Dental Infections

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Focused Ultrasound Therapy

Focused ultrasound is a rapidly evolving, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with tooth disease that requires a root canal or other procedures where it is very helpful to not have infections present.

How it Works
This novel technology sends beams of focused ultrasound energy into the cleaning fluid which forms cavitation bubbles. The negative pressure that comes from the cavitation greatly enhances the cleaning of the nerve root. This type of work is also being explored to help treat biofilms and more effectively deliver antibiotics.

Conventional techniques effectively clean 29% of the nerve root, and passive ultrasound techniques may achieve 80%. The focused ultrasound cavitation bubble technique achieved a cleanliness level reported at greater than 97%. For certain patients, focused ultrasound use may improve the success of this procedure and also enhance the patient’s comfort.

Focused ultrasound also preserves dentin maintenance compared to mechanical techniques and easily accommodates the variable structure of the nerve root.

For more information, please see the patient information site or the manufacturer’s (Sonendo) website.

Clinical Trials

At the present time, there are no clinical trials recruiting patients. However, a 12-month study was completed recently. 

Regulatory Approval and Reimbursement

This treatment is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Rajan SM, Shrestha B, Aati S, Kujan O, Tay A, Fawzy AS. Evaluation of Antibacterial Efficacy of High-Intensity Focused Ultrasound Versus Photodynamic Therapy Against Enterococcus faecalis-Infected Root Canals. Ultrasound Med Biol. 2023 Aug;49(8):1875-1881. doi: 10.1016/j.ultrasmedbio.2023.04.018. Epub 2023 May 30. PMID: 37263892 

Ordinola-Zapata R, Crepps JT, Arias A, Lin F. In vitro apical pressure created by 2 irrigation needles and a multisonic system in mandibular molars. Restor Dent Endod. 2021 Feb 8;46(1):e14. doi: 10.5395/rde.2021.46.e14. eCollection 2021 Feb.

Park SY, Kang MK, Choi HW, Shon WJ. Comparative Analysis of Root Canal Filling Debris and Smear Layer Removal Efficacy Using Various Root Canal Activation Systems during Endodontic Retreatment. Medicina (Kaunas). 2020 Nov 16;56(11):615. doi: 10.3390/medicina56110615.

Crozeta BM, Chaves de Souza L, Correa Silva-Sousa YT, Sousa-Neto MD, Jaramillo DE, Silva RM. Evaluation of Passive Ultrasonic Irrigation and GentleWave System as Adjuvants in Endodontic Retreatment. J Endod. 2020 Sep;46(9):1279-1285. doi: 10.1016/j.joen.2020.06.001. Epub 2020 Jun 15.

Grigsby D Jr, Ordinola-Zapata R, McClanahan SB, Fok A. Postoperative Pain after Treatment Using the GentleWave System: A Randomized Controlled Trial. J Endod. 2020 Aug;46(8):1017-1022. doi: 10.1016/j.joen.2020.04.004. Epub 2020 Jun 14.

Chen B, Szabo D, Shen Y, Zhang D, Li X, Ma J, Haapasalo M. Removal of calcifications from distal canals of mandibular molars by a non-instrumentational cleaning system: A micro-CT study. Aust Endod J. 2020 Apr;46(1):11-16. doi: 10.1111/aej.12376. Epub 2019 Oct 11.

Choi HW, Park SY, Kang MK, Shon WJ. Comparative Analysis of Biofilm Removal Efficacy by Multisonic Ultracleaning System and Passive Ultrasonic Activation. Materials (Basel). 2019 Oct 25;12(21):3492. doi: 10.3390/ma12213492.

Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative Endodontic Procedures for Traumatized Teeth after Horizontal Root Fracture, Avulsion, and Perforating Root Resorption. J Endod. 2016 Oct;42(10):1476-82. doi: 10.1016/j.joen.2016.04.028. Epub 2016 Aug 26.

Sigurdsson A, Garland RW, Le KT, Woo SM. 12-month Healing Rates after Endodontic Therapy Using the Novel GentleWave System: A Prospective Multicenter Clinical Study. J Endod. 2016 Jul;42(7):1040-8. doi: 10.1016/j.joen.2016.04.017.

Saoud TM, Martin G, Chen YH, Chen KL, Chen CA, Songtrakul K, Malek M, Sigurdsson A, Lin LM. Treatment of Mature Permanent Teeth with Necrotic Pulps and Apical Periodontitis Using Regenerative Endodontic Procedures: A Case Series. J Endod. 2016 Jan;42(1):57-65. doi: 10.1016/j.joen.2015.09.015. Epub 2015 Oct 31.

Molina B, Glickman G, Vandrangi P, Khakpour M. Evaluation of Root Canal Debridement of Human Molars Using the GentleWave System. J Endod. 2015 Oct;41(10):1701-5. doi: 10.1016/j.joen.2015.06.018. Epub 2015 Aug 12.

Click here for additional references from PubMed.

Clinical Trials