roots C.E. - the international magazine of endodontology

I case study_ GentleWave Procedure 18-month case study of a C-shaped mandibular molar: Preserving dentin and deep cleaning utilizing an innovative procedure Author_Khang T. Le, DDS, SC Endodontics, Santa Ana, Calif. _Introduction Complexities within the root canal system provide intricate regions for tissue, debris and bacteria-rich environments that remain untouched after standard root canal treatment. When the complicated anato- mies of a C-shaped canal are introduced, occurring in about 8 percent of mandibular second molars, the endodontic challenges for debridement and disin- fection are increased.1-3 An innovative technology, the GentleWave® Procedure (Sonendo®, Laguna Hills, Calif.) has been shown to enhance root canal cleaning and disinfection through advanced fluid dynamics, acoustics and tissue dissolution chemistry (Fig. 1).4-8 Studies have shown the GentleWave Pro- Fig. 1_The GentleWave Procedure (Image/Provided by Sonendo) Fig. 1 14 I roots 1_ 2017 cedure to have seven times faster tissue dissolution than standard root canal systems and demonstrated success rates of 97 percent at 12 months.6,9 _Background A 47-year-old female presented with a chief complaint of spontaneous pain and sensitivity to cold and chewing. The patient reported a history of hypothyroidism, but all other medical history was unremarkable. Upon clinical examination, the man- dibular second molar (#31) showed moderate sen- sitivity to percussion and palpation. Vitality testing elicited a lingering response (Fig. 2a). A diagnosis of symptomatic irreversible pulpitis and symptomatic apical periodontitis was made. _Methods Following conservative endodontic access, ex- amination of the pulp chamber floor revealed a C-shaped canal. To preserve tooth structure, orifice openers were not utilized. Two file paths were cre- ated to an apical diameter of #20 merely to facilitate a fluid and obturation path. This preservation of dentin is crucial, as clinical success in endodontics has been correlated to the maintenance of original canal shape.10 While excessive apical enlargement may lead to complications like apical transportation, ledges and instrument separation, it also has the potential to weaken the tooth, thereby increasing the likelihood of root fractures.11-13 The GentleWave System was utilized to remove pulp tissue remnants, debris, smear layer and bacteria from the entire root canal system.5-8 The GentleWave Procedure was the endodontic treatment modality of choice for this case, due to its ability to thoroughly

roots C.E. - the international magazine of endodontology

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