The GentleWave® Difference isn’t just in the patient experience—it is proven in post-procedure radiographic examination. The far-reaching capabilities of the GentleWave Procedure can be visualized in the following case study gallery, evidencing its ability to locate and efficiently clean the deepest, most complex portions of the root canal system2,3 that are frequently left untouched by standard root canal therapy.4
4 Paqué F et al. (2010) J Endod. 36:703-7
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 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."
After obturation of a mandibular left second molar, a complex apical anatomy was visible between the mesial and distal canals. This anatomy was not known prior to the GentleWave Procedure.
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.
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.
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.