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.

This article focuses on the use of extracorporeal shockwave therapy (ESWT) as a novel, noninvasive treatment to reverse primary failure of oral implants by promoting peri-implant tissue healing and osseointegration. A case report of a patient with a loosened maxillary canine implant treated with three weekly ESWT sessions demonstrated progressive increases in implant stability quotient (ISQ) values—from 17 initially to 68 at four months—leading to successful prosthetic rehabilitation and stable bone-implant interface confirmed at a six-year follow-up. The authors discuss ESWT’s potential immunomodulatory effects, particularly its influence on macrophage polarization from proinflammatory (M1) to anti-inflammatory (M2) phenotypes, which may restore the host-implant equilibrium described in the dynamic model of osseointegration. While this case suggests ESWT’s safety and efficacy in managing early implant failure, further animal studies and clinical trials are needed to optimize treatment parameters and clarify underlying biological mechanisms.