Evaluating the effect of extracorporeal shockwave therapy on rapid Osseointegration of titanium implants in rabbit femur

Abstract

Introduction: As the demand for dental implants is growing exponentially, new methods are developing to increase the success rate of implants. A rapid and appropriate integration of implant-bone interface plays an inevitably important role in success rate of dental implants. As Extracorporeal Shock Wave Therapy (ESWT) is believed to have osteogenic effects, we hypothesized that using ESWT as an adjuvant treatment would accelerate osseointegration of titanium dental implants. Material and methods: In this study we inserted 18 titanium mini-screws in 9 New Zealand rabbit’s femur bone, and divided screws in three groups; one-time treated screws, three-time treated screws and the control group. one-time treated screws underwent shockwave therapy once, three-time treated screws underwent shockwave therapy thrice, and the control group was left to heal naturally. We used 1800 focused shockwaves with an energy flux density of 0.3mJ/mm2 in every phase. 14 days after the last phase of ESWT, animals were sacrificed to assess the osseointegration of screws via Micro-CT scan, biomechanical pull-out test, and histopathological analysis. Result: Pull-out and histopathology analysis showed that ESWT significantly increased bone regeneration and osseointegration of implants, this was more severe and significant in three-time treated screws. However, Micro-CT results wasn’t statistically significant in favor of our hypothesis, and we believe it was due to improper methodology and limitations of our device. Conclusion: This study suggests that ESWT with proper dosage and intervals between treatment phases can appreciably facilitate osseointegration of dental implants. therefore, it can be used as a non-invasive, cost-beneficent adjuvant treatment alongside dental implant.