Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Medeniyet University, Istanbul, Turkey.
Department of Oral and Maxillofacial Surgery, Modern Oral and Dental Health Center, Kocaeli, Turkey.
Ann Med. 2023 Dec;55(1):1346-1354. doi: 10.1080/07853890.2023.2192958.
Osteoporotic individuals suffer from various complications such as spontaneous bone fractures due to decreased bone strength and failure in bone healing as a result of decreased bone mineral density and deterioration of bone microstructure. In this study, the effects of Extracorporeal Shock Wave Therapy (ESWT) in a distraction osteogenesis model in osteoporotic rabbits were investigated to prevent these failures and improve bone microstructure.
A total of 28 female New Zealand rabbits underwent mandibular distraction osteogenesis and were divided into four groups: non-ovariectomized control (Cont), ovariectomized control (O-Cont), ovariectomized ESWT1 (O-ESWT1) and ovariectomized ESWT2 (O-ESWT2). ESWT was only applied to the ESWT2 group before the osteotomy, and to both the ESWT1 and ESWT2 groups after the osteotomy. Dual-energy x-ray absorptiometry was used to determine bone mineral density on both the 7th and 28th day of the consolidation. Stereological methods were used to identify new bone formation, connective tissue and neoangiogenesis volume.
According to the dual-energy x-ray absorptiometry examination both at the 7th and 28th day of the consolidation, lower bone mineral density was seen in the ESWT groups. However, the stereological examination showed that shock wave therapy significantly increased new bone formation both ESWT1 and ESWT2 compared with O-Cont, significantly increased neoangiogenesis in O-ESWT1 compared with O-Cont.
The application of ESWT in these parameters after osteotomy was beneficial for bone regeneration in mandibular distraction in osteoporotics. However, ESWT has been shown to be ineffective in improving bone mineral density.KEY MESSAGESThe osteoporotic model can be successfully established in rabbits and the subjects can tolerate the distraction procedures.Stereology is a useful analysis method that can determine the volume of the new bone formation and neoangiogenesis.Extracorporeal shock wave therapy has biostimulatory effects on bone tissue.
骨质疏松症患者会因骨强度降低而出现自发性骨折等各种并发症，也会因骨密度降低和骨微结构恶化而导致骨愈合失败。本研究旨在通过体外冲击波疗法（ESWT）预防这些失败并改善骨微结构，观察其在骨质疏松症兔牵张成骨模型中的作用。
共 28 只雌性新西兰兔行下颌骨牵张成骨术，分为四组：非去卵巢对照组（Cont）、去卵巢对照组（O-Cont）、去卵巢 ESWT1 组（O-ESWT1）和去卵巢 ESWT2 组（O-ESWT2）。ESWT 仅在截骨前应用于 ESWT2 组，在截骨后应用于 ESWT1 组和 ESWT2 组。双能 X 线吸收仪用于测定第 7 天和第 28 天融合时的骨矿物质密度。体视学方法用于鉴定新骨形成、结缔组织和新生血管形成的体积。
根据融合第 7 天和第 28 天的双能 X 线吸收仪检查，ESWT 组的骨矿物质密度较低。然而，体视学检查显示，与 O-Cont 相比，冲击波治疗在 ESWT1 和 ESWT2 组均显著增加了新骨形成，与 O-Cont 相比，在 O-ESWT1 组显著增加了新生血管形成。
在骨质疏松症患者下颌骨牵张成骨术后应用 ESWT 对骨再生是有益的，但 ESWT 对改善骨矿物质密度无效。
兔骨质疏松模型可成功建立，实验对象可耐受牵张操作。体视学是一种有用的分析方法，可确定新骨形成和新生血管形成的体积。体外冲击波治疗对骨组织具有生物刺激作用。
