A History of Proven Efficacy

A 74-year-old male presented with intense pain and buccal swelling on tooth #30. His general dentist prescribed antibiotics. Upon examination, buccal swelling remained, and his pain had decreased from severe to moderate. The tooth was nonresponsive to cold and sensitive to percussion. The diagnosis was necrotic pulp with acute apical abscess.

"In a single visit, the GentleWave^® Procedure thoroughly cleaned the three mesial canals with three separate exits and multiple distal canal paths which joined into a common exit. Furthermore, the furcal bone loss seen in the radiographs might have misled us into suspecting a cracked tooth. Instead, we saw how the lateral canal on the mesial surface of the distal root caused this furcation radiolucency, thereby avoiding condemning this tooth to a potentially unnecessary extraction."

Does anatomy matter?

It’s one of the questions I considered when incorporating the GentleWave^® Procedure into my practice. When I obturated this case, treated with the GentleWave Procedure in a single visit, my initial excitement was certainly around the “crazy anatomy.”

The healing at two and ten months reiterates that anatomy does matter. Thorough cleaning and disinfection with minimal instrumentation, in a single visit and with these results, reminds me why I invested in the GentleWave^® Technology.

With the assistance of the GentleWave^® Procedure, I was able to complete a very challenging root canal on tooth #13 in a single visit. The patient presented with pain (4 on a 10-point scale) to cold and biting for the past month. The canal anatomy corkscrewed, with the final 2 mm turning beyond a 90-degree bend. Ni-Ti hand files and rotary instruments couldn't access beyond the bend without significant unwinding and risk of separation. Working length was achieved with sizes 6, 8 and 10 K files. Final instrumentation to 25.06 was completed to the point where the file could reach, which was essentially before the apical curve. Following the GentleWave Procedure, the canal was dried and filled with BC Sealer^™ and warm gutta-percha. The post-procedure radiograph revealed apical deltas. Post-operatively, the patient reported no pain or swelling and a complete relief of symptoms.

Before adopting the GentleWave^® Procedure, adequate debridement of the canal—especially apical to the curvature—would have been significantly more difficult, and the risk of instrument separation would have been greater.

A patient presented with pain to biting on the lower right. The PA showed periapical pathology on tooth #30. During examination, the tooth tested positive to percussion, negative to palpation and did not respond to cold (Endo-Ice^®). According to the patient, the crown was placed less than one year ago. Diagnosis was confirmed as necrotic pulp with symptomatic periapical periodontitis.

In a single visit, the GentleWave^® Procedure thoroughly cleaned the canals and provided visible evidence that the very intricate accessory anatomy of the canal system was cleaned and obturated.

“In my experience, traditional RCT treatment wouldn’t have come close to this result.”

A 58-year-old patient presented with symptoms on tooth #19. The tooth was diagnosed with pulp necrosis and symptomatic apical periodontitis. In a single visit, the GentleWave^® Procedure was able to effectively clean and disinfect a double, curved root in this conservatively shaped anatomy.

"At the two-month recall, rapid healing was evident. In my experience, I wouldn’t have obtained the same result if treated with standard RCT."

A 66-year-old male patient was referred by his restorative dentist for evaluation and potential treatment of tooth #31. The patient presented with an existing all-porcelain crown placed two weeks prior. Examination and findings were consistent with a pulpal diagnosis of irreversible pulpitis. Projection radiographs as well as limited FOV CBCT were acquired. Conservative orifice-directed access exposed vital pulp tissue in the root canal system. In a single visit, endodontic treatment was initiated and the root canal system was prepared for the GentleWave^® Procedure using 14/.03 and 17/.04 V-Taper™ 2H files. Obturation consisted of single non-standardized gutta-percha cones in each canal and sealer.

"With the cleaning ability of the GentleWave^® System, I was able to treat this vital pulp in a single visit, something that I may not have been able to do predictably with traditional endodontics. Postoperative radiographs showcased significant accessory root canal system anatomy, especially in the apical one third."