Despite multiple technological innovations in the field of endodontics in the past few decades, the approach for the treatment of root canal therapy has always remained the same. For the most part, the conventional endodontic protocols are the root cause for the complications suffered by patients after RCT treatment such as root fractures, perforation, and even extractions, etc. Recognizing the loopholes of traditional endodontic procedures, Sonendo Inc. aims to completely transform the way root canal therapies are performed, challenging the status quo, and leveraging new mechanism of action Multisonic Ultracleaning™ technology by introducing the advanced Sonendo’s groundbreaking GentleWave System. The system is specifically designed for endodontics to provide better treatment outcomes while maintaining the integrity of the tooth. Leveraging patented and novel endodontic technology, the GentleWave system delivers more thorough cleaning and disinfection in the entire root canal system, even in the deepest and microscopic places where bacteria could proliferate easily, and thereby leaves the tooth structure clean and intact. 

Unlike most conventional endodontic procedure that leaves the patient in distress and trauma, the GentleWave procedures are convenient and pain-free that enhances the patient’s experience as well as improves the quality of treatment. Most of the GentleWave procedures are performed in a single visit so the patient does not need to book multiple appointments, which saves their time and money. The GentleWave system is safe for clinicians, staff, and patients as it produces virtually no aerosolized materials into the air during normal use, and thus reduces the threat of airborne infections. Moreover, the instruments utilized in the GentleWave procedures are pre-sterilized and single use, which minimizes the risk of exposure from one patient to another. 

Sonendo’s GentleWave system is a milestone in the field of endodontics, which has positively impacted the lives of more than 500,000 patients till date. The patient-centric innovation is a minimally invasive alternative to standard root canal treatment which enables efficient cleaning to reach the entire root canal system and its complex anatomies and provide fewer chances of treatment failure over time. 

How Sonendo GentleWave System works?

Sonendo’s GentleWave system comes with a handpiece connected to a freestanding, ergonomic, mobile consoler containing a reservoir of treatment fluids. The user-friendly interactive screen guides clinicians step-by-step for the procedure. The GentleWave system utilizes Multisonic Ultracleaning™ technology to manage the efficient cleaning of the root canal system. The mechanism of action initiates with the fluid management system in the operating system, which automatically prepares and delivers the desired concentration of the treatment fluids such as sodium hypochlorite, EDTA, and distilled water. One of the important aspects of root canal cleaning is regulating the gas content of the treatment fluids, and GentleWave system is the ultimate solution for that. The gas content found in even the microscopic bubbles can prevent the treatment fluid from reaching the complex anatomy of the root canal system, so the system reduces the gas content of fluids. The bubbles could also result in apical vapor lock that has a detrimental impact on the efficacy of debridement because the fluids restrict to one-third of the canal. The GentleWave system extracts all gases and optimizes treatment fluids before they make an entry into the root canal system to prevent the formation of apical vapor. 

Then, the calibrated fluids pass through the GentleWave’s system instrument where patented Multisonic Ultracleaning technology makes things revolutionary. When the system is activated, the treatment solution flows into the tooth via the tip of the instrument. The interaction of stream fluid with the fluid inside the pulp chamber creates a strong force, causing hydrodynamic cavitation. The rapid formation and imposing of micro-bubbles inside the cavitation cloud generates a broad-spectrum acoustic field, that enables fluid to travel throughout the root canal system. The tip of the instrument is designed in such a way that it deflects the stream of treatment fluid to generate a flow over the orifices of the root canal. Degassing the treatment fluid minimizes the energy loss and ensures energized treatment fluid reaches the entire root canal system. Thus, the novel three-dimensional Multisonic Ultracleaning technology assures highly effective cleaning and disinfection from the crown to the apex without requiring any additional tools or instruments. 

Over-instrumentation within the canal can accumulate debris into the eccentricities and remove tooth structure. It can also lead to more retention of bacteria and tissues, which increases the chances of reinfection and weakening of the tooth. GentleWave technology enables the endodontists to use smaller instruments to shape and work in the main areas of the canal and thus preserves canal structure. Allowing simultaneous canal disinfection and debris removal, GentleWave system helps patients to get their root canal therapies in just one treatment session. 

GentleWave System vs Other Irrigation Techniques 

Different methods devised for the effective cleaning of root canal system are ultra-sonic irrigation (with or without simultaneous ultrasonic instrumentation), negative pressure irrigation (uses negative pressure to pull the irrigating solution), sonic irrigation (operate at a lower frequency than ultrasonic), photon-induced photoacoustic streaming (PIPS), and laser technologies. The safety and reliability of these techniques have been questioned time and again. The positive pressure-induced techniques may lead to severe patient trauma, irrigant extrusion to the peri-apex, and post-operative pain. Some of the techniques require increased dentin removal from the roots, which can weaken the remaining tooth and negatively affect long-term healing rates.

The GentleWave System consists of a console and a treatment instrument to clean and disinfect the root canal system, which requires minimum instruments. When compared to the conventional irrigation systems, the GentleWave System shows at least eight to ten times greater tissue dissolution efficacy. Besides, the system is ideal for cleaning the apical-third regions, which are inaccessible with conventional methods. The GentleWave system is the only technique capable of removing calcium hydroxide and thus guarantees overall canal cleanliness and safety. Moreover, the system results in negative pressure and zero extrusion at the apex, resulting in successful healing in the teeth. 

While post-operative pain is inevitable after most of the endodontic treatments, GentleWave system makes sure that patients do not feel a throbbing pain post-treatment. Over-instrumentation, extrusion of the irrigation solution, extrusion of root canal microbes into the periapical area, etc. are some of the factors that lead to excruciating pain, and the GentleWave system eliminates all these elemental root causes of pain. Contrary to standard root canal procedure that requires two appointments, the GentleWave system requires a single visit to the clinic, which has numerous advantages such as reduction of the inter-appointment infections, better patient acceptance, reduced costs, and time.  

Utilizing methods that minimally eliminate dentin structure while accessing the teeth, the GentleWave system preserves the dentin structure in its native form. RCT using the novel technology shows a healing rate of 97.4% within six months and long-term follow-ups further improve the healing. 

Conclusion

Besides GentleWave system, there are no current cleaning and shaping techniques that remove all bacteria, biofilm, and tissue from canal systems, and no instrumentation system able to reach every corner. The state-of-the-art, technique-sensitive, operator-sensitive is an unparalleled method to create “ultraclean” canals within less than 10 minutes. But the fact that the system would increase the cost multifold for the patients and require extensive training cannot be ignored as the factors can affect the adaptability of the system. Although there are many research papers and studies that demonstrate the efficacy of the system, most of them are sponsored which is enough to question the credibility of the new endodontic technology. However, the benefits of GentleWave™ system by Sonendo® are far too many which instils confidence in endodontists to use the system in their daily clinical practice. 

According to TechSci research report on “Global Dental Equipment Market By Type (Dental Radiology Equipment (Extraoral Radiology Equipment, Intraoral Radiology Equipment, Others), Therapeutic Dental Equipment (All Tissue Lasers v/s Soft Tissue Lasers), General Equipment (Dental Chairs, Dental Light Curing Equipment, Dental Handpieces, Casting Machine, Instrument Delivery Systems, CAD/CAM Systems, Others), Hygiene Maintenance Devices (Air Purification & Filters, Sterilizers, Hypodermic Needle Incinerator), Others) By Application (Orthodontic, Endodontic, Periodontic, Prosthodontic) By End User (Hospitals & Clinics, Dental Laboratories, Others) By Company, By Region, Forecast & Opportunities, 2026”, the global dental equipment is anticipated to grow at a formidable CAGR owing to various government initiatives to improve dental health and high-end investments made by top players in the market. Also, growing prevalence of dental disorders as well as use of computer aided technology are fuelling the growth of global dental equipment market in the coming years.