Effectiveness of GentleWave CleanFlow on Multispecies Endodontic Biofilm Removal in Single Rooted Extracted Teeth

Abstract

Introduction: One of the challenges of non-surgical root canal treatment is disinfection. Bacterial biofilms adhere to canal walls and invade the intricate anatomy present within root canal systems. Traditional irrigation methods are unable to deliver irrigation solutions to all parts of the canal system. The GentleWave system is an advanced irrigation method designed to improve irrigation and disinfection, ultimately leading to more successful root canal outcomes. Objective: The aim of this study is to evaluate the GentleWave CleanFlow posterior instrument’s ability to remove a multispecies biofilm from a single canaled extracted tooth compared to traditional irrigation techniques. Materials and Methods: Thirty-six single rooted premolar teeth with single canals were prepared to a uniform size, instrumented to size 25.06 and inoculated with a multispecies bacterial biofilm taken from an adult tooth with pulpal necrosis. Teeth were incubated and biofilm established before teeth were disinfected. Three disinfection groups included: GentleWave irrigation using the Posterior CleanFlow Procedure Instrument on the necrotic tooth cycle, standard needle irrigation with 2.5% NaOCl and 8% EDTA, and needle irrigation with sterile water. Following treatment, canals were swabbed and plated on blood agar plates and incubated for 48 hours when colony forming units were counted. Results: Both GW and standard needle irrigation demonstrated significantly lower CFU/mL than the negative control (p<0.001). However, the GW and positive control groups were not significantly different from one another (p=0.132). Conclusion: The findings of this study suggest that the GentleWave Posterior CleanFlow procedure instrument does not exhibit improved biofilm removal compared to standard needle irrigation. However, based on mixed results when comparing this study to previous GentleWave biofilm removal studies, it is clear that more research is necessary. Future studies should considering using a multispecies biofilm, the GentleWave CleanFlow procedure instrument and multiple techniques to assess biofilm removal.