Large external resorptive defect, involving the pulp with apical lesion and bony fenestration.

More extensive internal resorptive defects, however, have been very difficult to treat. These cases often have a highly irregular internal shape, often extending to the mid-root area or beyond, making traditional instrumentation difficult or impossible. They also often have multiple, small portals of entry that are not amenable to surgical intervention. Classically, these teeth had an unfavorable prognosis and were extracted. However, the novel Gentlewave procedure allows us to effectively clean these areas. Using apical negative pressure and multisonic frequency cleaning, it is now possible to clean these irregular and complex defects while still conserving dentin. We are then able to seal these defects using a highly flowable Bioceramic sealer.