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Year : 2019  |  Volume : 9  |  Issue : 2  |  Page : 71-81

The smear layer in endodontic: To keep or remove – an updated overview

Department of Conservative Dentistry, Division of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia

Correspondence Address:
Dr. Ruaa A Alamoudi
Department of Conservative Dentistry, Division of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 1119, Jeddah 21431
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sej.sej_95_18

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During mechanical preparation, the use of hand or rotary instruments results in the production of considerable amount of smear layer. The smear layer consists of two parts: a superficial layer that covers the dentinal wall and a smear plug which occludes that dentinal tubules. Researchers had reached to different conclusions on the importance of removing or maintaining this layer. Removing the smear layer allows for more cleaning and disinfecting root canal walls and better adaptation of root canal filling materials. However, the presence of smear layer can act as a seal to the dentinal tubules and minimize the ability of bacteria and its toxins from penetrating the dentinal tubules. The ability to remove smear layer depends primarily on chemomechanical preparation. There are three main methods to remove smear layer: chemically, mechanically (ultrasonically), laser, or combinations. No one single irrigant has the ability to kill microorganisms, dissolve organic tissues, and demineralize smear layer. Thus, alternating between organic and inorganic solvents and the use of different methods and techniques have been recommended. Indeed, there is little relevance attributed to the influence of smear layer on the clinical treatment outcomes. Moreover, there is critical lack of clinical studies to determine the role of smear layer since all previous studies were carried out on laboratory based. Further experimental model with a longitudinal observational characteristic should be applied.

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