The field of endodontics has changed tremendously over the years, and a big change is about to come again — a way to prevent root canal failure with extreme irrigation techniques throughout the whole tooth. .
I remember in dental school being in awe of the microscope. I would watch the endo residents and wonder what were they seeing. It didn’t make much sense to me at the time, simply because I didn’t have that much experience, but I now see the significance.
By the time I got to my residency, the CBCT started to make its way into the marketplace. I was able to play around with an ICAT, but only on a few patients. My experience with the technology was minimal. By the time I opened my own practice, this new cone beam imaging had started to really take off and I did everything in my power to make sure that I got one. And man am I glad that I did, because the CBCT has changed my life and the way I practice.
Just when I thought things couldn’t get any better for my specialty, it has! For the past decade, I have had a handful of patients who still have issues with their tooth after their root canal. The root canal looks great, there is no lesion, but the tooth feels different than their other teeth. And there is no evidence of a crack either. My answer until now has been to simply retreat the tooth and see if long term calcium hydroxide medication does the trick — and 8 times out of 10, it does. But, what about the other 20% of teeth? I don’t exactly have an explanation for patients’ persistent pain, but since everything is bacterial in endo, then this must be the problem.
Enter this new technology. Recently I completed a demo of the GentleWave Procedure by Sonendo, and I was blown away! This procedure is irrigation on steroids! I mean, we all know that our rotary files are only cleaning about 35% of the canals, so our success is heavily based on irrigation.
I wanted to share with you some of my pictures from my trip to Nashville, where my friends from Cumberland Endodontics so graciously welcomed me into their practice to share their knowledge with me.
I can’t wait to ramp up my endo game again and start using this in my practice. I mean, let’s face it, the CBCT + the microscope + the GentleWave= success!! I see a wave of amazing tooth stories in our future!
Enter this new technology. Recently I completed a demo of the GentleWave Procedure by Sonendo, and I was blown away! This procedure is irrigation on steroids! I mean, we all know that our rotary files are only cleaning about 35% of the canals, so our success is heavily based on irrigation.
This new technology addresses those issues with a traditional root canal. “Unlike standard root canal treatments, the GentleWave Ultracleaning Procedure is able to reach all throughout your tooth—even in the microscopic places where bacteria can hide.”THIS my friends, is the next hot topic in endo. And I can’t wait to start sharing my GentleWave cases with you. I really hope that this is the answer for my RCT patients, keeping those pesky retreat cases at bay.
Sonendo explains the GentleWave Technology: “The GentleWave® Procedure is a minimally invasive alternative to standard root canal treatment. The innovative procedure utilizes Multisonic Ultracleaning® technology, which enables procedure fluids to reach through the entire root canal system, providing efficient cleaning of the complex root canal anatomies. To visualize how Multisonic Ultracleaning works, envision a vortex of cleaning fluids traveling into the roots of your tooth. Even though the root canal system can be very complex, with several twists and turns, this vortex of fluids is able to reach the deepest portions that the files used in standard RCT simply cannot.”Watch this video to get an overview of the GentleWave Procedure:
I wanted to share with you some of my pictures from my trip to Nashville, where my friends from Cumberland Endodontics so graciously welcomed me into their practice to share their knowledge with me.
I can’t wait to ramp up my endo game again and start using this in my practice. I mean, let’s face it, the CBCT + the microscope + the GentleWave= success!! I see a wave of amazing tooth stories in our future!
woooowww. Be the guide to all ……
I salute your passion and the way you represent yourself
I really appreciate you reading AND your kind words!
-Sonia
Thanks for sharing this information. Informative and interesting!
Thank you for reading, Lian!
-Sonia
Has there been any incidents of the Gentlewave procedure perforated the sinus cavities?
Hi Robert. I believe that there have been a few slight incidences, however, I have never experienced them (knock on wood). You will have the patient feel it from time to time, but just like anything else, you have to be smart. All you have to do is lift your foot off the pedal and abort it. As soon as you stop, there is no longer any discomfort in those situations. Thanks for your question.
-Sonia
Thanks for sharing! You r doing tremendous job to all the dentists out there by sharing these informative blogs!! Stay blessed girl!
Thank you, Hina – I appreciate that!
-Sonia
Hi Dr. Chopra,
Would you recommend a general dentist to purchase the gentlewave system ?
Thanks
Ravi
Dr. Ravi,
If you feel that it is going to be cost effective for you, then sure. It’s not cheap and there is a learning curve, so keep that in mind!
-Sonia
Hi Dr Sonia,
Thanks for sharing your passion. Are there any chances of tissue damage caused by radicular extrusion of irrigant leading to IAN injury or sinus perforation. It will be great if you can share reported incidence or research done on that.
Hi Sunil,
I am sure there is no matter how you irrigate. I personally have not experienced any type of accident from the Gentlewave. And just like anything, you have to use it as directed. There are safety features of the device that help too. Plus, the irrigant comes out as a mist and not forceful, if the patient is uncomfortable you just stop the machine by lifting up your foot from the pedal. Simple!
Sonia
Nice article regarding root canal.
Thank you!
-Sonia
After 6 weeks I had a root canal failure. Same pain as I had 8 weeks prior to the root canal being done. See my general dentist every 6 months with beautiful teeth. High level of investment to be sure they are healthy. Gentle Wave was used by endodontist. Within weeks I have pain and another infection. Gentle wave does not do what it is supposed to do.
So within a month another root canal.
Hi there. I am so sorry that you are still having a problem with your tooth. Not everything is 100% successful in medicine. As an endodontist that uses Gentlewave, I will still have a case here and there that I will have to redo. Most of the time, after that redo, the patient feels better. Not everything is dependent on the treatment or the tools, there are also variables that exist within the host and how someone heals. I would have another visit with your endodontist to see if they can have another look. Best of luck.
-Sonia
Thank you for sharing this article with us. I am student of DDS and looking for this information for a long time. I have to make a thesis on root canal.
Thank you for reading! Good luck on your thesis!
-Sonia
I had the procedure with a good result the next day, but my swelling and bump on my gumline did not resolve. I was seen by the young endodontist’s partner who gave me antibiotics and a month later it looked exactly the same but he sent me to my dentist to have my tooth restored. My dentist still saw an infection and sent me back. The endodontist who performed the GentleWave said it wasn’t an infection. He said it was the biocompatible material he used to fill it that caused the bump and swelling and said my gum tissue had grown over it. I needed gum surgery to remove it and it would take 2 weeks to heal completely. The stitches were removed and it has not healed. I’ve lost trust in the endodontist as well as the procedure because I’ve had a traditional root canal at the same practice without complications. Have you had this experience?
Susan,
I am so sorry that you are having this experience. It is possible that you may not heal, no matter what is done. No matter how good a job we do, there will always be a few that fail. I hope that that is not you and that you just need more time, but nothing in medicine is 100%. But, that doesn’t mean that it doesn’t work. I wish I had more information to help guide you, but without getting my eyes on it, there is only so much that I can comment. Good luck.
-Sonia
You’re doing an amazing job for all dentists who read the informative blog posts! Keep it up!
Thank you for reading!
-Sonia
How many gentle wave procedures are necessary to prepare the root for final treatment.
Usually it takes just one. Sometimes you will have a case that requires two.
-Sonia
Do you believe that Gentle Wave, along with microscope, ultrasonics, CBCT is/will become the standard of care?
CG,
It is in my mind! I think it will take some time for it to be official though.
-Sonia
Hi Dr. Chopra! Thanks for telling us your experience with gentlewave. How much did it cost you to set up the gentlewave? I am thinking of incoporating the gentlewave in my future practice. And how much does it cost to run the machine for single case?
Dr. Sung, Trust me when I tell you that you will get your ROI on this technology. There are so many hidden ROIs with this tech. Most people charge their patients $100 for the handpiece to run the machine. I give a workshop on this to GW users, so feel free to reach out to Sonendo and see if you can attend. You will learn a lot.
-Sonia