Enhancment of Bone Regeneration in Distraction Osteogenesis of Rat Mandible using Extracorporeal Shock Wave Therapy
2Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus
Objectives: To investigate whether extracorporeal shock wave therapy can accelerate bony consolidation and regeneration in distraction osteogenesis of the rat mandible. Second, at which stage of distraction osteogenesis EWST is most effective to accelerate bone consolidation and regeneration.
Methods: 24 male Sprague Dawley rats were subjected to DO of the right mandible (latency period, 3 days; distraction period, 10 days at a rate of 0.5 mm/day). Rats were divided to three groups: group I (control) without ESWT, group II received ESWT (0.18 mJ/mm2) at latency period and group III received ESWT (0.18 mJ/mm2) at consolidation period.
Results: After 4 weeks of consolidation period animals were sacrificed and explants were removed for radiographic, histological, collagen orientation, micro-CT and immunohistochemical (IHC) evaluation. Radiographic X-ray showed more radiopacity in both ESWT treatment groups compared with control. Histological evaluation detected intense capillary formation, osteocytes within the mature bone, and bone remodeling compared to other groups. The collagen orientation index showed more lamellar bone in group III, as opposed to control group which exhibited more woven bone. µCT of the distracted mandible showed significantly increased bone mineral density, bone volume fraction and trabecular thickness in group III compared to control group (P<0.05). Immunohistochemistry demonstrated significantly increased expression of bone morphogenetic protein-2, vascular endothelial growth factor, proliferating cell nuclear antigen, osteocalcin and collagen type-1 proteins in group III compared to control group.
Conclusion: The present study demonstrated that ESWT application at consolidation period during DO in rat mandible enhances bone formation, extracellular bone matrix protein, osteogenic and angiogenic growth factors, improves bone mechanical properties and accelerates bone mineralization.
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