Effect of low-intensity pulsed ultrasound on bone formation during mandible distraction osteogenesis in a canine model--a preliminary study.

PURPOSE To make a preliminary study of the effect of low-intensity pulsed ultrasound on new bone formation during mandible distraction osteogenesis in dogs. MATERIALS AND METHODS Bilateral surgical cuts were made in mandibles of 7 dogs between the first and second premolar regions. Anterior mandibles were lengthened by 20 mm at the rate of 1 mm/day twice a day. During the distraction period 1 lateral distraction gap was irradiated by low-intensity pulsed ultrasound for 10 minutes twice a day and the other side was sham irradiated as control. After distraction was completed, the dogs were sacrificed at 0, 1, 2, 4, 6, 8, and 12 weeks. Before sacrifice, dynamic bone imaging with technetium (99)m-methylene diphosphonate ((99)mTc-MDP) single-photon emission computed tomography was performed. Mandible samples were harvested. Then plain x-ray, dual-energy x-ray bone mineral density measurement, 3-dimensional computed tomography, and regular histologic examination were performed. RESULTS The (99)mTc-MDP bone imaging showed that uptake of (99)mTc-MDP in the experimental side was higher than in the control side at the early period of the consolidation time, but the outcome was later reversed. Plain x-ray showed that new bone of the experimental side was mature sooner than that of the control side. Bone mineral density in the experimental side was higher than that of the control side. Volume of new bone of the 2 sides had no significant difference. Histologic examination showed that trabeculae of the experimental side were more numerous and thicker than those of the control side at the early period of the consolidation time. Endochondral bone formation was observed in the experimental side. CONCLUSION Low-intensity pulsed ultrasound could accelerate bone formation during mandibular distraction osteogenesis and increase bone mineral density but had no effect on the volume of new bone.

[1]  M. Dyson,et al.  The effect of therapeutic ultrasound on angiogenesis. , 1990, Ultrasound in medicine & biology.

[2]  W H Bell,et al.  Effect of electrical stimulation on mandibular distraction osteogenesis. , 2000, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[3]  M. Ziskin.  Intrauterine effects of ultrasound: human epidemiology. , 1999, Teratology.

[4]  M. Tercan,et al.  Comparative study of the effect of ultrasound and electrostimulation on bone healing in rats. , 1998, American journal of physical medicine & rehabilitation.

[5]  C. Rubin,et al.  The cellular basis of Wolff's law. Transduction of physical stimuli to skeletal adaptation. , 1988, Rheumatic diseases clinics of North America.

[6]  E. Chao,et al.  The effect of low intensity pulsed ultrasound applied to rabbit tibiae during the consolidation phase of distraction osteogenesis , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  Y. Azuma,et al.  Effects of timing of low‐intensity pulsed ultrasound on distraction osteogenesis , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[8]  G. Swennen,et al.  Morbidity related to transmandibular distraction osteogenesis for patients with developmental deformities. , 2008, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[9]  Hideki Yoshikawa,et al.  Low-intensity pulsed ultrasound accelerates maturation of callus in patients treated with opening-wedge high tibial osteotomy by hemicallotasis. , 2004, The Journal of bone and joint surgery. American volume.

[10]  M. Bhandari,et al.  The effect of low-intensity pulsed ultrasound therapy on time to fracture healing: a meta-analysis. , 2002, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[11]  K. Kawasaki,et al.  Effects of low-intensity pulsed ultrasound on proliferation and chondroitin sulfate synthesis of cultured chondrocytes embedded in Atelocollagen gel. , 2002, Journal of biomedical materials research.

[12]  G A Ilizarov,et al.  The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. , 1989, Clinical orthopaedics and related research.

[13]  C. Rubin,et al.  The use of low-intensity ultrasound to accelerate the healing of fractures. , 2001, The Journal of bone and joint surgery. American volume.

[14]  D. Kanishi.  99mTc-MDP accumulation mechanisms in bone. , 1993, Oral surgery, oral medicine, and oral pathology.

[15]  G. Swennen,et al.  Craniofacial distraction osteogenesis: a review of the literature: Part 1: clinical studies. , 2001, International journal of oral and maxillofacial surgery.

[16]  L. Qin,et al.  Low intensity pulsed ultrasound accelerated bone remodeling during consolidation stage of distraction osteogenesis , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[17]  C. Rubin,et al.  Enhancement of fracture healing by low intensity ultrasound. , 1998, Clinical orthopaedics and related research.

[18]  J. Ryaby,et al.  Low-intensity pulsed ultrasound in the treatment of nonunions. , 2001, The Journal of trauma.

[19]  T J Royston,et al.  Effects of Ultrasound Modes on Mandibular Osteodistraction , 2008, Journal of dental research.

[20]  Lynne E Bilston,et al.  Low-Intensity Ultrasound Stimulation in Distraction Osteogenesis in Rabbits , 2003, Clinical orthopaedics and related research.

[21]  G. Du,et al.  Temperature elevation in tissues generated by finite-amplitude tone bursts of ultrasound , 1990 .

[22]  Y. Azuma,et al.  Effects of ultrasound and 1,25-dihydroxyvitamin D3 on growth factor secretion in co-cultures of osteoblasts and endothelial cells. , 2000, Ultrasound in medicine & biology.

[23]  H. Genant,et al.  Bone-seeking radionuclides: an in vivo study of factors affecting skeletal uptake. , 1974, Radiology.

[24]  Hani El-Mowafi,et al.  The effect of low-intensity pulsed ultrasound on callus maturation in tibial distraction osteogenesis , 2005, International Orthopaedics.

[25]  F. Lin,et al.  Bone defect healing enhanced by ultrasound stimulation: an in vitro tissue culture model. , 1999, Journal of biomedical materials research.

[26]  M. Ueda,et al.  Ultrasound enhances transforming growth factor beta-mediated chondrocyte differentiation of human mesenchymal stem cells. , 2004, Tissue engineering.

[27]  L. R. Duarte.  The stimulation of bone growth by ultrasound , 2004, Archives of orthopaedic and traumatic surgery.

[28]  J F Greenleaf,et al.  Low‐intensity ultrasound stimulates proteoglycan synthesis in rat chondrocytes by increasing aggrecan gene expression , 1999, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[29]  N. Heybeli,et al.  Diagnostic Ultrasound Treatment Increases the Bone Fracture–Healing Rate in an Internally Fixed Rat Femoral Osteotomy Model , 2002, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[30]  A. Pilla,et al.  Non-invasive low-intensity pulsed ultrasound accelerates bone healing in the rabbit. , 1990, Journal of orthopaedic trauma.

[31]  Javad Parvizi,et al.  Exposure to low‐intensity ultrasound increases aggrecan gene expression in a rat femur fracture model , 1996, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[32]  B. Siegel,et al.  Skeletal uptake of 99mTc-diphosphonate in relation to local bone blood flow. , 1976, Radiology.