Dentaltown July 2020 - 42

treat a larger proportion of the root canal
system while keeping the tooth (and the
original dimensions of the root canals) in
more of a natural state. One of the ways I
explain the system to my patients is to say
that it's endodontics' answer to a minimally
invasive procedure.

A different approach
A GentleWave case starts much the same
way a conventional root canal treatment
would start. We access the tooth, aiming to
keep the access as conservative as possible.
I then locate all the canals and establish
working length using a Size 8 or 10 K-file.
Those are the last filing instruments that
need to go to working length; all other files
and rotary instruments are measured 1mm
short of the working length, depending on
other factors specific to each case.
The goal of filing canals in a GentleWave
case is no longer to shape the canals-in
fact, ideally, we don't want to alter the shape
of the original canal at all. Instead, the goal
becomes to simply ensure that we have a
path for the GentleWave fluids to follow
and flow through. So I usually finish my
hand instrument sequence with a Size 15
K-file and then follow that with a Size 15/.04
and 20/.04 Vortex Blue rotary instrument
(Dentsply Sirona) to the adjusted working
length. That's it for instrumentation on most
canals; occasionally, I will use a Size 25/.04
Vortex Blue on larger canals. Then it's time
for the GentleWave.
Before we can start this cycle, we need to
do some preparation of the tooth. The system
relies on an airtight closed system-the tooth,
the root canal system and the GentleWave
device-created by building a flat surface
(platform) on the tooth out of a light-cured
resin such as SoundSeal from Sonendo or
Kool-Dam from Pulpdent (Figs. 4a-c). Once
I have my platform built, we then place the
GentleWave procedure instrument (or PI,
which is Sonendo's term for "handpiece")
onto the platform and start the cycle (Fig. 5).

42

Fig. 4a: The template used to form
the platform for GentleWave to run.

Fig. 4b: After coating the platform template
with light-cured resin, it's placed over the
access preparation and cured.

Fig. 4c: The platform is modified to
achieve the same shape as the original
access preparation in the tooth.

Fig. 5

JULY 2020 // dentaltown.com

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Dentaltown July 2020

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