The new wave in endodontics?


Last night at our Study Club we saw a presentation about the Gentle Wave Endodontic System by two of our members, who are endodontists, Doctor Radu Buruiana and Corina Buruiana-Oades .  I found the presentation extremely interesting because it facilitates minimally instrumented and shaped root canals. This seems like it is a step in the right direction since for years it has been clear to the endodontic community that using irrigation to dissolve the organic matter in the canal system and sealing it afterwards is what make endodontics work.

Dentists instrument and shape canals in order to help the irrigants reach all parts of the system and to facilitate the filling of the canals with gutta percha.  The problem has been that aggressively shaping the canals can change the shape of the canal system in such away as to make it more likely for problems to develop later such as root fracture or over enlarging the apical foramen ( which can make it difficult to properly seal).

Based on their presentation, it appears that using Gentle Wave system allows minimal instrumentation at the apex of only 15 mm file and in many of the cases they showed, they were able to maintain the natural anatomy of the tooth's canal system. The system utilizes an automated irrigation sequence that is highly effective at dissolving the organic matter in canals and if used properly it even gets into tiny accessory canals that files can not negotiate.

This system most likely will not quickly be accepted by many endodontist because of its relatively high expense (  according to our presenters the system cost them about $100,000 to purchase) and the inherent difficulty in fitting tiny narrow gutta percha cones.  Also most endodontists like faster and easier and are not as likely to quickly embrace a system that has a high learning curve and may slow them down. After all conventional root canal techniques are predictably successful in high percentage of cases and dentists are for the most part likely to be slow to embrace this new and expensive system, in spite of its evident advantages.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/04/the-new-wave-in-endodontics.html - http://lspindelnycdds.blogspot.com/

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