ABSTRACT
PURPOSE: To evaluate the feasibility of reversing a primary failure through therapeutic mechanical stimulation induced by transcutaneous application of acoustic waves (ESWT) in the peri-implant tissues. Materials and Μethods: This clinical report evaluates the outcome of a new protocol proposed to treat a primary failure (loosened oral implant); application of three cycles of ESWT, once session per week for 3 consecutive weeks, with an equivalent positive energy of 0,18 mJ/mm² (therapeutic dose: 2000 impulses/ 8Hz/ 4.0 bar). Standardized intraoral radiographs, Cone Beam Computed Tomography (CBCT), Implant Stability Quotient (ISQ) and clinical evaluations were performed. RESULTS: It was possible to verify a progressive increase in the ISQ value after the ESWT protocol; 17 (initial), 46 (after two months) and 68 (after four months), which led to successful implant prosthetic rehabilitation (35 N/cm measured). Our evaluation at 6 years of follow-up confirms that the new bone-implant interface is preserved and ESWT as a safe non-invasive treatment. CONCLUSION: In the context of the new dynamic model of osseointegration, the Foreign Body Equilibrium (FBE), this represents the first report of a host-Implant equilibrium re-established after an early failure process. However, it is necessary to perform studies to determine both the medical device and the most effective therapeutic range for clinical applications of this technology in oral implantology.
ABSTRACT
We propose a novel approach for the treatment of atrophic bone non-unions via parallel applications of extracorporeal shock wave therapy (ESWT) and an autologous mesenchymal stem cell transplant. The hypothesis resides on the potentiality of shock waves (SWs) to act as a tool for manipulating the patient's mesenchymal stem cells (MSCs). In addition to the conventional physical stimulus achieved by delivering SWs at the site of non-union to stimulate the well-known trophic effects on bone tissue, a series of concomitant ESWT would be administered in tandem at a bone marrow donor site, such as the iliac crest, to precondition resident bone marrow stromal cells (BMSCs) in vivo, priming resident MSCs by enlarging and conditioning their population prior to bone marrow aspiration. The resulting sample could then be treated to further augment cell concentration and injected, under fluoroscopic control, into the non-union site through a percutaneous approach.
Subject(s)
Bone Diseases/therapy , Fractures, Ununited/therapy , High-Energy Shock Waves , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/cytology , Atrophy , Bone Regeneration , Bone Transplantation , Bone and Bones , Humans , Ilium/pathology , Joints , Models, Theoretical , Transplantation, AutologousABSTRACT
The Raman spectra (1800-200 cm(-1)) of isolated dried collagen types I and III were recorded at different times after shockwave (SW) application in aqueous media. SWs were applied in a single session. One week after the SW application the vibrational data analysis indicates changes in the conformation of the collagens; orientational changes are also inferred. During the next three weeks collagens tended to recover the conformation and orientation existing before SW application.
Subject(s)
Collagen/chemistry , High-Energy Shock Waves , Spectrum Analysis, Raman/methods , Animals , Cattle , Rats , Time Factors , VibrationABSTRACT
Entre mayo de 1996 y mayo de 1999, se solicitaron tomografias axial computadas de hombro en todos los pacientes con dolor anterior y refractario al tratamiento medico, midiendose la distancia coracohumeral segun Gerber. Sobre un total de 31 pacientes tratados con coracoplastia artroscopica del hombro, se evaluaron 10 pacientes con coracoplastia aislada. Se analizaron la anatomia, fisiologia, patologia, sintomas y signos, examenes complementarios, en especial, tomografia axial computada y correlacion con artroscopia, como asi el tratamiento quirurgico. El seguimiento de la serie fue de 6 a 36 meses, con un promedio de 18 meses. El resultado final obtenido, de acuerdo al puntaje de UCLA, fue 80 por ciento excelente, 10 por ciento bueno y 10 por ciento regular. En relacion a la evaluacion de la tecnica de coracoplastia artroscopica realizada en todos los pacientes con dolor anterior de hombro y distancia coracohumeral disminuida, es un procedimiento facil y reproducible. Los autores se refieren al pinzamiento anteromedial subcoracoideo como una patologia poco frecuente y recomiendan su conocimiento en el diagnostico diferencial
Subject(s)
Arthroscopy , Shoulder Joint/anatomy & histology , Shoulder Joint/surgery , Shoulder Joint/pathologyABSTRACT
Entre mayo de 1996 y mayo de 1999, se solicitaron tomografias axial computadas de hombro en todos los pacientes con dolor anterior y refractario al tratamiento medico, midiendose la distancia coracohumeral segun Gerber. Sobre un total de 31 pacientes tratados con coracoplastia artroscopica del hombro, se evaluaron 10 pacientes con coracoplastia aislada. Se analizaron la anatomia, fisiologia, patologia, sintomas y signos, examenes complementarios, en especial, tomografia axial computada y correlacion con artroscopia, como asi el tratamiento quirurgico. El seguimiento de la serie fue de 6 a 36 meses, con un promedio de 18 meses. El resultado final obtenido, de acuerdo al puntaje de UCLA, fue 80 por ciento excelente, 10 por ciento bueno y 10 por ciento regular. En relacion a la evaluacion de la tecnica de coracoplastia artroscopica realizada en todos los pacientes con dolor anterior de hombro y distancia coracohumeral disminuida, es un procedimiento facil y reproducible. Los autores se refieren al pinzamiento anteromedial subcoracoideo como una patologia poco frecuente y recomiendan su conocimiento en el diagnostico diferencial
