A History of Proven Efficacy

A 65-year-old female with no clinical symptoms was referred by her dentist, who noticed radiographic signs of bone loss surrounding the roots of her molar. In a single visit, the canals were cleaned and disinfected with the GentleWave Procedure. Eight weeks later, the periodontal reading at the distobuccal root surface measured 2 mm, and periapical imaging revealed extensive bone regeneration. Continued bone regeneration was evident at 3-month, 5-month and 13-month recalls.

The patient presented with biting and palpation tenderness localized to tooth #19 with a draining sinus tract. Probing 12+ mm to the distal apex posed a prognosis challenge. The endo-perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. Diagnosis, prognosis and treatment planning are complicated due to the influence of pulp pathology, which may cause periodontal involvement and vice versa.

Pulpal diagnosis was necrotic pulp with an apical diagnosis of chronic apical abscess. The GentleWave^® Procedure gave me the confidence to complete disinfection and finish treatment in a single visit. Re-evaluation in four weeks demonstrated resolution of the sinus tract and probing depths. At three months, this case demonstrated nearly complete osseous regeneration of previous low-density areas.

“The resolution of symptoms is one factor. However, the ‘early healing’ I am seeing in my practice with the GentleWave^® Procedure is extraordinary.”

This patient’s first molar, diagnosed with necrotic pulp with symptomatic apical periodontitis, was cleaned and disinfected with the GentleWave® Procedure in a single visit. Post-GentleWave Procedure, intricate apical anatomy with at least eight visible portals of exit was revealed.

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 patient presented to our office with a complaint of swelling in the area of tooth #15. A sinus tract had been present for about one month. Upon examination, the tooth was diagnosed as necrotic pulp with chronic apical abscess. In a single visit, I was able to thoroughly clean and disinfect the tooth with the GentleWave^® Procedure. The tooth was obturated using AH Plus^® Sealer and warm vertical compaction of gutta-percha.

"The cleaning ability of the GentleWave^® Procedure allowed me to effectively clean exquisite anatomy and provide a result that I was unable to attain previously via traditional methods."

A tooth’s survivability is greatly reduced when there’s a crack at or near the level of its roots. In this case, tooth #31 was cracked with a diagnosis of pulpal necrosis and symptomatic apical periodontitis. Initial recommendation was tooth extraction, but the patient’s preference was to save the tooth. The GentleWave® Procedure was our best approach to preserve as much of the remaining structural integrity of the root. In a single visit and with minimal instrumentation, the GentleWave Procedure thoroughly cleaned and disinfected the root canal system to promote tooth healing.

"With minimal instrumentation, I was able to depend on the GentleWave® Procedure to thoroughly disinfect the root canal system. And for healing to occur in the presence of a crack is even more impressive."

At 6-month recall, the results are impressive. The patient is asymptomatic and showing excellent healing.