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

Abstract

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. 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. 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.