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Extracorporeal Shockwave Therapy Improves Outcomes Following Secondary Alveolar Bone Grafting
Demetrius M. Coombs, MD; Viren Patel, MD; Nicholas Kochenour, DMD; Niyant Patel, MD; Ananth S. Murthy, MD
The Cleveland Clinic & Akron Children's Hospital
2023-01-31
Presenter: Demetrius Coombs, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Steven Bernard, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Recent studies have reported that extracorporeal shock wave therapy (ESWT) enhances bone formation during mandibular distraction osteogenesis. This study seeks to investigate the clinical outcomes in children undergoing ESWT alongside secondary alveolar bone grafting procedures at our institution.
Methods:
Retrospective review of all children that underwent secondary alveolar cleft bone grafting with adjunctive ESWT between 2019 and 2021. Variables including age, gender, cleft type, cleft width, pre-operative cleft dentition, volume of bone graft placed intraoperatively, ESWT settings, pain medication utilization, length of stay (LOS), follow-up, cone beam computed tomography (CBCT) data, and complications were recorded.
Results:
Twenty patients met inclusion criteria. Mean age at surgery was 9.9 years (range 8-16). Four (20%) patients were female; 16 (80%) were male. Eight (40%) patients had bilateral alveolar clefts; 12 (60%) had unilateral clefts. All (100%) patients were discharged on the day of surgery. Twelve (60%) patients required an average of 2 oxycodone doses post-operatively (range 0-6.5). All patients received ESWT treatments intra and post-operatively. All patients demonstrated an increase in bone graft volume visualized on CBCT: mean increase of 9.5% (range 1.3-35.7%) between 106.8 days (19.5% of ideal visualized, range 5-42%) and 291.9 days (29% of ideal, range 8-55.7%). Three (15%) patients experienced minor complications.
Conclusions:
Initial outcomes suggest that ESWT may expedite visualization of bone consolidation and facilitate recovery without increasing complications. ESWT could further represent an opportunity to improve care in craniofacial surgery. Pertinent considerations, the role of standardized assessment protocols, and future directions will be reviewed.
