Shtybel N. Improving the healing efficiency of cavitary bone defects on mandible using shock wave therapy

The objects – postoperative cavitary bone defects in mandible; the purpose – improving the process of reparative osteogenesis in the area of postoperative cavity bone defects in mandible using shock wave therapy in their treatment process; methods – retrospective analysis, clinical-anamnestic, general clinical examination, radiological (cone-beam computed tomography (CBCT), 3d modeling), morphological (histological, morphometric investigation), digital visual-analytical and mathematical-statistical research methods; results – It was found that the most effective method of physical stimulation of healing processes of postoperative cavity bone defects is extracorporeal shock wave therapy, which can also be used in the practice of maxillofacial surgery for the treatment of joint disorders, linear fractures, including nonunion prophylaxis, periimplantitis and postoperative scars prophylaxis. Retrospectively, it was found that among the cavitary bone defects of the jaws, the most common were defects of large size (> 8 mm), which accounted for 47.1% of all bone defects of the jaws. The dominant method of treatment of postoperative bone defects was augmentation of the defect using collagen-based grafts and platelet-rich fibrin. The effectiveness of shock wave therapy to optimize reparative osteogenesis was proved, which was confirmed radiologically and histologically, the tissues in the area of bone defects in animals receiving shock wave therapy in the postoperative period at different comparable stages were more mature and more related to intact tissues compared to control. Optimal for the healing of cavitary bone defects of the mandible is the filling of the defect with a collagen sponge impregnated with synthetic ceramics and treatment with 3 sessions of extracorporeal shock wave therapy at a dose of 500 pulses at a frequency of 5 Hz with an increasing pressure on a front wave from 1,2 Bars up to 1.6 Bar on affected area after the acute phase. Significant role in the dynamics of healing has the type of bone tissue (compact or trabecular in the basis of the defect. The use of shock wave therapy does not play a significant role in preventing vertical reduction of the alveolar ridge; branch – Health care.