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

Comparison of monoblock and twinblock mandibular advancement devices in patiens with obstructive sleep apnea and temporomandibular disorder: effects on airway volume, polysomnography parameters, and sleepiness scale scores

PURPOSE

This study aimed to compare the effects of two different mandibular advancement devices on the upper airway volume, polysomnographic parameters, and sleepiness scale scores in patients with obstructive sleep apnea and Temporomandibular disorders (TMD).

MATERIALS AND METHODS

Monoblock and twinblock mandibular advancement devices were applied to patients with obstructive sleep apnea syndrome for 3 months separated by a wash-out period of 2 weeks. Research Diagnostic Criteria for TMD (RDC/TMD), Polysomnographic parameters and cone-beam computed tomography findings were recorded before and after the use of the mandibular advancement devices. A three-dimensional analysis of the airway was then performed.

RESULTS

The use of the monoblock device significantly increased the upper airway volume compared with the use of the twinblock device (p = 0.032). The polysomnographic parameters similarly improved with the use of the twin-block and monoblock devices. The significant reduction in TMD symptoms was observed.

CONCLUSION

The use of the monoblock device increased the retropalatal airway volume. This volume increase may be attributed to the fact that the design of the monoblock device allows less mandibular movement than does that of the twinblock device. Indicates the potential benefits of MADS treatment in alleviating TMD-related issues.

CLINICAL SIGNIFICANCE

Monoblock MADs have improved effects on respiratory parameters and upper airway dimensions in patients with OSA and mild to moderate TMD.

The effects and underlying mechanism of extracorporeal shockwave therapy on fracture healing

The clinical efficacy of ESWT in treating bone non union has been widely recognized, but the biological mechanism of ESWT promoting bone non union healing is still unclear. ESWT can make old callus micro fracture through mechanical conduction, form subperiosteal hematoma, promote the release of bioactive factors, reactivate the fracture healing mechanism, rebalance the activities of osteoblasts and osteoclast, promote the angiogenesis of fracture site, and accelerate the healing of bone nonunion.Over recent years, great efforts have been made by both scientists and clinicians to explore the underlying mechanism behind the healing effect of ESWT on bone fractures. In this review, we introduced the growth factors during osteogenesis induced by ESWT hoping to provide new insights in the clinical use of ESWT.

The Effects of the Exposure of Musculoskeletal Tissue to Extracorporeal Shock Waves

Extracorporeal shock wave therapy (ESWT) is a safe and effective treatment option for various pathologies of the musculoskeletal system. Many studies address the molecular and cellular mechanisms of action of ESWT. However, to date, no uniform concept could be established on this matter. In the present study, we perform a systematic review of the effects of exposure of musculoskeletal tissue to extracorporeal shock waves (ESWs) reported in the literature. The key results are as follows: (i) compared to the effects of many other forms of therapy, the clinical benefit of ESWT does not appear to be based on a single mechanism; (ii) different tissues respond to the same mechanical stimulus in different ways; (iii) just because a mechanism of action of ESWT is described in a study does not automatically mean that this mechanism is relevant to the observed clinical effect; (iv) focused ESWs and radial ESWs seem to act in a similar way; and (v) even the most sophisticated research into the effects of exposure of musculoskeletal tissue to ESWs cannot substitute clinical research in order to determine the optimum intensity, treatment frequency and localization of ESWT.

Overview of Physical and Pharmacological Therapy in Enhancing Bone Regeneration Formation During Distraction Osteogenesis

Distraction osteogenesis (DO) is a kind of bone regeneration technology. The principle is to incise the cortical bone and apply continuous and stable distraction force to the fractured end of the cortical bone, thereby promoting the proliferation of osteoblastic cells in the tension microenvironment and stimulating new bone formation. However, the long consolidation course of DO presumably lead to several complications such as infection, fracture, scar formation, delayed union and malunion. Therefore, it is of clinical significance to reduce the long treatment duration. The current treatment strategy to promote osteogenesis in DO includes gene, growth factor, stem-cell, physical and pharmacological therapies. Among these methods, pharmacological and physical therapies are considered as safe, economical, convenience and effective. Recently, several physical and pharmacological therapies have been demonstrated with a decent ability to enhance bone regeneration during DO. In this review, we have comprehensively summarized the latest evidence for physical (Photonic, Waves, Gas, Mechanical, Electrical and Electromagnetic stimulation) and pharmacological (Bisphosphonates, Hormone, Metal compounds, Biologics, Chinese medicine, etc) therapies in DO. These evidences will bring novel and significant information for the bone healing during DO in the future.

Translational Applications of Extracorporeal Shock Waves in Dental Medicine: A Literature Review

Extracorporeal shock wave therapy (ESWT) has been studied and applied extensively in medical practice for various applications including musculoskeletal, dermal, vascular, and cardiac indications. These indications have emerged from primary ESWT use in treating urolithiasis and cholelithiasis. Likewise, dental medicine has had its share of utilizing ESWT in various investigations. This review aimed to provide an up-to-date summary of ESWT use in preclinical and clinical dental medicine. There is growing interest in ESWT use stemming from its non-invasiveness, low cost, and safe qualities in addition to its proven regenerative biostimulating aspects. Targeted tissue and parameters of ESWT delivery continue to be an integral part of successful ESWT treatment to attain the clinical value of the anticipated dose’s effect.

Distraction Osteogenesis Versus Orthognathic Surgery: Demystifying Differences in Concepts, Techniques and Outcomes

Introduction

The popularity and interest evoked by orthognathic surgery and distraction osteogenesis are undisputed in the field of oral and maxillofacial surgery. However, questions regarding the individual identities of either of them with clarity in their concepts, techniques and outcomes have remained unanswered. The aim of this review is to shed light on these questions.

Methods

This review is structured as a narrative review of thirty years of literature available in the specialities of orthognathic surgery and distraction osteogenesis.

Conclusion

The authors present a review of existing literature combined with contrasting experience gained over the years in providing an overview of the merits and demerits of the two surgical techniques which will aid the clinician in justifying the use of one technique over the other.

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

Purpose:

This study aims to evaluate the effects of extracorporeal shock wave therapy applied before and/or immediately after the osteotomy on the maturation during the consolidation phase.

Materials and methods:

21 female New Zealand rabbits were used in the study. Subjects were divided randomly into three groups: Control (Distraction without ESWT), A (Distraction +ESWT After Osteotomy), AB (Distraction+ESWT After and Before Osteotomy). ESWT (500 pulses, 5 Hz, 0.19 mJ/mm2 energy flux density) was applied to group A and group AB after 5, 12 and 19 days after osteotomy and group AB only on days 7,14 and 21 before osteotomy. On the 28th day of the consolidation period, all subjects were sacrificed. Dual-energy x-ray absorptiometry (DEXA) was used to determine bone mineral density (BMD) and bone mineral content (BMC), and stereological methods were used to determine the new bone, connective tissue and neovascularization volumes.

Results:

As a result of DEXA examinations made on the 1st and 4th week of consolidation, there was no significant difference between groups regarding BMD and BMC values. According to the results of stereological examination, when the connective tissue and new bone tissue were evaluated, higher values were observed in AB when compared to A, and in AB and A compared to the control group, but the differences are not statistically significant. There was no difference between the groups in terms of neovascularization.

Conclusion:

ESWT in these parameters was not positively effective in bone maturation during consolidation when applied before osteotomy or both before and after osteotomy.