A History of Proven Efficacy

This case is a beautiful example of the power of the GentleWave^® Procedure with conservative instrumentation. Using VTaper 2H files to retain as much cervical root structure as possible, the Multisonic Ultracleaning^® energy of the GentleWave Procedure allowed us to accomplish our goals for maximum cleaning and disinfection. Notice the secondary anatomy — areas clearly cleaned by the GentleWave^® System — where I never introduced a file.

A 61-year-old male was referred by his dentist for endodontic examination of tooth #4. The diagnosis was necrotic pulp and asymptomatic apical periodontitis. The tooth was accessed and instrumented to size 17/.06. The GentleWave^® Procedure was used to clean and disinfect the root canal system and was followed by obturation with warm vertical condensation. Given the file’s inability to completely remove bacteria and biofilm, many clinicians feel that a two-visit approach to root canal therapy is prudent, especially in necrotic teeth. The GentleWave System’s ability to reach deep into dentinal tubules and other complex anatomy allows for the confidence to treat patients with a one-visit procedure.

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 31-year-old female patient presented to our clinic with a chief complaint of pain in the lower right jaw. Tooth #30 was diagnosed with pulp necrosis/symptomatic apical periodontitis.

By the end of canal instrumentation, four canals had been located: two in the mesial and two in the distal roots. Following the GentleWave^® Procedure, two tiny orifices became noticeable between MB and ML canals; they turned out to be two mid-mesial canals. Pre-op CBCT had not hinted at the presence of mid-mesial canals.

The immediate post-op radiograph shows the filling of six canals with gutta-percha and BC Sealer™. The two mid-mesial canals join each other at the apical half, and all four canals in the mesial root join at the apical 3 mm level.

“Without the cleaning ability of the GentleWave Procedure, I would have missed the additional two middle canals, which could have resulted in a persistent infection.”

A mandibular right second molar with a large carious lesion invading the pulpal space was treated with the GentleWave® System. The entire root canal system including the lateral canal was cleaned and obturated.

Six months post-op, the periradicular bone appeared to have completely healed. The patient resumed active orthodontic treatment. This case illustrates the power of a single-visit GentleWave® Procedure in effectively cleaning and disinfecting the root canal system and promoting rapid healing.