Effects of Timing of Extracorporeal Shock Wave Therapy on Mandibular Distraction Osteogenesis: An Experimental Study in a Rat Model

Ginini, Jiriys George; Emodi, Omri; Sabo, Edmond; Maor, Gila; Shilo, Dekel; Rachmiel, Adi

doi:10.1016/j.joms.2018.07.018

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Rather, the applicable evidence centers upon the use of this technology when studying mandibular distraction osteogenesis in rodents. 3,4,7 The reported benefits include the following: increased bone mineral density, bone volume fraction, trabecular thickness, and osteoblastic recruitment, along with formation of new bone and enhanced vascularization. On the molecular level, increased expression of PCNA, VEGF, and BMP have been additionally described.…”

Section: Discussionmentioning

confidence: 99%

“…On the molecular level, increased expression of PCNA, VEGF, and BMP have been additionally described. 3,4,7 Relevant studies in humans reveal that ESWT remains safe, increases blood flow within the uninjured scaphoid, and may accelerate bone healing in patients receiving non-vascularized bone grafts for reconstruction of scaphoid nonunion. [8][9][10] Our preliminary findings support the safety and utility of ESWT in pediatric craniofacial surgery and contribute to the growing body of evidence regarding various treatment regimens.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the aforementioned intra and post-operative settings were configured based upon recommendations from the manufacturer after discussing findings with authors from prior studies. 3,4,42,43 Altering energy delivery settings may prove beneficial pending further study. Some of our patients had dental extractions during surgery which could, in part, account for smaller consolidation volumes in certain patients.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have reported the success of extracorporeal shock wave therapy (ESWT), which consists of targeted acoustic waves, for enhancing bone formation and accelerating bone mineralization in the setting of mandibular distraction osteogenesis. 3,4 More specifically, ESWT results in increased bone mineral density, bone volume fraction, trabecular thickness, and expression of various growth factors-bone morphogenic protein (BMP), vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA). 3 From a clinical standpoint, this may translate to a decreased consolidation period without any increase in side effects or complications.…”

Section: Introductionmentioning

confidence: 99%

“…This technology is easily applied in the outpatient setting and has been utilized at Akron Children's Hospital Pediatric Plastic and Reconstructive Surgery Department in patients following alveolar bone grafting since 2019. Our protocol FACE 4 (4) involves both intra-operative and 2 sessions of post-operative ESWT. This study seeks to investigate the clinical outcomes, most notably the rate and quality of bony consolidation in children undergoing ESWT as part of their alveolar bone grafting procedure.…”

Section: Introductionmentioning

confidence: 99%

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Extracorporeal Shockwave Therapy Improves Outcomes Following Secondary Alveolar Bone Grafting

Coombs,

Patel,

Kochenour

et al. 2023

FACE

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Background: Recent studies have reported that extracorporeal shock wave therapy (ESWT) enhances bone formation during mandibular distraction osteogenesis. This study seeks to investigate the clinical outcomes in children undergoing ESWT alongside secondary alveolar bone grafting procedures at our institution. Methods: Retrospective review of all children that underwent secondary alveolar cleft bone grafting with adjunctive ESWT between 2019 and 2021. Variables including age, gender, cleft type, cleft width, pre-operative cleft dentition, volume of bone graft placed intraoperatively, ESWT settings, pain medication utilization, length of stay (LOS), follow-up, cone beam computed tomography (CBCT) data, and complications were recorded. Results: Twenty patients met inclusion criteria. Median age at surgery was 9 years (range 8-16). Four (20%) patients were female; 16 (80%) were male. Eight (40%) patients had bilateral alveolar clefts; 12 (60%) had unilateral clefts. All (100%) patients were discharged on the day of surgery. Twelve (60%) patients required a median of 1.3 oxycodone doses post-operatively (range 0-6.5). All patients received ESWT treatments intra and post-operatively. All patients demonstrated an increase in bone graft volume visualized on CBCT: median increase of 6.8% (range 1.3%-35.7%) between 106.5 days (17.5% of ideal visualized, range 5%-42%) and 245.5 days (27.9% of ideal, range 8%-55.7%). Three (15%) patients experienced minor complications. Conclusions: Initial outcomes suggest that ESWT may expedite visualization of bone consolidation and facilitate recovery without increasing complications. ESWT could further represent an opportunity to improve care in craniofacial surgery. Pertinent considerations, the role of standardized assessment protocols, and future directions will be reviewed.

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Section: Discussionmentioning

confidence: 99%