Abstract
This study evaluated the effect of pulsed ultrasound on tissue repair and bone growth during mandibular osteodistraction. Twenty-one rabbits were divided into three groups of 7. The distraction started 72 h after surgically severing both sides of the mandible and proceeded at a rate of 1.5 mm/12 h for 5 days. Group 1 received pulsed ultrasound (nominally 200 μs pulse of 1.5 MHz at a 1.1 kHz pulse repetition frequency, 30 mW/cm2) for 20 min on both sides of the mandible every other day (alternating sides). Group 2 received the same pulsed ultrasound treatment on one side of the mandible every day for 20 min. Group 3 did not receive any ultrasound treatment. Bone formation at the distraction site was assessed by photodensitometry on head radiographs, a vibratory coherence test across the distraction site, a postmortem three-point bending mechanical stiffness test, and a postmortem histological examination. Statistical analyses performed using analysis of variance revealed that pulsed ultrasound enhanced bone formation at the distraction site with a high level of significance when assessed by the increase in new bone photodensity (p=0.001), vibratory coherence (p=0.001), mechanical stiffness (p=0.003), and qualitative histological studies, especially when the pulsed ultrasound treatment was directly applied daily. © 2002 Biomedical Engineering Society.
PAC2002: 8750Kk, 8763Df
Similar content being viewed by others
REFERENCES
Akkus, O., F. Korkusuz, S. Akin, and N. Akkas. Relation between mechanical stiffness and vibration transmission of fracture callus: An experimental study on rabbit tibia. Proc. Inst. Mech. Eng. Part H: J. Eng. Med. 212:327–336, 1998.
Dessner, S., C. A. Evans, T. H. El–Bialy, and Y. Razdolsky. Mandibular lengthening using preprogrammed intraoral tooth–borne distraction devices. J. Oral Maxillofac. Surg. 57:1318–1322, 1999.
Duarte, L. R. The stimulation of bone growth by ultrasound. Arch. Orthop. Trauma Surg. 101:153–159, 1983.
Duinkerke, A. S., A. C. van de Poel, W. H. Doesburg, and W. A. Lemmens. Dosimetric analysis of experimentally produced periapical radiolucencies. Oral Surg., Oral Med., Oral Pathol. 43:782–797, 1977.
El–Bialy, T. H., C. A. Evans, S. Dessner, and Y. Razdolsky. Outcome of mandibular distraction in patients using a toothborne device. J. Dent. Res. 77:990, 1998.
El–Bialy, T. H., T. J. Royston, A. Sakata, and R. L. Magin. Vibratory coherence as an alternative to radiography in assessing bone healing after osteo–distraction. Ann. Bioengineering. 30:226–231, 2002.
Enwemeka, S. C., O. Rodriguez, and S. Mendosa. The biomechanical effects of low–intensity ultrasound on healing tendons. Ultrasound Med. Biol. 16:801–807, 1990.
Genant, H. K., K. Engelke, T. Fuerst, C. C. Gluer, S. Grampp, S. T. Harris, M. Jergas, T. Lang, Y. Lu, S. Majumdar, A. Mathur, and M. Takada. Noninvasive assessment of bone mineral and structure: State of the art. J. Bone Miner. Res. 11:707–730, 1996.
Goss, S. A., R. L. Johnston, and F. Dunn. Compilation of empirical ultrasonic properties of mammalian tissues, II. J. Acoust. Soc. Am. 68:93–108, 1980.
Goss, S. A., R. L. Johnston, and F. Dunn. Comprehensive compilation of empirical ultrasonic properties of mammalian tissues. J. Acoust. Soc. Am. 64:423–457, 1978.
Guerrissi, J., G. Ferrentino, D. Margulies, and D. Fiz. Lengthening of the mandible by distraction osteogenesis: Experimental work in rabbits. J. Craniofac. Surg. 5:313–317, 1994.
Hagiwara, T., and W. H. Bell. Effect of electrical stimulation on mandibular distraction osteogenesis. J. Craniofac. Surg. 28:12–19, 2000.
Heckman, J. D., J. B. Ryaby, J. McCabe, J. J. Frey, and R. F. Kilcoyne. Acceleration of tibial fracture–healing by noninvasive, low–intensity pulsed ultrasound. J. Bone Joint Surg. 76:26–34, 1994.
Ito, M., Y. Azumaa, T. Ohtaa, and K. Komoriyaa. Effects of ultrasound and 1,25–dihydroxyvitamin D3 on growth factor secretion in co–cultures of osteoblasts and endothelial cells. Ultrasound Med. Biol. 26:161–166, 2000.
Knothe–Tate, M. L., U. Knothe, and P. Neiderer. Experimental elucidation of mechanical load–induced fluid flow and its potential role in bone metabolism and functional adaptation. Am. J. Med. Sci. 316:189–195, 1998.
Komuro, Y., T. Takato, K. Harii, and Y. Yonemara. The histologic analysis of distraction osteogenesis of the mandible in rabbits. Plast. Reconstr. Surg. 94:152–159, 1994.
Kristiansen, T. K., J. P. Ryaby, J. McCabe, J. J. Frey, and L. R. Roe. Accelerated healing of distal radial fractures with the use of specific, low–intensity ultrasound. A multicenter, prospective, randomized, double–blind, placebo–controlled study. J. Bone Jt. Surg., Am. Vol. 79:961–973, 1997.
Mayr, E., A. Laule, G. Suger, A. Ruiter, and L. Cloes. Radiographic results of callus distraction aided by pulsed lowintensity ultrasound. J. Orthop. Trauma 15:407–414, 2001.
McCarthy, J., J. Schrieber, N. Karp, C. Thorn, and B. Grayson. Lengthening the human mandible by gradual distraction. Plast. Reconstr. Surg. 89:1–10, 1992.
Molina, F., and M. F. Ortiz. Mandibular elongation and remodeling by distraction: A farewell to major osteotomies. Plast. Reconstr. Surg. 96:825–840, 1995.
Pilla, A. A., M. A. Mont, P. R. Nasser, S. A. Khan, M. Figueiredo, J. J. Kaufman, and R. S. Siffert. Non–invasive low–intensity pulsed ultrasound accelerate bone healing in the rabbit. J. Orthop. Trauma. 4:246–253, 1990.
Razdolsky, Y. Intraoral tooth borne distraction osteogenesis device (ROD): Proceedings of First International Symposium on Distraction Processes, Paris, June 1997.
Rooney, J. A. Nonlinear Phenomena. In: Methods of Experimental Physics, edited by P. D. Edmonds. New York: Academic, 1981, Vol. 19, Chap. 6, pp. 299–353.
Shimazaki, A., K. Inui, Y. Azuma, N. Nishimura, and Y. Yamano. Low–intensity pulsed ultrasound accelerates bone maturation in distraction osteogenesis in rabbits. J. Bone Jt. Surg., Br. 82–B:1077–1082, 2000.
Stewart, K. J., B. Weyand, R. J. van't Hof, S. A. White, G. O. Lvoff, N. Maffulli, and M. D. Poole. A quantitative analysis of the effect of insulin–like growth factor–1 infusion during mandibular distraction osteogenesis in rabbits. Br. J. Plast. Surg. 52:343–350, 1999.
Stewart, K. J., G. O. Lvoff, S. A. White, S. F. Bonar, W. R. Walsh, R. C. Smart, and M. D. Poole. Mandibular distraction osteogenesis: A comparison of distraction rates in the rabbit model. J. Maxillofacial Surg. 26:43–49, 1998.
Sun, J. S., Y. H. Tsuang, F. H. Lin, H. C. Liu, C. Z. Tsai, and W. H. Chang. Bone defect healing enhanced by ultrasound stimulation: An in vitro tissue culture model. Biomed. Mater. Res. 46:253–261, 1999.
Tanzer, M., E. Harvey, A. Kay, P. Morton, and J. D. Bobyn. Effect of noninvasive low intensity ultrasound on bone growth into porous–coated implants. J. Orthop. Res. 14:901–906, 1996.
Tsai, C. L., W. H. Chang, and T. K. Liu. Preliminary studies of duration and intensity of ultrasonic treatments on fracture repair. Chin. J. Physiol. 35:21–26, 1992.
Wang, S. J., D. G. Lewallen, M. E. Bolander, E. Y. Chao, D. M. Ilstrup, and J. F. Greenleaf. Low intensity ultrasound treatment increases strength in a rat femoral fracture model. J. Orthop. Res. 12:40–47, 1994.
Young, S. R., and M. Dyson. The effect of therapeutic ultrasound on angiogenesis. Ultrasound Med. Biol. 16:261–269, 1990.
Zorlu, U., M. Tercan, I. Ozyazgan, I. Taskan, Y. Kardas, F. Balkar, and F. Ozturk. Comparative study of the effect of ultrasound and electrostimulation on bone healing in rats. Am. J. Phys. Med. Rehabil. 77:427–432, 1998.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
El-Bialy, T.H., Royston, T.J., Magin, R.L. et al. The Effect of Pulsed Ultrasound on Mandibular Distraction. Annals of Biomedical Engineering 30, 1251–1261 (2002). https://doi.org/10.1114/1.1529196
Issue Date:
DOI: https://doi.org/10.1114/1.1529196