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SMEAR LAYER
In Endodontics
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BY : ARISHA JAIN
CONS AND ENDO
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History
Contents Definition

Components

Diffusion permeability

Microleakage

Effect of Instrumentation

Obturation and smear layer

Methods of removal

Conclusion

Reference
 History

McComb and Smith in

Grinding debris was first 1975 observed this layer on
referred to as smear layer the walls of instrumented
by Boyde, switsur and canal and reported that it
stewart in 1963. was similar to coronal
smear layer.
Goldman observed
presence of smear layer
after use of endodontic
instruments.
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The smear layer term was used to describe the amorphous

and irregular particles that resulted from root canal
instrumentation and covers all the instrumented surfaces of
the prepared root canals.
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DEFINITION
According to Operative Dentistry Journal (1984) smear
layer is defined as:

“Any debris produced iatrogenically by the cutting,

not only of dentin, but also of enamel, cementum and
even the dentin of the root canal”
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DEFINITION
The American Association of Endodontics
defined smear layer as :

“ Surface film of debris retained on dentin or other

tooth surfaces like enamel, cementum after
instrumentation with either rotatory instruments or
endodontic files”
Components of Smear Layer
•Coagulated protein
•Necrotic or viable pulp tissue
01 Organic •Odontoblastic processes,
blood cells , micro organisms

•Tooth structure
02 Inorganic •Non specific inorganic
contaminants
 Smear Layer
Dilemma

•To remove

To Remove Not To Remove

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In Support of Retaining Smear Layer

 Blocks the dentinal tubules , preventing exchange of bacteria and

other irritants by altering the permeability (Michelich et al. 1980).

 Vojinovic et.al. showed that bacteria could not penetrate dentin in

presence of smear layer.

 Williams & Goldman (1985) reported that the smear layer was not
a complete barrier and could only delay bacterial penetration.

 Drake et al. suggested that smear layer formed during mechanical

instrumentation can prevent bacterial colonization of root canals as
it limits bacterial penetration into dentinal tubules.
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In Support of Smear Layer Removal

 Smear layer is of unpredictable thickness and volume because of it great portion consist of
water.(cergneux et al. 1987)
 It consists of bacteria , their by products and necrotic tissue (McComb & Smith 1975).
 Bacteria survive ,multiply and can proliferate into dentinal tubules (Meryon & Brook 1990)
 Act as barrier between filling material and canal wall and compromise seal formation.
 It may limit the penetration of disinfecting agents.
 A subsequent study concluded that the smear layer delayed but did not abolish the action of
the disinfectant (Ørstavik & Haapasalo 1990).
 Saunders & Saunders (1992) concluded that coronal leakage of root canal filling was less in
smear-free groups than those with a smear layer.
 Thickness Depends On

The reported thickness

Type and sharpness of Whether dentin is cut dry
of smear layer is 1-5
cutting instrument used. or wet (Barnes 1974)
um.

Proximity of instrument to
dentin wall forms thicker
and more resistant smear
layer due to increased
centrifugal forces (Austin
1981).
Automatic preparation
with GG drills or peso
remears produce more
volume than hand filing.
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Diffusion Permeability
 The smear layer lowers the dentin permeability and act as a
barrier thus preventing fluid passage , delay the passage of
endodontic sealers and root filling materials.
 The smear layer reduces the diffusion ability of the NaOCl
more than 50%.
 Presence of smear layer can inhibit or delay the penetration of
antimicrobial agents.
 Ca(OH)2 diffuses from root canal to exterior surface of root
and that removal of smear layer may facilitate this diffusion.
Smear Layer And Microleakage
➢ Smear layer is non homogenous and weakly adherent structure, may slowly
disintegrate, creating void between root canal and sealer.
➢ Prepared dentinal surface should be clean to increase the sealing efficiency of
obturation.
➢ Studies have shown a significant increase in adhesive strength and resistance to
microleakage of AH26 sealer when the smear layer was removed.
➢ Zinc oxide eugenol based sealers failed to enter dentinal tubules in presence of
smear layer.
➢ Pashley found that microleakage is decreased after smear layer removal.
 Effect of Instrumentation on Smear
Layer
➢ During preparation, insufficient removal of debris and smear layer material will
induce stress on the cutting segment of endodontic instruments.
➢ The removal depends on the way the instrument is used and method of
preparation of root canal.
➢ Mechanical preparation is considered to produce large amount of smear layer.
➢ The use of coarse diamond burs produce a thicker layer compared to carbide
burs.

Carbide bur Diamond

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Obturation Smear layer may interfere with the
adhesion and penetration of sealer into
and Smear dentinal tubules.

Layer
Not being firmly attached to dentin, smear
layer may laminate off the canal wall ,
forms false seal leading to microleakage.

Removing of smear layer will improve

gutta percha seal.
Approaches for Smear Layer
Removal

Chemically

Organic acids

Ultrasonically

Laser
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Chemical Various chemicals used for smear

layer removal include :
Removal
 sodium hypochlorite,
 chelating agents such as EDTA,
organic acids
 Their combinations
 Sodium Hypochlorite

Its capacity to remove smear layer alone from the

instrumented root canal walls has been considered
to be low as it only dissolves the organic
material.

1% sodium hypochlorite, 10% citric acid and 0.9%

saline represented the best chemical treatment in
smear layer removal
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Chlorhexidine

 2% CHX is considered a potent antiseptic for root

canal irrigation.

 However, it did not show any dissolving capability

towards organic material or removing effect on smear
layer.
 Chelating agents
EDTA
• A 3- minute application of EDTA in the root
canal has been advised for the removal of
smear layer and cleaning of the canal walls
• Crumpton et al. showed that the smear
layer was removed with the final rinse of
1mL of 17% EDTA for 1 minute followed by 3
mL of 5.25% NaOCl.
•Goldman (1982) recommended alternate
use of Naocl and EDTA Middle third of canal (17%
EDTA)
• Mc comb and Smith ( 1976) Showed that the root canal
surfaces were uniformly occupied by patent dentinal tubules.
• REDTA removed the inorganic portion and left an organic layer
intact in the tubules.
• A quaternary ammonium bromide (cetrimide) is added to EDTA
solution to reduce surface tension by Nygaard- Ostby in 1963.
i.e EDTAC
➢ Doxycycline hydrochloride (100 mg mL-1) was effective in removing
the smear layer from the surface of instrumented canals and root-end
cavity preparations.

➢ MTAD to be an effective solution for the removal of the smear layer.

 Organic Acids
Citric acid – Effective root canal irrigant
(coel 1975) even more effective than
Naocl alone in removing smear layer
(baumgartner et.al. 1984)
50% citric acid
Citric acid removed smear layer better
than polyacrylic acid, lactic acid, and
phosphoric acid except EDTA

Disadvantage – Leaves precipitated

crystals
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Ultrasonic Removal
 Cameron (1988) - 2–4% sodium hypochlorite in combination
with ultrasonic energy effectively removed the smear layer.

 He also noticed that 3-5 minute irrigation resulted in smear-

free canal walls.
 Laser removal
➢ Dederich et al. used variants of the
neodymium–yttrium aluminium-garnet
(Ne:YAG) laser and reported findings from no
change to disruption of the smear layer to actual
melting and recrystallization of the dentin.

➢ Takeda et al. Used erbium yttrium aluminium-

garnet (Er:YAG) laser, demonstrated optimal
removal of the smear layer without melting,
charring or re-crystallization
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Conclusion The smear layer is a microscopic
layer comprising of organic and
inorganic material formed during
instrumentation in endodontics
that often hinders treatment .

To prevent infection in dentinal

tubules, microleakage and for
proper adhesion , it is adviced to
remove the smear layer and
smear plugs.
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References
Pathways of pulp – Cohen 8th edition
Clinical implications of the smear layer in endodontics: A review
article.
ŞEN, B. H., WESSELINK, P. R., & TÜRKÜN, M. (1995). The
smear layer: a phenomenon in root canal therapy. International
Endodontic Journal, 28(3), 
Alamoudi RA. The smear layer in endodontic: To keep or remove
– an updated overview. Saudi Endod J [serial online] 2019 
Violich, D. R., & Chandler, N. P. (2010). The smear layer in
endodontics – a review. International Endodontic Journal