Six-month healing success rates after endodontic treatment using the novel GentleWave™ System: The pure prospective multi-center clinical study

Asgeir Sigurdsson, Khang T Le, Stacey M Woo, Shahriar A Rassoulian, Kimberly McLachlan, Farah Abbassi, Randy W Garland, Asgeir Sigurdsson, Khang T Le, Stacey M Woo, Shahriar A Rassoulian, Kimberly McLachlan, Farah Abbassi, Randy W Garland

Abstract

Background: This prospective multi-center (PURE) clinical study evaluated healing rates for molars after root canal treatment employing the GentleWave® System (Sonendo, Inc., Laguna Hills, CA).

Material and methods: Eighty-nine patients met the inclusion criteria and consented for this clinical study after referral for a root canal treatment. All enrolled patients were treated with the GentleWave System. Five endodontists performed the clinical procedures and follow-up evaluations. Pre-operative, intra-operative, and post-operative data were collected from the consented patients. Each patient was evaluated for clinical signs and symptoms. Two trained, blinded, and independent evaluators scored the subject tooth radiographs for apical periodontitis using the periapical index (PAI). The teeth classified as healing or healed were considered as a success and composed of a cumulative success rate of healing. Statistical analysis was performed by using the Fisher's exact test, Pearson correlation, and multivariate logistic regression analyses of the pre-operative prognostic factors at 0.05 significance level.

Results: Seventy-seven patients were evaluated at six months with a follow-up rate of 86.5%. The cumulative success rate of healing was 97.4%. Eleven prognostic factors were identified using bivariate analyses. Using logistic analyses, the two prognostic significant variables that were directly correlated to healing were the pre-operative presence of periapical index (p value=0.016), and single treatment visits (p value=0.024).

Conclusions: In this six-month PURE clinical study, the cumulative success rate of healing was 97.4% when patients were treated with the GentleWave® System.

Key words: Healing rate, root canal treatment, molar, GentleWave™, Sonendo®, Multisonic Ultracleaning™ .

Conflict of interest statement

Conflict of interest statement: AS and RG are consultants at Sonendo® Inc.

Figures

Figure 1
Figure 1
The handpiece of the GentleWave System placed on the subject tooth. The treatment instrument does not enter the tooth but sits on a sealed platform. The tip of the handpiece enters the pulp chamber of the tooth.

References

    1. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16:498–504.
    1. Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – Part 1. Effects of study characteristics on probability of success. Int End J. 2007;40:921–39.
    1. Loest C. Quality guidelines for endodontic treatment: consensus report of the european society of endodontology. Int Endod J. 2006;39:921–30.
    1. Siqueira JF. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34:1–10.
    1. Hulsmann M, Hahn W. Complications during root canal irrigation: literature review and case reports. Int Endod J. 2000;33:186–93.
    1. Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Top. 2005;10:77–102.
    1. Tay FR, Gu L, Schoeffel GJ, Wimmer C, Susin L, Zhang K. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010;36:745–50.
    1. Muñoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars J Endod. 2012;38:445–88.
    1. Beus C, Safavi K, Stratton J, Kaufman B. Comparison of the effect of two endodontic irrigation protocols on the elimination of bacteria from root canal system: a prospective, randomized cinical trial. J Endod. 2012;38:1479–83.
    1. Li D, Jiang S, Yin X, Chang JWW, Ke J, Zhang C. Efficacy of needle, ultrasonic, and endoactivator irrigation and photon-induced photoacoustic streaming in removing calcium hydroxide from the main canal and isthmus: an in vitro micro-computed tomography and scanning electron microscopy study. Photomed and Las Surg. 2015;33:330–7.
    1. Martins MR, Carvalho MF, Vaz IP, Capelas JA, Martins MA, Gutknecht N. Efficacy of Er, Cr:YSGG laser with endodontic radial firing. Lasers Med Sci. 2013;28:1049–55.
    1. Merino A, Estevez R, de Gregorio C, Cohenca N. The effect of different taper preparations on the ability of sonic and passive ultrasonic irrigation to reach the working length in curved canals. Int End J. 2013;46:427–33.
    1. Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A. Effect of Different Apical Preparation Sizes on Outcome of Primary Endodontic Treatment: A Randomized Controlled Trial. J Endod. 2012;38:1309–15.
    1. Haapasalo M, Wang Z, Shen Y, Curtis A, Patel P, Khakpour M. Tissue dissolution by a novel multisonic ultracleaning system and sodium hypochlorite. J Endod. 2014;40:1178–81.
    1. Ma J, Shen Y, Yang Y, Gao Y, Wan P, Gan Y. In vitro study of calcium hydroxide removal from mandibular molar root canals using a GentleWave™ System. J Endod. 2015;41:553–8.
    1. Charara K, Friedman S, Sherman A, Kishen A, Malkhassian G, Khakpour M. Assessment of apical extrusion during root canal procedure with the novel GentleWave System in a simulated apical environment. J Endod. 2016;42:135–9.
    1. Molina B, Glickman GN, Vandrangi P, Khakpour M. Histological evaluation of root canal debridement of human molars using the GentleWave™ System. J Endod. 2015;41:1701–5.
    1. Segura-Egea JJ, Cisneros-Cabello R, Llamas-Carreras JM, Velasco-Ortega E. Pain associated with root canal treatment. Int End J. 2009;42:614–20.
    1. Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986;2:20–34.
    1. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod. 2003;29:787–93.
    1. Friedman S, Lost C, Zarrabian M, Trope M. Evaluation of success and failure after endodontic therapy using a glass ionomer cement sealer. J Endod. 1995;21:384–90.
    1. Murphy WK, Kaugars GE, Collett WK, Dodds RN. Healing of periapical radiolucencies after nonsurgical endodontic therapy. Oral Surg Oral Med Oral Pathol. 1991;71:620–4.
    1. Asgary S, Eghbal MJ, Ghoddusi J, Yazdani S. One-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial. Clin Oral Invest. 2013;17:431–9.
    1. Barone C, Dao TT, Basrani BB, Wang N, Friedman S. Treatment outcome in endodontics: the Toronto study—phases 3, 4, and 5: apical surgery. J Endod. 2010;36:28–35.
    1. Chong BS, Pitt Ford TR, Hudson MB. A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J. 2003;36:520–6.
    1. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single and multiple-visit endodontic treatment: a systematic review. Int End J. 2008;41:91–9.
    1. Ng YL, Glennon JP, Setchell DJ, Gulabivala K. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int End J. 2004;37:381–391.
    1. Gondim E, Setzer FC, Dos Carmo CB, Kim S. Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod. 2010;36:1295–301.
    1. Xiao D, Zhang DH. A clinical study of one-visit endodontic treatment for infected root canals. Hua Xi Kou Qiang Yi Xue Za Zhi. 2010;28:57–60.
    1. Murdoch-Kinch CA, McLean ME. Minimally invasive dentistry. J Am Dent Assoc. 2003;134:87–95.

Source: PubMed

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