scholarly journals Smear Layer in Endodontics: A review of its role and management

2020 ◽  
Vol 4 (2) ◽  
pp. 38-50
Author(s):  
Asma Abognah
Keyword(s):  
Root Canal ◽  
Smear Layer ◽  
Inorganic Substance ◽  
Root Canal Filling ◽  
Dentinal Tubules ◽  
Root Canals ◽  
Filling Materials ◽  
Root Canal Instrumentation ◽  
Apical Leakage ◽  
By Products

Whatever the technique used for root canal instrumentation; a layer of debris termed “smear layer” is formed. This is a layer composed of an organic and inorganic substance and it harbors bacteria and their by-products. Removing the smear layer enhances the cleaning and disinfecting of root canal walls and grant maximum adaptation of root canal filling materials. Nonetheless, the existence of smear layer can seal the dentinal tubules and decrease the probability of dentinal tubule’s invasion by bacteria and their toxins, this issue is still controversial. Smear layer removal approaches including chemical, ultrasonics, and laser have been widely studied. However, none of them is entirely efficient along the length of all canals or is universally recognized. If the decision was to remove smear layer, irrigating root canals with EDTA followed by NaOCl will fulfill the objective. It is still debatable whether the removal of smear layer will decrease the apical leakage or not. Additional research is required to determine the consequence of removing or preserving the smear layer.

scholarly journals Radiographic and scanning electron microscopic assessment of root canal filling remnants after endodontic re-instrumentation

2017 ◽  
Vol 20 (1) ◽  
pp. 80 ◽  
Author(s):  
Luciane Geanini Pena Santos ◽  
Wilson Tadeu Felippe ◽  
Beatriz Dulcineia Mendes Souza ◽  
Andrea Cristina Konrath ◽  
Mabel Mariela Rodríguez Cordeiro ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Root Canal ◽  
Filling Material ◽  
Root Canal Filling ◽  
Root Canals ◽  
Filling Materials ◽  
Ah Plus ◽  
Endodontic Retreatment ◽  
Scanning Electron

<p><strong>Objective: </strong>Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic re-instrumentation. <strong>Material and Methods:</strong> Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were re-instrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P &lt; 0.05). <strong>Results: </strong>Radiographic and SEM analysis showed that material from the<strong> </strong>MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. <strong>Conclusion: </strong>After re-instrumentation<strong>, </strong>MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third.</p><p><strong>Keywords </strong></p><p>Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.</p>

scholarly journals Technical Quality and Associated Iatrogenic Errors of Endodontic Treatments Performed in Extracted Anterior Single-Rooted Teeth by Preclinical Undergraduate Students

2015 ◽  
Vol 19 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Konstantinos Dervenis ◽  
Andreas Koutroulis ◽  
Georgios Chatzopoulos ◽  
Vasileios Kapralos
Keyword(s):  
Undergraduate Students ◽  
Root Canal ◽  
Technical Quality ◽  
Dental Clinic ◽  
Root Canal Filling ◽  
Root Canals ◽  
Anterior Teeth ◽  
Root Canal Instrumentation

SUMMARYAim: To evaluate technical quality of root canal treatments performed in extracted anterior single-rooted teeth in an undergraduate dental clinic, and to record the associated iatrogenic errors.Material and Method: 287 root canal treatments performed by 114 preclinical undergraduate students in extracted anterior teeth at the Department of Endodontology were radiographically evaluated, based on the following parameters: access cavity dimensions and direction, root canal instrumentation, and root canal filling quality.Results: The access cavity was found of adequate dimensions in 28.9% and straight in direction in 71.1% of the material. Erroneous position, overextension of the access cavity and non-straight access were noted in 39.7 %, 21.6% and 28.9% of the cases, respectively. The frequency of ledged root canals was 10.1%, while 84.7% of the teeth had no instrumentation related iatrogenic errors. Regarding root canal filling, incomplete density apically and technical inadequacies in the middle and cervical thirds were observed in 76.3% and 82.3% of the cases. The percentage of flawless endodontic treatments was 3.1%.Conclusions: Most of the endodontic treatments evaluated were classified unacceptable. Inadequate root canal filling density in the middle and cervical third and ledge formation were the most common faults.

scholarly journals The Tubular Penetration Depth and Adaption of Four Sealers: A Scanning Electron Microscopic Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Huan Chen ◽  
Xinyuan Zhao ◽  
Yu Qiu ◽  
Dengyou Xu ◽  
Li Cui ◽  
...  
Keyword(s):  
Penetration Depth ◽  
Root Canal ◽  
Electron Microscopic ◽  
Root Canal Filling ◽  
Adaptation Capacity ◽  
Root Canals ◽  
Filling Materials ◽  
Ah Plus ◽  
Maximum Penetration ◽  
Scanning Electron

Background. The tubular penetration and adaptation of the sealer are important factors for successful root canal filling. The aim of this study was to evaluate the tubular penetration depth of four different sealers in the coronal, middle, and apical third of root canals as well as the adaptation of these sealers to root canal walls. Materials and Methods. 50 single-rooted teeth were prepared in this study. Forty-eight of them were filled with different sealers (Cortisomol, iRoot SP, AH-Plus, and RealSeal SE) and respective core filling materials. Then the specimens were sectioned and scanning electron microscopy was employed to assess the tubular penetration and adaptation of the sealers. Results. Our results demonstrated that the maximum penetration was exhibited by RealSeal SE, followed by AH-Plus, iRoot SP, and Cortisomol. As regards the adaptation property to root canal walls, AH-Plus has best adaptation capacity followed by iRoot SP, RealSeal SE, and Cortisomol. Conclusion. The tubular penetration and adaptation vary with the different sealers investigated. RealSeal SE showed the most optimal tubular penetration, whereas AH-Plus presented the best adaptation to the root canal walls.

scholarly journals Carrier-based Root Canal Filling Materials: A Literature Review

2013 ◽  
Vol 14 (4) ◽  
pp. 777-783 ◽  
Author(s):  
Ahmed Mubarak Al-Kahtani
Keyword(s):  
Literature Review ◽  
Root Canal ◽  
Clinical Success ◽  
Review Of The Literature ◽  
Root Canal Filling ◽  
Filling Materials ◽  
Treatment Techniques ◽  
Sealing Ability ◽  
Root Canal Filling Materials ◽  
Apical Leakage

ABSTRACT A review of the literature on the use of carrier based obturation materials focusing on Thermafil and Resilon based obturator (RealSeal 1) are presented in this article. The review addressed the history, apical leakage, coronal leakage, biocompatibility, sealing ability and clinical success of Thermafil and RealSeal 1. Based on the studies gathered, this review concluded that both treatment techniques (Thermafil and RealSeal 1) did not provide excellent apical sealing ability. More research should be done to try to overcome their main drawback, its sealing ability. How to cite this article Al-Kahtani AM. Carrier-based Root Canal Filling Materials: A Literature Review. J Contemp Dent Pract 2013;14(4):777-783.

scholarly journals Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

2009 ◽  
Vol 21 (2) ◽  
Author(s):  
Kurniasri Amas Achiar ◽  
Endang Sukartini
Keyword(s):  
Root Canal ◽  
Smear Layer ◽  
Layer Formation ◽  
Canal System ◽  
Pulp Tissue ◽  
Root Canal Filling ◽  
Irrigation Solution ◽  
Root Canal System ◽  
Effective Seal ◽  
Apical Leakage

One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gutta-percha, or through voids within the sealer. Hence, the sealing quality of root canal filling depends much on the sealing ability of the sealer. Therefore, anything that may influence the adaptation of the root filling to the canal wall is can determine the degree and the extent of leakage, and ultimately the prognosis of the endodontic therapy. In endodontic therapy, the smear layer formation results from root canal preparation and may influence the effective seal of the root canal system. The smear layer formation is mainly composed of inorganic components (dentin debris) and organic materials, such as pulp tissue remnant, bacteria, and blood cells. Removal of the smear layer from the root canal walls before the obturation can reduce the leakage of root canal sealer. To remove the smear layer use 10 ml 17% EDTA followed by 10 ml of 5.25% NaOCl as irrigating solution. This paper discribe about how the effectivity of EDTA as irigating solution to remove the smear layer especially in the apical root canal with many lateral canal to reduce the apical leakage.

scholarly journals In Vivo Comparative Evaluation of Periapical Healing in Response to a Calcium Silicate and Calcium Hydroxide Based Endodontic Sealers

2018 ◽  
Vol 6 (8) ◽  
pp. 1475-1479 ◽  
Author(s):  
Dalia Y. Zaki ◽  
Mohamed H. Zaazou ◽  
Maram E. Khallaf ◽  
Tamer M. Hamdy
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Calcium Silicate ◽  
Negative Control ◽  
Root Canal Filling ◽  
Root Canals ◽  
Filling Materials ◽  
Gutta Percha ◽  
Periapical Healing

BACKGROUND: The composition of the root canal filling materials together with the apical limit of the root canal obturation affect the complete periapical healing after root canal therapy.AIM: This study was performed to evaluate and compare the periapical healing in response to calcium-silicate (iRoot SP) and calcium-hydroxide (Apexit) based-sealers.MATERIAL AND METHODS: Seventy-two upper premolars root canals of six dogs were used. The teeth were randomly assigned to four groups: Group one: roots were obturated using gutta-percha and Apexit-sealer; Group two: roots were obturated using gutta-percha&iRoot SP-sealer; Group three: the teeth were left open without obturation; Group four: where healthy teeth were used as a negative control. Teeth were evaluated after one, two and three months. The newly formed mineralised apical tissue and the periapical inflammatory infiltrate of the obtained photomicrographs were evaluated, and scorings were statistically-analysed.RESULTS: The mean percentage of the periapical inflammatory infiltrates and mineralisation scoring after one, two and three months evaluation period were not significantly different among the four groups (P > 0.05).CONCLUSIONS: Regardless of the sealer used, iRoot SP and Apexit promote healing of periapical tissues. IRoot SP sealer showed early insignificant more partial and almost full healing after two and three months.

An in vitro Evaluation of Antimicrobial Efficacy of Primary Root Canal Filling Materials

2012 ◽  
Vol 37 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Hegde Sapna ◽  
Lala Priti Kamlesh ◽  
B Dinesh Rao ◽  
AB Shubha
Keyword(s):  
Zinc Oxide ◽  
Calcium Hydroxide ◽  
Sodium Fluoride ◽  
Root Canal ◽  
Antimicrobial Efficacy ◽  
Root Canal Filling ◽  
Root Canals ◽  
Filling Materials ◽  
Zinc Oxide Eugenol

Objective: The present study aimed to evaluate and compare six different materials commonly used for filling the root canals of primary teeth for antimicrobial efficacy against some of the microorganisms commonly found in infected root canals. Study design: In this experimental in vitro study six root canal filling materials were tested for antimicrobial efficacy against eight microbial strains using the agar diffusion method. Results: Zinc oxide eugenol paste exhibited the strongest antimicrobial potential followed by Endoflas™, zinc oxide-calcium hydroxide-sodium fluoride mixture, zinc oxide-calcium hydroxide mixture and calcium hydroxide paste (Apexcal™). The addition of sodium fluoride to the zinc oxide-calcium hydroxide mixture enhanced the antimicrobial efficacy. Metapex™ demonstrated minimal inhibition and Vaseline™ was non-inhibitory. Conclusions: All the test filling materials demonstrated varying antimicrobial activity against the microorganisms tested. Zinc oxide eugenol paste and materials containing zinc oxide were found to be more effective against the microorganisms compared to materials without zinc oxide.

Comparative Evaluation of Bactericidal Potential of Four Root Canal Filling Materials against Microflora of Infected Non -Vital Primary Teeth

2010 ◽  
Vol 35 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Priya Harini ◽  
Sham Bhat ◽  
K Sundeep Hegde
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Primary Teeth ◽  
Microbiological Analysis ◽  
Filling Material ◽  
Root Canal Filling ◽  
Posterior Teeth ◽  
Root Canals ◽  
Filling Materials ◽  
Root Canal Filling Materials

Background and objectives: Since complete debridement of the root canals of the primary teeth is not practically possible due to the highly variable root canal anatomy, success of the endodontic therapy depends partly on the use of antibacterial irrigating agents and root canal filling materials. Recent literature indicates that anaerobes comprise a majority of the bacteria in necrotic root canals of primary teeth. The study determined the antibacterial effectiveness of four root canal filling materials namely Calcium hydroxide,Zinc oxide eugenol, Vitapex and Metapex against microbial specimens obtained directly from necrotic root canals of primary teeth. Method: Microbial specimens were collected using sterile paper points, from 15 primary maxillary and mandibular posterior teeth of randomly selected children in the age group of 4-10 years with infected non vital primary teeth, requiring pulpectomy procedure. The microbial specimens collected were subjected to microbiological analysis and the antimicrobial potential of root canal filling materials were tested using Agar diffusion technique. Results: were statistically analyzed using one-way ANOVA. Facultative/Aerobic organisms were isolated in all the cases, anaerobic organisms were isolated in 80% of the cases, and Candida albicans was isolated in 1 case. ZOE showed superior inhibitory activity against most of the organisms isolated followed by Vitapex, Calcium hydroxide and Metapex in descending order.Conclusion: Our data may be useful as a guide for relative antimicrobial effectiveness or non-effectiveness of the materials employed. In vivo studies are required to state the specific antimicrobial activity and merits and demerits of any of the test filling material.

scholarly journals Development of A Nano-Apatite Based Composite Sealer for Endodontic Root Canal Filling

2021 ◽  
Vol 5 (1) ◽  
pp. 30
Author(s):  
Angelica Bertacci ◽  
Daniele Moro ◽  
Gianfranco Ulian ◽  
Giovanni Valdrè
Keyword(s):  
Citric Acid ◽  
Liquid Phase ◽  
Calcium Phosphate ◽  
Root Canal ◽  
Acid Attack ◽  
Root Canal Filling ◽  
Bioactive Materials ◽  
Dentinal Tubules ◽  
Sealing Capacity ◽  
Endodontic Sealers

Recently, endodontic sealers based on injectable bioactive materials were proposed to improve the filling of anatomical irregularities during root canal obturation. In this context, this preliminary work investigated the possibility of realizing a new calcium phosphate-based composite sealer for root canal filling with an optimized composition on setting kinetics and dentin tubules occlusion. Several calcium phosphate/liquid phase mixtures were initially evaluated for their workability, finding two suitable formulations. Both of them contained 66 wt.% of a nano-apatite-based cement (solid powdered phase). The liquid phase (34 wt.%) comprised 13.6% propanediol and 20.4% PEG 1000 (formulation 1), and formulation 2 comprised 27.2% glycerin and 6.8% PEG 200 (formulation 2). Then, these formulations were tested by means of permeability measurements and observation by scanning electron microscopy of treated model dentin samples. Both formulations succeeded in occluding dentinal tubules: the first one was able to create a full-bodied layer on dentin surface and, moreover, to resist, at least to a large extent, against citric acid attack. The second one showed a lower effectiveness after citric acid exposure. The composite compound that better satisfied the overall required characteristics of use, workability and sealing capacity was formulation 1.

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