smear layer formation in root canal
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During instrumentation using hand instruments or rotary instruments in endodontics, the dentine will be incised and fragmented, forming a large amount of debris. This dentinal debris, alongside pulp remnants, bacteria and bacterial by-products, will form what is known as the smear layer. This layer will form a plug which will block the entrance of the dentinal tubules, and can have a thickness of 1-2 micrometers, but sometimes can extend reaching up to 40 micrometers into the dentinal tubules. With the smear layer, the entrance and exit of the dentinal tubules will be occluded, this preventing any irrigation solution from penetrating into the dentinal tubules and achieving proper disinfection of the root canal. Furthermore, the smear layer is a naturally unstable and prone to displacement, making it an unpredictable layer. Due to these reasons, amongst others such as reducing microleakage and improving the obturation quality within the root canal, many researchers have suggested the removal of the smear layer from the root canal system. One method of removing it includes irrigation with chelating agents such as Ethylene-Diamene-Tetraacetic Acid (EDTA), followed by irrigation with Sodium hypochlorite to achieve the ideal disinfection and obturation. Other newer methods of removing the smear layer are being introduced to the market, for example Dentsply's QMix 2in1 which can achieve the removal of the smear layer and the disinfection effect at the same time.