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.
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!

Takeaway:

Know the tools available at your specialists’, and how endodontists are changing the game with technology like this. Just when you think you need to give up, you can give a tooth a chance! -Sonia

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