A History of Proven Efficacy

A 40-year-old male presented with severe intermittent pain on the lower left side of the mouth for two months. His diagnosis was pulpal necrosis and symptomatic apical periodontitis. The old filling material and underlying carious lesion were removed and missing tooth structure was restored. The tooth was prepared with conservative straight-line access, and the canals were instrumented to size 20/.07. The GentleWave^® Procedure was employed to clean and disinfect the root canal system, followed by obturation with warm vertical technique. Post-procedure, an isthmus was visualized between the two mesial canals, and a lateral canal and an apical delta were seen on the distal canal. Evaluation at 6, 9 and 18 months showed the tooth was asymptomatic. Significant bone regrowth with complete periradicular healing were evident at 18-month recall.

Upon clinical examination, the mandibular left second premolar (#20) revealed an asymptomatic tooth with no sensitivity to percussion or palpation and Class I mobility. Post GentleWave^® Procedure, at nine-month recall, clinical evaluation showed the tooth was asymptomatic. Radiographic evaluation showed complete bone regrowth and periradicular healing.

A 41-year-old female patient was referred by her general dentist for evaluation for retreatment of tooth #14. The patient presented with mild swelling of the facial gingival tissues adjacent to #14, and a sinus tract was present. Periodontal probing was within normal limits.  

The initial treatment of the tooth 20 years ago missed the mesiopalatal (MB2) canal, causing significant periradicular bone loss. It was remarkable to see the significant bone regeneration at the 4-month recall.

"The GentleWave^® Procedure allowed me to perform a retreatment in a single visit, without continued instrumentation and further canal enlargement."

Upon post-operative radiographic examination, multiple lateral canals within the apical third of the palatal and distobuccal canals as well as an isthmus between the mesiobuccal canals were visualized. Upon contact with the patient three days post-operative, the patient reported no discomfort.

In a single visit, three canals were prepared to an apical diameter of 20/04, followed by the GentleWave^® Procedure to clean and disinfect the canals. Following obturation, an isthmus communication between the fused mesiobuccal and palatal roots was noted. The unusual PAX findings were evaluated by CBCT. An apical delta containing multiple exits was discovered in the palatal canal. The GentleWave Procedure cleaned a deep split isthmus between the mesiobuccal canal and palatal canal, which otherwise may have been left uncleaned and unfilled.

"Obturation revealed the GentleWave^® Procedure debrided a mid-root and apical isthmus as well as multiple exits in the palatal canal, in the apical third of the mesiobuccal-palatal root formation and connections."

The patient reported no pain two days postoperatively (after reporting a preoperative pain level of 8 on an 11-point verbal pain scale). This case highlights the clinical significance of utilizing the GentleWave Procedure for cleaning complex apical anatomy during endodontic therapy.

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.