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Review Article
Outcomes of the GentleWave system on root canal treatment: a narrative review
Hernán Coaguila-Llerena, Eduarda Gaeta, Gisele Faria
Restor Dent Endod 2022;47(1):e11.   Published online February 14, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e11
AbstractAbstract PDFPubReaderePub

This study aimed to describe the outcomes of the GentleWave system (GW) (Sonendo) on root canal treatment. Published articles were collected from scientific databases (MEDLINE/PubMed platform, Web of Science, Scopus, Science Direct and Embase). A total of 24 studies were collected from August/2014 to July/2021, 20 in vitro and 4 clinical. GW System was not associated with extrusion of the irrigant, promoted faster organic dissolution than conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) continuous ultrasonic irrigation (CUI) and EndoVac, reduced more bacterial DNA and biofilm than PUI and CUI, promoted higher penetration of sodium hypochlorite into dentinal tubules than PUI and CUI in vitro, and removed more intracanal medication than CSI and PUI. GW was able to remove pulp tissue and calcifications. Moreover, its ability to remove hard-tissue debris and smear layer was better than that of CSI, and its ability to remove root canal obturation residues was lower or similar to that of PUI, and similar to that of CSI and EndoVac. Regarding root canal obturation of minimally instrumented molar canals, GW was associated with high-quality obturation. Clinically, the success rate of endodontic treatment using GW was 97.3%, and the short-term postoperative pain in the GW group was not different from CSI. Further research, mainly clinical, is needed to establish whether GW has any advantages over other available irrigation methods.

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Research Article
Smear layer removal by passive ultrasonic irrigation and 2 new mechanical methods for activation of the chelating solution
Ricardo Machado, Isadora da Silva, Daniel Comparin, Bianca Araujo Marques de Mattos, Luiz Rômulo Alberton, Ulisses Xavier da Silva Neto
Restor Dent Endod 2021;46(1):e11.   Published online January 26, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e11
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to compare smear layer removal by conventional application (CA), passive ultrasonic irrigation (PUI), EasyClean (EC), and XP-Endo Finisher (XPF), using 17% ethylenediaminetetraacetic acid (EDTA) after chemomechanical preparation, as evaluated with scanning electron microscopy (SEM).

Materials and Methods

Forty-five single-rooted human mandibular premolars were selected for this study. After chemomechanical preparation, the teeth were randomly divided into 5 groups according to the protocol for smear layer removal, as follows: G1 (control): CA of distilled water; G2 (CA): CA of 17% EDTA; G3 (PUI): 17% EDTA activated by PUI; G4 (EC): 17% EDTA activated by EC; and G5 (XPF): 17% EDTA activated by XPF. SEM images (×1,000) were obtained from each root third and scored by 3 examiners. Data were evaluated using the Kruskal-Wallis and Dunn tests (p < 0.05).

Results

In the apical third, there were no statistically significant differences among the groups (p > 0.05). In the cervical and middle thirds, the experimental groups performed better than the control group (p < 0.05); however, G2 presented better results than G3, G4, and G5 (p < 0.05), which showed no differences among one another (p > 0.05).

Conclusions

No irrigation method was able to completely remove the smear layer, especially in the apical third. Using CA for the chelating solution performed better than any form of activation.

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Original Article
Time-dependent effects of EDTA application on removal of smear layer in the root canal system
Ja-Kyong Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(3):169-178.   Published online May 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.3.169
AbstractAbstract PDFPubReaderePub

This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. Furthermore it was aimed to find out the optimal time for the application of EDTA.

Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ml of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ml of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule.

The results were as follows;

The control group:

The smear layer was not removed at all.

The other groups:

1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time.

2) Apical⅓: The cleaning effect of 2 min group was better than the others.

The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.

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