removal of smear layer has been considered as an important step in periodontal regenerative therapy . scaling and root planning alone with saline irrigation does not remove the smear layer .
the addition of a detergent to edta proved to remove smear layer more efficiently than edta alone .
traditional surgical and non - surgical periodontal therapies aim at arresting periodontal disease by removal of plaque from disease affected roots .
thus , etching has been recommended as an adjunct to mechanical root surface debridement to remove smear layers and root - associated endotoxins,[24 ] and to expose collagen fibers on the dentin surface .
however , concerns have been expressed regarding the possible necrotizing effect on surrounding vital periodontal tissues of etching agents operating at low ph , and thus , etching at neutral ph with calcium chelating agents such as ethylenediaminetetraacetic acid ( edta ) have been explored giving favorable results with respect to less flap failure and more connective tissue attachment .
several studies have shown that contaminated cementum as well as the smear layer inhibit cell migration and attachment leading to impaired marginal periodontal healing .
however , both histological and clinical surgical studies have presented contradictory results regarding the success of marginal periodontal healing following etching , and thus , the rationale for routine use of etching in conventional periodontal therapy has been questioned .
nevertheless , in regenerative procedures where recolonization of large areas of the root surface by periodontal connective tissue is a necessity , removal of the smear layer is of singular importance .
in addition , etching has been reported to expose collagen fibers on the root surface .
etching at neutral ph was shown to preserve tissue vitality , while etching at low ph induced an immediate necrosis .
it was concluded that etching at neutral ph appeared in the short - term perspective to produce a more biocompatible surface compared to etching at low ph .
etching of such a surface may yield variable results compared to the more homogenous dentin exposed after scaling and root planning .
cell and fiber attachment to healthy cementum surfaces in vitro is facilitated by citric acid etching .
although the same is not seen after etching of periodontitis affected cementum surfaces , cementum bound endotoxin is capable of both cell death and decrease cell proliferation . smear layer is resistant to saline irrigation and the effect of edta alone has already been proven .
the addition of texapon , a derivative of sodium lauryl sulfate ( sls ) with edta , has shown to provide better smear layer removal than edta alone .
soft soap , a detergent , belongs to the sls family and is cost effective .
hence , the aim of the present in vitro study is to evaluate the efficacy of 15% edta - s ( edta with soft soap ) preparation for the removal of smear layer at human root surfaces .
twenty teeth ( molars ) indicated for extraction , due to periodontal disease were obtained from the department of diagnosis and oral surgery at the s.d.m.c.d.s , dharwad . after extraction , the teeth were stored in a container with saline solution to avoid dehydration of the specimens . using high speed cylindrical bur under copious irrigation ,
two parallel retention grooves were made on the root surface , one at cemento - enamel junction ( cej ) and other 4 mm apical to the first groove .
an experimental smear layer was induced by instrumenting the root surfaces 12 times with gracey 7 - 8 curette ( hu - friedy ) . following root planning ,
the root surface was cut using diamond disc and crown was separated from the root .
all root conditioning agents were drawn in a 5 ml syringe ( 15% edta , saline control , and 15% edta with soft soap 1:1 concentrate ) .
samples were then randomly divided into five groups ; one sample from each group was randomly selected for the application of root conditioning agent .
the efficacy of two different methods of application active application with brush and passive with cotton pellet was also assessed .
the samples were treated with the test and the control agents and allowed to dry for three min .
after lapse of the allotted time interval , the specimen was thoroughly irrigated with copious amount of saline .
the specimens were then mounted on metallic stubs , coated with 20 nm of gold ( ion sputtering ) for observation and photography by scanning electron microscopy ( jeol jsm 840a ) at 3500 for the presence or absence of smear layer .
root surface without smear layer , with the dentinal tubules completely opened without evidence of smear layer in the dentinal tubulesroot surface without smear layer , with the dentinal tubules completely opened , but with some evidence of smear layer in the dentinal tubules entranceroot surface without smear layer with the dentinal tubules partially openedroot surface covered by a uniform smear layer with evidence of dentinal tubule openingroot surface covered by a uniform smear layer without evidence of opening of the dentinal tubulesroot surface covered by an irregular smear layer , with the presence of grooves and or scattered debris 
  root surface without smear layer , with the dentinal tubules completely opened without evidence of smear layer in the dentinal tubules root surface without smear layer , with the dentinal tubules completely opened , but with some evidence of smear layer in the dentinal tubules entrance root surface without smear layer with the dentinal tubules partially opened root surface covered by a uniform smear layer with evidence of dentinal tubule opening root surface covered by a uniform smear layer without evidence of opening of the dentinal tubules root surface covered by an irregular smear layer , with the presence of grooves and or scattered debris
smear layer removal was evaluated according to sampaio et al . , index . 
 root surface without smear layer , with the dentinal tubules completely opened without evidence of smear layer in the dentinal tubulesroot surface without smear layer , with the dentinal tubules completely opened , but with some evidence of smear layer in the dentinal tubules entranceroot surface without smear layer with the dentinal tubules partially openedroot surface covered by a uniform smear layer with evidence of dentinal tubule openingroot surface covered by a uniform smear layer without evidence of opening of the dentinal tubulesroot surface covered by an irregular smear layer , with the presence of grooves and or scattered debris 
  root surface without smear layer , with the dentinal tubules completely opened without evidence of smear layer in the dentinal tubules root surface without smear layer , with the dentinal tubules completely opened , but with some evidence of smear layer in the dentinal tubules entrance root surface without smear layer with the dentinal tubules partially opened root surface covered by a uniform smear layer with evidence of dentinal tubule opening root surface covered by a uniform smear layer without evidence of opening of the dentinal tubules root surface covered by an irregular smear layer , with the presence of grooves and or scattered debris
scanning electron microscope of the control group revealed a root surface covered by an irregular smear layer , with the presence of grooves and or scattered debris .
the edta groups , both passive and active applications , revealed open dentinal tubules with evidence of smear layer present . the edta - s groups with active application revealed completely open dentinal tubules with no evidence of smear layer , whereas edta - s passive application revealed open dentinal tubules with evidence of smear layer present [ figures 15 ] .
presence of heavy smear layer ( score-6 ) 15% edta group : passive application for three minutes .
root surface covered by smear layer with evidence of dentinal tubules opening ( score-4 ) 15% edta - s group : passive application for three minutes .
root surface covered by smear layer with evidence of dentinal tubules opening ( score-4 ) 15% edta group : active application for three minutes .
root surface devoid of smear layer with evidence of dentinal tubules opening , but some evidence of smear layer at dentinal tubule opening ( score-2 ) 15% edta - s group : active application for three minutes .
root surface devoid of smear layer with evidence of dentinal tubules opening , but no evidence of smear layer at dentinal tubule opening ( score-1 )
the purpose of this study was to assess the efficacy of edta preparation with soft soap , a detergent in removing the smear layer on the root surface of human teeth .
several authors have shown that three minute etching with edta is sufficient for the removal of smear layer compared to 10 , 20 , 30 , 40 sec , and 1 and 2 minutes . on the other hand , soft soap is widely used in the medical field to remove incrustation in scaly skin diseases ; it is also used in solution form with warm water as an enema and this signifies its reaction with the mucous membranes and degree of safety .
hence , an attempt was made to incorporate the advantages of edta and detergent like soft soap .
the addition of soft soap , a tense active detergent , decreases the surface strain .
, 2005 achieved better results with 15% edta - t ( texapon ) in comparison with edta alone and found it to be statistically similar at 20% and 24% edta - t .
hence , in this pilot study , we used 15% edta - s ; further studies are required to evaluate removal of smear at varying concentrations and time of application .
the optimal ph for vital fibroblast cell function varies between 7.2 - 7.4 , though some cells may tolerate ph of 6.6 - 7.8 .
demineralized root surfaces serve as a reservoir of biologically active extracellular matrix proteins and growth factors which are essential for bone and cementum formation .
we also found that smear layer removal by active application was better than passive application , which was in conjunction with the study by pilatti et al .
the application with the brush seems to provide a larger surface area compared to application by cotton pellet .
thus , the method of application also plays an important role in determining the success of root conditioning .

 the etching of surface with edta is more effective than saline solution ( control group).edta 15% is more effective , when mixed with soft soap than when used alone.active application of 15% edta - s was more efficacious than passive application . 
 
the etching of surface with edta is more effective than saline solution ( control group ) .
edta 15% is more effective , when mixed with soft soap than when used alone .
 background : to evaluate the efficacy of 15% ethylenediaminetetraacetic acid ( edta)-s ( edta with soft soap ) preparation for the removal of smear layer at human root surfaces.materials and methods : twenty teeth indicated for extraction due to periodontal disease were sectioned using high speed cylindrical bur under copious irrigation . 
 the root surfaces were instrumented with gracey 7 - 8 curette ( hu - friedy ) , 12 times to induce an  experimental smear layer  . following root planning 
 , the root surface was cut using diamond disc and separated from the crown . 
 samples were randomly distributed into five groups . 
 one group was control , saline and test groups were edta 15% alone , by active and passive applications ( groups 2 and 3 ) , and edta 15%+soft soap , by active and passive applications ( groups 4 and 5 ) . 
 specimens were then subjected to scanning electron microscope study . 
 smear layer removal was evaluated according to sampaio et al . , index.results:edta-s removed the smear layer better than plain edta and the control group , while active application of the root conditioning agent had significant difference than the passive application of the agent.conclusion:edta-s has favorable benefits over edta alone , and active application is better in comparison with passive application of root conditioning agent.clinical relevance : removal of smear layer has been considered as an important step in periodontal regenerative therapy . scaling and root planning alone with saline irrigation does not remove the smear layer . 
 edta is a commonly used root conditioning agent in periodontal therapy . 
 the addition of a detergent to edta proved to remove smear layer more efficiently than edta alone . 
Clinical Relevance:
INTRODUCTION
MATERIALS AND METHODS
Data analysis
RESULTS
DISCUSSION
CONCLUSIONS