Clinical and Laboratory Insights Into the GentleWave System: A Scoping Review

The GentleWave System is an advanced endodontic irrigation technology that utilizes multisonic energy and optimized fluid dynamics to improve root canal cleaning and disinfection. While early studies report encouraging outcomes, its comparative clinical effectiveness, long-term benefits, and cost-efficiency remain under investigation. This scoping review aims to systematically assess the available clinical and laboratory evidence on the GentleWave System in endodontics.

This review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews guidelines and was prospectively registered in the Open Science Framework. A comprehensive search of 5 electronic databases (Cochrane Library, EMBASE, PubMed/MEDLINE, SciVerse Scopus, and Web of Science) was performed to identify clinical and in vitro studies evaluating the GentleWave System.

A total of 34 studies met the inclusion criteria, including 28 laboratory-based investigations (82.4%) and 6 clinical studies (17.6%). Clinical trials reported high periapical healing rates, exceeding 97% at 6- and 12-month follow-ups, and postoperative pain levels comparable to passive ultrasonic irrigation. However, recent prospective data indicate similar healing outcomes when compared to other advanced irrigation techniques. Laboratory studies consistently demonstrated significant performance in removing biofilm, smear layer, calcium hydroxide, and filling materials, while maintaining reduced apical pressure and minimal dentin erosion. Methodological variability and limited long-term clinical data remain key limitations.

The GentleWave System shows potential as an adjunctive irrigation technology, particularly in anatomically complex cases. Overall, the evidence mapped in this scoping review appears low to moderate, reflecting the limited number of available clinical studies and their high risk of bias.