Article Menu

Export Article

More by Authors Links

Article Data

  • Views 869
  • Dowloads 229

Systematic reviews

Open Access

Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review

  • Andréa Vaz Braga Pintor1
  • Marcello Rotter Marins dos Santos1
  • Daniele Masterson Ferreira2
  • Roberta Barcelos3
  • Laura Guimarães Primo1
  • Lucianne Cople Maia1,*,

1Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

2Library of the Health Science Center, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

3Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil

DOI: 10.17796/1053-4628-40.1.1 Vol.40,Issue 1,January 2016 pp.1-7

Published: 01 January 2016

*Corresponding Author(s): Lucianne Cople Maia E-mail: rorefa@terra.com.br

PDF (396.96 kB) View Full-text

Abstract

Objective: The aim of this systematic review was to determine whether the smear layer (SL) removal procedure influences the outcome of root canal treatment. Study design: We performed a search on Pubmed, Scopus, ISI Web of Science, Cochrane Library, Lilacs and SIGLE. We included randomized controlled clinical trials (RCT), with clinical and radiographic outcomes, conducted on subjects who had undergone root canal therapy. The protocol differed only in the SL removal or maintenance procedure. We evaluated the papers for risk of bias according to the Cochrane assessment tool. Results: A total of 1,983 articles were found, after removal of duplicates, 892 remained. We included two studies in this review. One study revealed a low risk of bias and a high success rate for the SL removal group compared to the non SL removal group (P = 0.04), while the other study had a high risk of bias and found no difference between the SL removal and non SL removal groups (P = 1.00). Conclusion: We concluded that the SL removal for root canal treatment of primary teeth with initial clinical signs and symptoms or pulpal necrotic status, could benefit the outcome, although further RCT should be performed to achieve evidence.

Keywords

smear layer, endodontics, root canal therapy, root canal irrigants

Cite and Share

Andréa Vaz Braga Pintor,Marcello Rotter Marins dos Santos,Daniele Masterson Ferreira,Roberta Barcelos,Laura Guimarães Primo,Lucianne Cople Maia. Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review. Journal of Clinical Pediatric Dentistry. 2016. 40(1);1-7.

URL:

https://www.jocpd.com/articles/10.17796/1053-4628-40.1.1

References

1. Peeters HH, Suardita K. Efficacy of Smear Layer Removal at the Root Tip by Using Ethylene diamine tetra acetic Acid and Erbium, Chromium:Yt-trium, Scandium, Gallium Garnet Laser. J Endod, 37: 1585-1589, 2011.

2. Mccomb, D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod,1: 238-242, 1975.

3. Mader CL, Baumgarten JC, Peters DD. Scanning electron investigation of the smeared layer on root canal walls. J Endod,10: 477-483, 1984.

4. Shahravan A, Haghdoost A-A, Rahimi H, Shadifar F. Effect of Smear Layer on Sealing Ability of Canal Obturation: A Systematic Review and Meta-analysis. J Endod, 33 :96-105, 2007.

5. Clark-Holke D, Drakeb D, Walton R, Riverac E, Guthmillerd JM. Bacte-rial penetration through canals of endodontically treated teeth in the pres-ence or absence of the smear layer. J Dent, 31: 275-281, 2003.

6. Violich DR, Chandler NP. The smear layer in endodontics – a review. Int Endod J, 43: 2-15, 2010.

7. Gençoglu N, Sanami S, Gunday M. Dentinal wall adaptation of thermo plasticized gutta-percha in the presence or absence of smear layer: a Scan-ning electron investigation. J Endod, 19: 558-562, 1993.

8. Barcelos R, Tannure PN, Gleiser R, Luiz RR, Primo L. The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized and controlled clinical trial evaluation. Int J Paediatr Dent, 22: 369-381, 2012.

9. Scelza MFZ, Antoniazzi JH, Scelza P. Efficacy of final irrigation- : a Scanning microscopic evaluation. J Endod, 26: 355-358, 2000.

10. Ballal NV, Kandian S, Mala K, Bath KS, Acharya S. Comparison of the Efficacy of Maleic Acid and Ethylenediaminetetraacetic Acid in Smear Layer Removal from Instrumented Human Root Canal: A Scanning Elec-tron Microscopic Study. J Endod, 35: 1573-1576, 2009.

11. Blank-Gonçalves LM, Nabesshima CK, Martins GHR, Machado MLM. Qualitative Analysis of the Removal of the Smear Layer in the Apical Third of Curved Roots: Conventional Irrigation versus Activation Systems. J Endod, 37: 1268-1271, 2011.

12. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 8: 332-336, 2009.

13. Higgins JPT, Altman DG. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www. cochrane-handbook.org.

14. Tannure PN, Azevedo CP, Barcelos R, Gleiser R, Primo LG. Long-term Outcomes of Primary Tooth Pulpectomy With and Without Smear Layer Removal: A Randomized Split-mouth Clinical Trial. Pediatr Dent, 33: 546- 550, 2011.

15. Mortazavi M, Mesbahi M. Comparison of zinc oxide and eugenol, and Vitapex for root canal treatment of necrotic primary teeth. Int J Paediatr Dent, 14: 417-424, 2004.

16. Ozalp N, SarogluI, Sonmez H. Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study. Am J Dent, 18: 347-350, 2005.

17. Trairatvourakul C, Chunlasikaiwan S. Success of pulpectomy with zinc oxide-eugenol vs calcium hydroxide/iodoform paste in primary molars: a clinical study. Pediatr Dent, 30: 303-308, 2008.

18. Paredes-Vieyra J, Enriquez FJ. Success rate of single- versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial. J Endod, 38: 1164-1169, 2012.

19. Zahed M, Alireza F, Mehdi T. One-visit versus multiple-visit endodontic therapy – a review. Int Dent J, 56: 289-293, 2006.

20. Onçag O, Cogulu D, Uzel A. Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study. J Clin Pediatr Dent, 30: 233-237, 2006.

21. Ahmed HMA. Anatomical challenges, electronic working length deter-mination and current developments in root canal preparation of primary molar teeth. Int Endod J, 46: 1011-1022, 2013.

22. Sisodia R, Ravi KS, Shashikiran ND, Singla S, Kulkarni V. Bacterial penetration along different root canal fillings in the presence or absence of smear layer in primary teeth. J Clin Ped Dent, 38: 229-234, 2014.

23. Pitoni CM, Figueiredo MC, Araújo FB, Souza MAL. Ethylenedi-aminetetraacetic acid and citric acid solutions for smear layer removal in primary tooth root canals. J Dent Child, 78: 131-137, 2011.

24. Czonstkowsky M, Wilson EG, Holstein FA. The smear layer in endodon-tics. Dent Clin North Am, 34: 13-25, 1990.

25. Hariharan VS, Nandlal B, Srilatha KT. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: A scanning electron microscopy study. J Indian Soc Pedod Prev Dent, 28: 271-277, 2010.

26. Rodd HD, Waterhouse PJ, Fuks AB, Fayle A, Moffat MA. Pulp therapy for primary molars. Int J Paediatr Dent, Suppl 1: 15-23, 2006.

27. AAPD. Guideline on pulp therapy for primary and immature permanent teeth. Available at http://www.aapd.org/media/Policies_Guidelines/G_ Pulp.pdf. Acessed in Feb 02, 2015.

28. Maia LC, Antonio AG. Systematic Reviews in Dental Research. A Guide-line. J Clin Ped Dent, 37: 117-124, 2014.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top