Systematic review finds Gentle Wave System is more effective for healing apical periodontitis compared to other methods, suggesting better treatment options.
Background and aim: The use of modern methods for root canal disinfection and the improvement of apical periodontitis are of great importance. Therefore, the present Systematic Review and Meta-Analysis was conducted to investigate the Healing of Apical Periodontitis after the Gentle Wave System versus Ultrasonic Activation with Negative Pressure Irrigation.Material and methods: The international databases PubMed/Scopus, MEDLINE (Ovid), Cochrane Library, and Embase were searched using keywords aligned with the study objective, up to August 2025. Two blinded, independent authors reviewed all articles. STATA/MP.v17 (College Station, Texas, USA) was used to perform the analyses.Results: Based on the findings of 12 included studies, healing rates for Gentle Wave System was 97% (ES: 97% 95% CI= 95%, 99%; p=0.51; I2=0); the healing rates for Ultrasonic Activation was 77% (ES: 77% 95% CI=75%, 79%; p=0.01; I2=62.88); the healing rates for Negative Pressure Irrigation. was 82% (ES: 82% 95% CI=79%, 85%; p=0.05; I2=60.79). There was a statistically significant difference in healing rates among the groups, with the Gentle Wave System performing significantly better than both Negative Pressure Irrigation and Ultrasonic Activation (p < 0.001).Conclusions: Based on the present meta-analysis, the Gentle Wave System was found to be more effective than Negative Pressure Irrigation and Ultrasonic Activation in improving apical periodontitis.
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Sedghi et al. (2025) studied this question.
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