The Effect of Smear Layer Removal on Endodontic Outcomes
Abstract
Introduction: A layer of organic and inorganic debris referred to as the smear layer is produced during mechanical instrumentation of the root canal system. The combination of ethylene-diamine-tetraacetic-acid (EDTA) and sodium hypochlorite (NaOCl) has been shown to effectively remove the smear layer. To date, no prospective controlled in vivo studies have been published regarding the effect of smear layer removal on endodontic outcomes in permanent teeth. The purpose of this randomized, prospective, double-blinded clinical trial was to compare the endodontic outcomes of teeth where the smear layer was either removed or left intact. A secondary analysis assessed the influence of covariate factors on healing. Methods: Subjects meeting study inclusion criteria were randomly assigned to one of two irrigation groups. Root canals were instrumented in a standardized manner followed by a final irrigation of either 1ml of 17% EDTA or 1ml of 0.9% saline. Clinical and radiographic evaluations were completed no earlier than 12-months post-treatment to assess outcome. A modified periapical index (PAI) score (1-5) was used for radiographic analysis. Data were analyzed using Fishers exact test (a<0.05). Results: For this interim analysis of 205 subjects, no significant difference in outcome was found between groups (p=0.37). Pre-operative necrosis (p=0.01), preoperative apical lesion (p<0.0001) and pre-operative diabetes (p=0.02) were the only covariates found to affect healing rates (why talk about healing rates? It was never defined in the abstract). Conclusion: Within the limitations of this in-vivo clinical study, removal of the smear layer did not affect endodontic outcomes.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 15, 2020
- Accession Number
- AD1182693
Entities
People
- Alyse D. Fleming
Organizations
- Uniformed Services University of the Health Sciences