title: Effect of extracorporeal shockwave therapy (ESWT) on pulpal blood flow after orthodontic treatment: a randomized clinical trial.
abstract: OBJECTIVE
  The effect of non-invasive extracorporeal shockwaves on pulpal blood flow in orthodontic patients who have undergone active treatment was investigated.
  
  
  METHODS
  Seventy-two adult patients were enrolled in the clinical trial and allocated by block randomization to a treatment or a placebo group at a 1:1 ratio. The patients were required to be otherwise healthy. Blinding was performed for the subjects and the outcome assessor. The region of interest was the mandibular incisors and canines, which were vital, unrestored, and had experienced no trauma. The active treatment group received a single shockwave treatment with 1000 impulses at 0.19-0.23 mJ/mm(2) while the placebo group was treated with a deactivated shockwave applicator but acoustic sham. Pulpal blood flow was evaluated four times over a period of 6 months starting from the day of bracket removal, using a laser Doppler device.
  
  
  RESULTS
  Thirty patients were evaluated in each group. Orthodontic patients who have undergone active treatment tend to have high levels of pulpal blood flow which decrease over a period of 6 months. Pulpal blood flow did not differ significantly over 6 months between the placebo and treatment group. Shockwave treatment was associated with no significant effect in respect of tooth type, age, sex, or mean blood pressure, and had no unintended pernicious effects.
  
  
  CONCLUSIONS
  Extracorporeal shockwaves had no statistically significant effect on pulpal blood flow. Multiple applications of ESWT in a pathological setup may be needed in future studies to demonstrate significant differences.
  
  
  CONCLUSIONS
  The absence of any adverse effects justifies further principal investigations of the use of shockwave treatment in the oral cavity.
authors.affiliation: Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria. frank.falkensammer@meduniwien.ac.at.|Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria. frank.falkensammer@meduniwien.ac.at.
authors.forename: Frank
authors.initials: F
authors.lastname: Falkensammer
authors.affiliation: AUVA-Trauma Center Meidling, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schaden
authors.affiliation: Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Krall
authors.affiliation: Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Freudenthaler
authors.affiliation: Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bantleon
mesh_terms: D000293:Adolescent; D000328:Adult; D003481:Cuspid / Q000098:blood supply; D003782:Dental Pulp / Q000098:blood supply*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D007180:Incisor / Q000098:blood supply; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009971:Orthodontics, Corrective
keywords: ESWT; Extracorporeal shockwave; LDF; Laser Doppler; PBF; Pulpal blood flow