Is it possible to change of the duration of consolidation period in the distraction osteogenesis with the repetition of extracorporeal shock waves?

Abstract

BackgroundIn this study we examined the effects of two different repeated Extracorporeal Shock Waves (ESW) on the consolidation period of the distraction osteogenesis (DO) of the rabbit mandible using stereological, radiological and immunohistochemical methods.Material and MethodsDO was performed unilaterally in the mandible of 18 New Zealand rabbits (six months old, weighing between 2.5-3 kg). In the consolidation period, rabbits were divided into three groups randomly after the distraction period. The distraction zone of the mandible was received no treatment as controls (E0*2). Group 2 (E 500*2) received ESWT (twice 500 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation. Group 3 (E1000*2) treated with ESWT (twice 1000 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation period. After the sacrification, radiologically bone mineral density, new bone formation, new fibrous tissue and new vessel formation were analyzed by stereological.ResultsIt was found a statistically significant difference between the study groups and control group in the bone mineral density measurements and the highest value was in the E1000*2 group. In the stereological analysis, new bone formation was highest in the E1000*2 group and there was a significant difference compared to the other groups (E0*2 and E500*2) (p=0.000). The lowest connective tissue volume was found in the E500*2 and there was a significant difference compared to the other groups (E0*2 and E1000*2) (p=0.000). The volume of the new vessel was highest in the E500*2 and lowest in the E0*2 group. It was found statistically significant difference between the values of the study and control groups.ConclusionsInterestingly, we found that repetition of the 1000 impulses ESWT accelerated the consolidation, 500 impulses ESWT extended consolidation period of the DO. Key words:Distraction osteogenesis, extracorporeal shock waves, stereology, rabbit.

WITHDRAWN: Morphological and Biochemical Changes in the Rat Ovaries Following Electromagnetic Field Exposure

“…In this context, the points falling on the area of interest were counted and the total number (Σp) was obtained. The obtained numbers were multiplied by a (p) to achieve surface area (A) measurements for ovarian volume, cortex/medulla ratio and follicle volume [14].…”

The assessment of new bone formation induced by unfocused extracorporeal shock wave therapy applied on pre-surgical phase of distraction osteogenesis

“…Only Önger et al (12) performed a second session on the fourth day of the consolidation. Whereas Lai et al (17) reported that a 500 pulse shock wave therapy with an energy flow density of 0.19 mJ/mm2 is effective in increasing angiogenesis and bone regeneration and in shortening the consolidation process, Önger et al(12) showed that a 1,000 x2 pulse shock wave therapy at an energy flux density of 0.19 mJ/ mm2 resulted in a higher new bone volume and bone mineral density. Lai et al (17) also found that shock waves applied at 21 kV and 500 pulses caused necrotic changes.…”

“…Many studies have shown that ESWT has this effect by triggering the expression of transcription factors, mediators, and growth hormones (13,14, 15). ESWT has also been reported to induce mesenchymal cell proliferation and differentiation, and to promote osteogenesis by stimulating osteoblasts (12,13,15,16). These effects have been shown to induce open fracture healing, shorten consolidation period in DO, and increase bone mineral density (12,17).…”

Effects of Extracorporeal Shock Wave Therapy in The Maxillofacial Surgery Practice – A Systematic Review

“…A number of methods to promote callus formation have been reported. These attempts include; bisphosphonates, thrombocyterich plasma, hormones, demineralized bone matrix, calcium sulphate, electrophysiological applications, low-intensity laser, growth factors, shock waves, ultrasound, hyperbaric oxygen, bone grafts, cytokines, stem cells 5,6 . However, there are no sufficient studies on the effects of ESWT on the new bone formation in DO in the maxillofacial area.…”

“…ESWT was first used in the maxillofacial area after the 1990s, in the treatment of sialolithiasis 2,3 . Later on, studies on mandibular distraction osteogenesis, fracture and defect healing, acceleration of orthodontic tooth movement and alveolar bone regeneration surged [4][5][6] . Experimental and clinical studies have confirmed that shock waves have different dose dependent biological and mechanical effects on each tissue 7 .…”