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Background  Smear layer removal has been shown to reduce bacterial penetration through root canal obturations when resin-based endodontic sealer is used. The purpose of this in vitro study was to test this effect when a non-resin-based sealer is used.    Material and methods  Thirty root segments were assigned to the following groups: Smear layer removed ( n  = 8); smear layer retained ( n  = 8); negative controls ( n  = 10; 5 with smear layer, 5 without); and positive controls ( n  = 4; 2 with smear layer, 2 without). After rotary instrumentation, smear layers were removed in the treatment group and half of controls using 17% ethylenediamenetetraacetic acid (EDTA) prior to obturation. Each obturated root was affixed into a dual-chamber leakage model employing  Streptococcus mutan s. Roots were incubated at 37 °C for 120 d. Days until lower chamber turbidity occurred was recorded for each sample, and data were analyzed using  Kaplan-Meier  survival curve analysis ( p  = 0.05).    Results  No negative controls leaked, while all positive controls were turbid within 1 day. Mean days to leakage for roots with smear layer intact was 82.75 (+/− 33.29, 95% CI), although three never leaked. Mean days to leakage through roots with smear layer removed was 46.25 (+/− 26.67, 95% CI), and all leaked. Treatment survival curves were significantly different ( p  = 0.048).    Conclusions  Under the conditions and limitations of this study, retaining the smear layer reduced the rate of bacterial penetration through canals which had been obturated using zinc oxide eugenol (ZOE) -based sealer.

The effect of smear layer on bacterial penetration through roots obturated using zinc oxide eugenol-based sealer