The assessment of new bone formation induced by unfocused extracorporeal shock wave therapy applied on pre-surgical phase of distraction osteogenesis

Purpose This study aims to evaluate the effects of extracorporeal shock wave therapy applied before and/or immediately after the osteotomy on the maturation during the consolidation phase. Materials and Methods 21 female New Zealand rabbits were used in the study. Subjects were divided randomly into three groups: Control (Distraction without ESWT), A (Distraction +ESWT After Osteotomy), AB (Distraction+ESWT After and Before Osteotomy). ESWT (500 pulses, 5 Hz, 0.19 mJ/mm^2 energy flux density) was applied to group A and group AB after 5, 12 and 19 days after osteotomy and group AB only on days 7,14 and 21 before osteotomy. On the 28^th day of the consolidation period, all subjects were sacrificed. Dual-energy x-ray absorptiometry (DEXA) was used to determine bone mineral density (BMD) and bone mineral content (BMC), and stereological methods were used to determine the new bone, connective tissue and neovascularization volumes. Results As a result of DEXA examinations made on the 1^st and 4^th week of consolidation, there was no significant difference between groups regarding BMD and BMC values. According to the results of stereological examination, when the connective tissue and new bone tissue were evaluated, higher values were observed in AB when compared to A, and in AB and A compared to the control group, but the differences are not statistically significant. There was no difference between the groups in terms of neovascularization. Conclusion ESWT in these parameters was not positively effective in bone maturation during consolidation when applied before osteotomy or both before and after osteotomy.