Growth Factors in Bone Marrow Blood of the Mandible With Application of Extracorporeal Shock Wave Therapy

Enhancement of bone regeneration is crucial to dental implantology. Growth factors play a significant role during osteogenesis and angiogenesis. Extracorporeal shock wave therapy (ESWT) enhances bone healing; however, no studies have yet been performed in oral implantology. Twenty patients who underwent bilateral mandibular wisdom tooth removal were included. ESWT was applied to 1 side of the jaw. Blood samples were collected from the peripheral vein (PB), mandibular bone marrow without and with ESWT (BM-/+SW). Quantity and quality of the growth factors bone morphogenetic protein (BMP)-2, BMP-4, insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β) were investigated via ELISA and cell proliferation assay. ELISA revealed superior amounts of IGF-1 and VEGF in BM-/+SW compared to PB (P < 0.05). TGF-β demonstrated no variance. Levels of BMP-2 and BMP-4 were too low for adequate detection in the ELISA. No difference was noticed upon ESWT. The cell proliferation assay did not identify any changes comparing PB versus BM-SW versus BM + SW. IGF-1 and VEGF are present at higher levels in mandibular bone marrow than in peripheral blood (PB). This study did not identify any benefits of extracorporeal shock wave therapy to increase the investigated growth factors.