Extracorporeal shock wave therapy application at the consolidation period during distraction osteogenesis in the rat mandible enhances bone formation and osteogenic and angiogenic growth factors, improves bone mechanical properties, and accelerates bone mineralization.

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Titanium plats are the gold-standard for fracture fixation. Titanium is considered biocompatible, corrosion resistant with an elasticity-modulus closest to bone. Nonetheless, titanium plates are not always as inherent as hoped. The authors investigated morbidity associated with titanium plates in mandibular fractures. A retrospective study of mandibular fractures treated between 2000 and 2018 using internal-fixation was conducted. Data included age, gender, complications, and location. Predictor-variable was location. Outcome-variable was plate removal. A total of 571 patients were included, 107 resulted in plate removal (18.7%). Body was the most prevalent location of fracture (29.3%). Symphysis/para-symphysis showed the highest removal rate (24.1%), followed by body and angle (21.3/19.8%). A total of 23.4% of double-plating cases resulted in plate removal, upper-border in 15% and lower-border in 8.8%, all reconstruction-plates. Exposure was the most frequent complication leading to removal. Although titanium plates are the gold standard, almost every fifth patient returns for plate removal. Agedistribution emphasizing 41 to 50 with decrease towards extremities may imply better healing in the young and soft-tissue elasticity and less complaints in the elderly. Significantly more complications in doubleplating compared to lower border suggests proximity to the oral-cavity as a risk-factor for removal. Complication rates and patterns are not negligible and perhaps should encourage clinicians to consider using biodegradable-systems for upper-border plates.

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The purpose of this report is to review systematically all studies performed regarding the influence of low intensity pulsed ultrasound (LIPUS) on bone regeneration in animals during distraction osteogenesis (DO). Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist structure, a systematic search using PubMed and EMBASE electronic databases was undertaken utilizing the key words "distraction osteogenesis" and "low intensity ultrasound". Human trials, review articles, case reports and non-English language publications were excluded. Data items were extracted from each eligible study, regarding the study design, risk of bias, results and whether or not LIPUS accelerated bone regeneration. The search identified 40 relevant articles, 15 of which were included for full review. Included studies were characterized by a high risk of bias and considerable variations in study design was observed. However, most studies which reported LIPUS in an intensity of 30-40 mW/cm 2 accelerated bone formation via endochondral ossification, thus shortening the consolidation period when applied during distraction and early consolidation periods. According to the current review, application of LIPUS during DO shows promise in accelerating bone formation and density during DO, that bears no adverse effects, thus shortening the consolidation period. Optimal timing of LIPUS application is during the distraction and early consolidation phases. The preferred intensity should be between 30-40 mW/cm 2. Histological analysis indicates influence via endochondral ossification. Thus, the effect of LIPUS on chondrocytes should be further investigated in order to decipher the exact molecular and cellular influence of LIPUS on enhancement of bone formation. These findings should be used in future clinical protocols and raise potential directions for future research regarding the molecular mechanisms underlying the influence of LIPUS on bone formation.

Background: We aimed to compare the clinical and histological secondary healing effectiveness of various types of high-level laser versus scalpel excision in mucosa frenectomy. Methods: Forty-five Sprague Dawley rats were used in this study. These rats were divided into two laser intervention groups (CO2, n = 15; diode, n = 15) and one control group with scalpel excision (n = 15). The effectiveness of therapy has been assessed based on the comparison of intraoperative, postoperative, and histological parameters on days 7, 21, and 35, and postoperative weight changes as pain indicator. Results: Both laser groups demonstrated significantly (P < 0.05) less bleeding than did the control group during the intraoperative stage, whereas the CO2 laser showed more precise cutting compared with the diode laser (P < 0.05). The highest healing score was reported in the CO2 and scalpel groups on the first week of healing than in the diode group (P < 0.05). However, no significant difference was observed between the groups on days 21 and 35. Weight loss was significantly (P < 0.05) demonstrated in the diode group compared to the scalpel and CO2 groups till day 7. Both laser groups demonstrated delayed healing process compared with the scalpel. Nevertheless, the CO2 group followed the scalpel trends after day 7. Conclusion: Scalpel and CO2 laser yielded a superior clinical outcome compared with the diode excision of oral mucosa, whereby the CO2 has been proposed as the most effective laser type at the end of the first postoperative month.