Smear layer removing ability of root canal irrigation solutions: A review

Mohammadi, Z. and Shalavi, S. and Yaripour, S. and Kinoshita, J. I. and Manabe, A. and Kobayashi, M. and Giardino, L. and Palazzi, F. and Sharifi, F. and Jafarzadeh, H. (2019) Smear layer removing ability of root canal irrigation solutions: A review. Journal of Contemporary Dental Practice, 20 (3). pp. 395-402.

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Aim: The purpose of this review is to address the smear layer removing the ability of root different canal irrigants including ethylenediaminetetraacetic acid (EDTA), a mixture of tetracycline, acid and detergent (MTAD), tetraclean, citric acid, Q-Mix, maleic acid, and smear clear. Background: Smear layer is a layer which is produced during instrumentation. It contains both organic and inorganic materials. It may also contain bacteria and their byproduct considering the root canal situation. This layer may prevent the penetration of the healing material introduced to the canal to the interior of the dentinal tubules. In addition, it can affect the adaptation of sealing materials to the root canal walls. Review results: The smear layer removal ability of MTAD is superior and faster than EDTA. Tetraclean is similarly composed of an acid, an antibiotic, and a detergent. The presence of doxycycline is believed to help the smear layer removal ability of these irrigants. Antibiotics such as tetracycline had similar smear layer removal ability as even citric acid. EDTA is an amino acid with a chelating ability that sequestrates metal ions. Some believed EDTA smear layer removing ability is better than MTAD, tetraclean, SmearClear, and 20 citric acid which is controversial in case of comparison between MTAD and EDTA. Phosphoric acid is efficient enough to be comparable to EDTA in removing the smear layer. Maleic acid is an organic compound with acid etching smear layer removal. Its ability seems to be similar or even better than EDTA. Citric acid as another organic acid is believed to be used as smear removing agent. HEBP is another chelating agent that can be used in combination with NaOCl; however, HEBP is a weak decalcifying agent compared to EDTA and hence cannot be applied as a mere final rinse. QMiX is a combination of CHX, EDTA, and detergent and should be used at final rinse. It is believed that QMiX is as efficient as EDTA. Smear clear is a 17 EDTA solution including an anionic and cationic (cetrimide) surfactant. The ability of QMiX is similar to EDTA. Conclusion: There are different canal irrigation solutions with various smear layer removal ability that some should be used as a mere final rinse and some should not. Clinical significance: The usage of canal irrigation solutions depends on the clinical situation and preference of the dentists. This study provides a good guide for clinician of the field. © 2019, Jaypee Brothers Medical Publishers (P) Ltd.

Item Type: Article
Additional Information: Cited By :1 Export Date: 16 February 2020 Correspondence Address: Jafarzadeh, H.; Dental Research Center, Mashhad University of Medical SciencesIran; email:
Uncontrolled Keywords: Acid and detergent Citric acid Ethylenediaminetetraacetic acid Irrigation Maleic acid Mixture of tetracycline Smear layer biomedical and dental materials edetic acid hypochlorite sodium polysorbate dental pulp cavity dental surgery human scanning electron microscopy Humans Microscopy, Electron, Scanning Polysorbates Root Canal Irrigants Sodium Hypochlorite
Subjects: WU Dentistry. Oral surgery
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 21 Jun 2020 09:10
Last Modified: 21 Jun 2020 09:10

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