GentleWave versus Established Irrigation Techniques: Current Evidence from a Scoping Review

The GentleWave System, based on multisonic ultra-cleaning technology, has been proposed as an irrigation approach capable of enhancing disinfection while preserving dentin structure. However, evidence regarding its comparative efficacy and clinical relevance remains inconsistent. This scoping review aimed to comprehensively evaluate the performance of the GentleWave System in comparison with conventional syringe irrigation and other activation techniques.

This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Six electronic databases (PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar) were systematically searched without language restrictions. Studies were eligible if they compared GentleWave with at least one other irrigation or activation technique and reported measurable outcomes. In vitro, ex vivo, and clinical studies were included. Study characteristics, irrigation protocols, outcomes, and key findings were extracted and synthesized descriptively across thematic domains.

Twenty-two studies met the inclusion criteria. Laboratory evidence demonstrated that GentleWave enhanced debris removal, irrigant penetration, and calcium hydroxide removal compared to conventional syringe irrigation. However, several studies have reported no significant differences between GentleWave and ultrasonic or sonic activation in terms of smear layer removal, biofilm reduction, or removal of filling materials. Findings related to endotoxin reduction and disinfection were also heterogeneous. Clinical evidence was limited and generally indicated no differences in postoperative pain or early healing when compared with alternative techniques.

The present scoping review indicates that the GentleWave System demonstrates promising performance across multiple laboratory outcomes, particularly in debris removal, disinfection, and irrigant penetration. However, the available evidence remains inconsistent, with several well-designed studies reporting no significant differences between GentleWave and established irrigation or activation techniques.