Extracorporeal Shockwave Therapy (ESWT)-A Novel Method for Transferring Oral Implant Primary Failures to Final Clinical Success: A Test Case Report Followed up for More Than 6 Years.

Abstract

Purpose: To evaluate the feasibility of reversing a primary failure through therapeutic mechanical stimulation induced by transcutaneous application of acoustic waves (extracorporeal shockwave therapy [ESWT]) in the peri-implant tissues.

Materials and methods: 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 (one session per week for 3 consecutive weeks) with an equivalent positive energy of 0.18 mJ/mm2 (therapeutic dose: 2,000 pulses, 8 Hz, 4.0 bar). Standardized intraoral radiographs and CBCT scans were taken, the implant stability quotient (ISQ) was determined, and clinical evaluations were performed.

Results: It was possible to verify a progressive increase in ISQ values after the ESWT protocol: 17 initially, 46 at 2 months, and 68 at 4 months. This led to successful implant prosthetic rehabilitation (35 Ncm). Follow-up evaluations at 6 years confirm that the new bone-implant interface is preserved and that ESWT is a safe, noninvasive treatment.

Conclusions: In the context of the new dynamic model of osseointegration (the foreign body equilibrium), this represents the first report of a host-implant equilibrium reestablished after an early implant failure process. However, more studies are needed to determine both the medical device and the most effective therapeutic range for clinical applications of this technology in oral implantology.