A History of Proven Efficacy

Post obturation, an apical delta containing multiple exits was discovered in the palatal canal, which would have otherwise been left undiscovered and uncleaned without the GentleWave^® Procedure.

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, with no reported postoperative discomfort. Especially in today’s environment, single visit appointments are ideal for patients and our practice while having confidence in the clinical outcome."

A female patient presented with tooth sensitivity and pain on biting on tooth #31. In 2003, the patient had two apicoectomies completed on tooth #30 and #31. Tooth #30 had a retrograde prep and fill placed that was still intact. Tooth #31 did not receive a retrograde fill; the mesiobuccal root was resected with a high bevel, and the mesiolingual was never fully resected through. Tooth #31 was diagnosed with symptomatic apical periodontitis. In a single visit, the GentleWave^® Procedure cleaned and disinfected the tooth. At the six-month recall, radiographs revealed healing of the bone. The patient reported experiencing no post-op pain immediately following the procedure or in the six months since.

"If I could go back in time, I would elect to have the GentleWave^® Procedure completed on my first root canal procedure. For 21 years, I continued to experience discomfort while professionals justified my discomfort through bite adjustments and new crowns, saying that another tooth was to blame. I truly felt this would be a never-ending problem I’d have to deal with. For the first time in 21 years, I feel whole and am no longer experiencing discomfort."

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.”

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 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.