopathological study and 4 cases for SEM observation. Group TC: EDTA-treatment and lining with gutta-percha temporary material, 10 cases for histopathological study and 4 cases for SEM observation. Group P: No EDTA-treatment and lining with Protect Cement. 20 cases for histopathological study and 8 cases for SEM observation. Group TP: EDTA-treatment and lining with Protect Cement. 20 cases for histopathological study and 8 cases for SEM observation. After local anesthesia, Black's simple class I cavities were made in the experimental teeth with a diamond instrument mounted on a high-speed air turbine at room temperature with a water spray coolant. In Groups TC and TP only, an aqueous solution of 0.5% EDTA (pH 7.4) 10 ml was applied from cavity floor to dentin for 60 seconds. All cavities were then washed with distilled water, and the dentin was dried with an air stream. The floor of cavities were lined with thin layers of the following materials: Group C and TC, gutta-percha temporary material (G-C Dental Industrial Co., Tokyo, Japan). Group P and TP lining of Protect Cement which is a zinc phosphate cement containing 0.5% paraformaldehyde (Neo Dental Chemical Products, Tokyo, Japan). The restoration of each cavity was then filled with silver amalgam. Experimental teeth were clinically observed for 2 periods: short (about 14 days) and long (about 60 days) after treatment. They were then extracted under local anesthesia and prepared for histopathological study and SEM observation. Results 1. Clinical observations. During the observation period, symptoms occurred as indicated below. Group C: 2 (20%) out of 10 cases Group TC: 3 (30%) out of 10 cases Group P: None out of 20 cases Group TP: 3 (15%) out of 20 cases The only kind of clinical discomfort observed hypersensitivity to cold water. 2. Clinical evaluations Group C: 10 cases (100%) were good.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Evaluation of sealing properties of Thermafil and Ultrafil techniques in the absence or presence of smear layer.

The apical sealing abilities of two thermoplasticized gutta-percha techniques were evaluated. A total of 128 single-rooted teeth were divided into six groups in which Ultrafil, Thermafil, and lateral condensation techniques, with and without the smear layer, were used to obturate 20 roots in each group. The roots were implanted subcutaneously in rats for 90 days to expose the materials to vital tissue and tissue fluids. The roots were recovered, immersed in 1% methylene blue for 2 wk, cleared, and the dye penetration was measured using a dissecting microscope. Thermafil showed the least leakage with smear layer present and Ultrafil the least with it absent. The two thermoplasticized gutta-percha techniques both showed significantly less leakage than lateral condensation with and without the smear layer. Removing the smear layer reduced the leakage significantly in all groups.

Dental Leakage↗

Evaluation of the influence of smear layer on the apical and coronal sealing ability of two sealers.

The aim of this in vitro study was to determine the effect of the smear layer on apical and coronal leakage in root canals obturated with AH26 or RoekoSeal sealers. A total of 160 maxillary anterior teeth extracted for periodontal reasons were used. The root canals were prepared to a size #7 with ProFile.06 taper Series 29 rotary instruments in a crown-down manner. Eight groups were created by all possible combinations of three factors: smear layer (present/absent), leakage assessment (apical/coronal), and sealer used (AH26/RoekoSeal). All teeth were obturated using lateral condensation technique of gutta-percha. A fluid filtration method was used to test apical or coronal leakage. According to the results of this study, the smear (+) groups displayed higher apical and coronal leakage than those smear (-) groups for both root canal sealers (p < 0.05). There was no statistically significant difference in either apical or coronal leakage between RoekoSeal and AH26, regardless of the presence or absence of the smear layer (p > 0.05). However, apical leakage was significantly higher than coronal leakage for both root canal sealers used in this study (p < 0.05). Under the conditions of this study, the results indicate that removal of the smear layer has a positive effect in reducing apical and coronal leakage for both AH26 and RoekoSeal root canal sealers.

Bismuth↗

Shear bond strength of three resin based sealers to dentin with and without the smear layer.

Bond strength of root canal sealers to dentin is an important property for the integrity of the sealings of root-canals. The purpose of this study was to test shear bond strength of three endodontic sealers (Diaket, AH Plus and Endo-REZ). The coronal two thirds of ninety extracted human third molars were removed. The smear layer of the exposed dentin surfaces were removed using 17% EDTA followed by 5.25% NaOCl and the teeth were randomly divided into two groups (n = 45). Group 1 was kept as control and in group 2, uniform smear layer was created using waterproof polishing papers. Three-mm long sections of polyethylene tubing were filled with freshly mixed sealer and placed on the dentin surfaces for conducting a shear bond strength test. The data was calculated as MPa and was statistically analyzed using a two way ANOVA, Kruskal-Wallis and Mann-Whitney U tests. A significant difference was found among the bond strength of the sealers, smear layer, and control groups. AH Plus sealer showed the highest bond strength in smear layer removed surfaces (p < 0.05). Pretreatment with EDTA/NaOCl affected bond strength of AH Plus. AH Plus had the highest bond to dentin with or without smear layer.

Analysis of Variance↗

Dentinal wall adaptation of thermoplasticized gutta-percha in the absence or presence of smear layer: a scanning electron microscopic study.

The dentinal adaptation of injected thermoplasticized gutta-percha and thermoplasticized gutta-percha resulting from Ultrafil and Thermafil systems was evaluated by scanning electron microscopy and compared with adaptation obtained with the lateral condensation of gutta-percha. Each method was evaluated with and without the smear layer removed. Scanning electron microscopic observations showed the thermoplasticized gutta-percha resulting from either system to have better dentinal wall adaptation than lateral condensation of gutta-percha in either the absence or presence of the smear layer. In the absence of smear layer, the adaptation of gutta-percha was improved in all groups. Although sealer was used, removing the smear layer was found to enhance the ability of the thermoplasticized gutta-percha to enter the patent tubules.

Dental Pulp Cavity↗

Effectiveness of 1 mol L-1 citric acid and 15% EDTA irrigation on smear layer removal.

AIM: The aim of this study was to evaluate in vitro the cleansing and smear layer removal capability of alternate canal irrigation with citric acid and NaOCl. METHODOLOGY: Eighty-one teeth were divided into three groups on the basis of the type of instrumentation, namely, manual stainless steel, Ni-Ti mechanized ProFile .04 taper or MACXim. The groups were further divided on the basis of irrigation protocol: 5% NaOCl alone, NaOCl alternated with 1 mol L-1 citric acid solution or a combination of 15% EDTA and Cetrimide solution. After longitudinal sectioning, dentinal walls were microphotographed with scanning electron microscopy at x300 and x1000 magnifications. Qualitative and quantitative cleansing level evaluations were performed using computerized image analysis software. Data were statistically evaluated using Kruskal-Wallis analysis and t-test. RESULTS: Qualitative evaluation at x300 and x1000 showed no statistically significant differences in cleansing ability between citric acid, EDTA and NaOCl groups. Quantitative evaluation of smear layer removal, measured as open tubules/total dentinal surface ratio, showed that 1 mol L-1 citric acid solution was comparable to EDTA (11.97% vs. 10.36%) (NS); in samples treated with ProFile .04 taper instruments citric acid was most effective (16.17%), whilst in the group treated with manual instrumentation EDTA and Cetrimide were the most effective (11.94%). Specimens irrigated with 5% NaOCl demonstrated significantly more cleansing than those obtained in the other two groups (P < 0.001). CONCLUSIONS: 1 mol L-1 citric acid solution was as effective in removing smear layer as EDTA, but was superior in specimens treated with ProFile .04 taper instruments.

Cetrimonium↗

Pulpal responses to amalgam restorations in cavities with and without smear layer removal.

A conventional low copper amalgam was placed in cavities with and without smear layer removal and the amalgam restorations were covered with a resin overlay. The restored teeth were retrieved at 2, 28 and 56 days postoperatively in order to test for leakage and then pulpal reactions. More inflammation was seen in the teeth from which the smear layer had been removed. Abscesses were present in 6 teeth at 28 days but only one was associated with demonstrable bacteria. This study does not support smear layer removal before insertion of low copper amalgam restorations.

Animals↗

Dentin permeability: effects of smear layer removal.

The results of this study permit the following conclusions: 1. The use of dilute (6%) citric acid for very short time intervals permits sequential removal of the smear layer on human dentin. 2. Acid-etching for as little as 5 seconds removes much of the smear layer and exposes the orifices of dentinal tubules. 3. Dentin permeability increased rapidly during acid-etching with 6% citric acid, reaching a maximum value after only 15 seconds of etching. 4. The production of a smear layer on dentin during restorative procedures establishes a protective diffusion barrier. Removal of the smear layer by acid-etching increases the permeability of dentin which, under some conditions, must be regarded as a liability.

Acid Etching, Dental↗

Effect of smear layer removal on bleaching of human teeth in vitro.

The purpose of this study was to evaluate objectively in vitro the effectiveness of bleaching artificially discolored teeth with or without the smear layer present using sodium perborate mixed with sterile water or 35% hydrogen peroxide (H2O2). Seventy fully developed maxillary anterior teeth were artificially stained with human hemoglobin and separated into one control and four experimental groups. After the smear layer was removed on half the experimental teeth and left intact on the other half, all of the teeth were bleached intracoronally with sodium perborate and 35% H2O2 or sodium perborate plus water. The bleaching agents were applied twice over a 6-day period. The changes in tooth shade were objectively analyzed using a SP78 sphere spectrophotometer at 1, 30, and 60 days postbleaching. The presence or absence of the smear layer did not significantly influence the outcome of bleaching (p > 0.05). The teeth bleached with sodium perborate and 35% H2O2 were significantly lighter than the teeth bleached with sodium perborate and sterile water (p < 0.0001) at each experimental period. Based on the findings of this study, it is not advantageous to remove the smear layer before intracoronal bleaching.

Borates↗

Effect of smear layer removal agent and/or fluoride on the surface of dentin.

A study was conducted to observe the effectiveness of an EDTA-based agent, Tubulicid Red, and a polyacrylic acid-based agent, Dentin Conditioner, for removal of the smear layer from a prepared dentin surface, with or without a fluoride dentin reinforcing agent, using the dye penetration test and scanning electron microscopy (SEM). Bovine mandibular first and second incisors were used. After removal of the enamel, the smear layer on the dentin surface was treated with 38% H3PO4, Tubulicid Red, Dentin Conditioner, 1% NaF, 1% SnF2, Tubulicid Red (including 1% SnF2), Dentin Conditioner (including 1% NaF) and Dentin Conditioner (including 1% SnF2). In the dye penetration test, Dentin Conditioner (including 1% SnF2) was the most effective agent for preventing dye penetration. SEM evaluation of the dentin surface after treatment with the smear layer removal agents and/or fluorides showed that the smear layer was removed by H3PO4 and Dentin Conditioner. However, dentinal plugs remained after treatment with Dentin Conditioner alone. The other agents left some layers on the dentin surface.

Acid Etching, Dental↗