Endodontist’s Practice Thrives on Relationships and Quality
The GentleWave® System from Sonendo® provides unprecedented capabilities
Opening an endodontic practice in your hometown as the son of a longtime general dentist might seem like a turnkey method of establishing a large referral base. Gregory Myers, DDS, MS, found it to be quite the opposite. When Myers opened his practice in Solon, Ohio, in 2002, he found that the dentists who knew his father were typically older and had long-standing relationships with other endodontists.
"I had to build my practice from scratch," Myers says. "I had to pound the pavement to let people know who I was."
Within approximately 6 months, Myers was seeing four to five patients per day. Now, 18 years later, he handles more than 1,200 cases per year.
Myers attributes much of his success to building a strong rapport with the dentists who provide him with referrals. Although he works with more than 100 dentists each year, a core of about 25 to 30 of them account for most of his business. Managing any more than that, he says, would prevent him from servicing them adequately.
"I am there for my referrers all the time," Myers says. "We reserve room for emergencies each day. You never want to be so busy that your quality becomes compromised."
Myers has continued to grow his business by devoting his resources to the right cases. "Learning how to vet cases to avoid those that will not be restorable helps keep your days constantly productive," he says.
Another way to remain productive is to use the best technology in order to provide the most efficient and effective care. One such piece of technology is the GentleWave® System from Sonendo®. The GentleWave System harnesses broad-spectrum acoustic energy, advanced fluid dynamics, and accelerated chemistry to debride and disinfect the root canal system—even the undetected, uninstrumented spaces—with a minimally invasive protocol that leaves more of the tooth structure intact.
The concept of using sonic activation and fluidics was not new to Myers; a fellow resident at The Ohio State University had performed a research project to test ultrasonic irrigation in 2002. Because there was nothing on the market at the time to use clinically, Myers retrofitted his ultrasonic units to provide ultrasonic irrigation."I was sold on the concept of the GentleWave System's technology when it hit the market in 2016," he says. "It was just a matter of reaching a point where it was broadly commercially accepted as not only safe and effective but also efficient for practicality."
Myers purchased a GentleWave System in 2018 and has used it regularly ever since. He affirms that it allows him to be more confident in thoroughly debriding a tooth. "We can do a great job with traditional endodontics," he says, "but dealing with anatomy that you cannot mechanically clean or see is a challenge. This system allows us to clean the microanatomy found in lateral canals and isthmuses. It chemically debrides this anatomy, which allows our obturation techniques to successfully seal these areas."
Conserving tooth structure is another benefit of the GentleWave System. "Some instrumentation techniques have tended to overprepare and greatly enlarge the canal systems to achieve access to the apex," Myers says. "We do not have to use that approach anymore, which means we are maintaining the natural anatomy of the canals and not weakening the tooth. Once patency and working length have been established, minimal instrumentation with one or two rotary files establishes the fluid path for the GentleWave System to thoroughly clean and debride with acoustics, fluid dynamics, and chemistry."
Fewer files are necessary as well. Breakage occurs less frequently because there is less instrument fatigue. Myers estimates that his file ordering has decreased by two-thirds.
"The chance of separating files decreases because we are able to use smaller files that adapt better to the canal system," he says. "The GentleWave System eliminates the obstructions that occur in canals that can result in more strain on files."
In fact, Myers has experienced an increase in cases in which other dentists have broken files. Those cases might once have been sent to an oral surgeon for extraction. "During my lectures, I've demonstrated the techniques that I use to remove or bypass separated instruments," Myers says. "The GentleWave can disinfect past separated instruments, and at times, help remove them. Following disinfection, I can flow sealer around and past the separated instrument to seal the canal. This saves the tooth from extraction or a possible apicoectomy."
The GentleWave System has also eliminated the need for internal bleaching in many trauma cases involving anterior teeth. "The system cleans out the dentinal tubules, and the discoloration is gone," Myers says.
Patients who have had traditional root canal treatments in the past notice a difference with the GentleWave System. Myers says they note it frequently in online reviews. "It involves less manipulation of the mouth and less pressure, so it is a very benign and relaxing process," he says.
In Myers' experience, patients with pulp necrosis typically heal in 3 to 6 months after treatment with the GentleWave System. This can take from 6 to 12 months with traditional endodontics.
"They are healing better and faster with less prolonged postoperative irritation," Myers says.
Although the GentleWave System offers numerous benefits to the endodontist, Myers emphasizes that the most important thing is the benefit to the patient. "The bottom line is doing the best that you can," he says, "because you are treating a human being, and you want to make sure that you are performing treatments perfectly every time."
Myers attributes much of his success to building a strong rapport with his core referrers.
Once patency and working length have been established, minimal instrumentation with one or two rotary files establishes the fluid path for the
GentleWave System to thoroughly clean and debride with acoustics, fluid dynamics, and chemistry.
Patients who have had traditional root canal treatments in the past notice a difference with the GentleWave System.