Private Endodontic Practice, Tauranga, New Zealand.
Int Endod J. 2010 Jan;43(1):2-15. doi: 10.1111/j.1365-2591.2009.01627.x.
Root canal instrumentation produces a layer of organic and inorganic material called the smear layer that may also contain bacteria and their by-products. It can prevent the penetration of intracanal medicaments into dentinal tubules and influence the adaptation of filling materials to canal walls. This article provides an overview of the smear layer, focusing on its relevance to endodontics. The PubMed database was used initially; the reference list for smear layer featured 1277 articles, and for both smear layer dentine and smear layer root canal revealed 1455 publications. Smear layer endodontics disclosed 408 papers. A forward search was undertaken on selected articles and using some author names. Potentially relevant material was also sought in contemporary endodontic texts, whilst older books revealed historic information and primary research not found electronically, such that this paper does not represent a 'classical' review. Data obtained suggests that smear layer removal should enhance canal disinfection. Current methods of smear removal include chemical, ultrasonic and laser techniques - none of which are totally effective throughout the length of all canals or are universally accepted. If smear is to be removed, the method of choice seems to be the alternate use of ethylenediaminetetraacetic acid and sodium hypochlorite solutions. Conflict remains regarding the removal of the smear layer before filling root canals, with investigations required to determine the role of the smear layer in the outcomes of root canal treatment.
根管器械预备会产生一层被称为玷污层的有机和无机物质，其中可能还含有细菌及其产物。它可以防止根管内药物渗透到牙本质小管中，并影响填充材料对根管壁的适应性。本文概述了玷污层，重点介绍了其与牙髓学的相关性。最初使用了 PubMed 数据库；玷污层的参考文献有 1277 篇，玷污层牙本质和玷污层根管分别有 1455 篇出版物。玷污层牙髓学披露了 408 篇论文。对选定的文章和一些作者的名字进行了向前搜索。同时在当代牙髓学教科书中寻找潜在相关材料，而旧书中则揭示了电子文献中未找到的历史信息和原始研究，因此本文并不代表“经典”综述。获得的数据表明，去除玷污层应能增强根管消毒效果。目前去除玷污层的方法包括化学、超声和激光技术——这些方法都不能在所有根管的全长内完全有效，也不是普遍被接受的。如果要去除玷污层，似乎交替使用乙二胺四乙酸和次氯酸钠溶液是首选方法。在根管充填前是否要去除玷污层仍存在争议，需要进行研究以确定玷污层在根管治疗效果中的作用。
