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Abstract
PURPOSE The aim of this systematic review was to evaluate studies reporting on the effects of therapeutic ultrasound on the physis. SUMMARY OF KEY POINTS Eight studies were included in the final analysis, all of which were animal studies. At higher doses, studies found skin and bone necrosis and inhibition of growth, while in lower doses some studies found that ultrasound had a transient stimulatory effect on growth, increased thickness of the hypertrophic zone, and increased thickness of the whole growth plate. Overall, experimental evidence in animal models suggests that therapeutic ultrasound, even at low doses, might induce microscopic changes to the histology of the growth plate. CONCLUSION While we found no reports of growth disturbance in humans, given the histological changes found in animal studies, the current limited literature seems to support the recommendation that the application of therapeutic ultrasound around the physis should be avoided.
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Maurya RK, Jayan B, Singh H, Nakra O, Sharma P. Effects of Low-Intensity Pulsed Ultrasound Therapy on the Temporomandibular Joint Complex in Conjunction With a Fixed Functional Appliance: A Prospective 3-Dimensional Cone Beam Computed Tomographic Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1661-1676. [PMID: 30393868 DOI: 10.1002/jum.14850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/07/2018] [Accepted: 09/28/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This prospective study aimed to analyze 3-dimensional changes in the temporomandibular joint (TMJ) complex with a synergistic effect of functional jaw orthopedics using a fixed functional appliance and low-intensity pulsed ultrasound (LIPUS) therapy. METHODS Forty patients with skeletal class II malocclusion were randomly assigned to 4 groups (2 control groups and 2 test groups) of 10 patients each. After insertion of the fixed functional appliance, the test group was stimulated with LIPUS therapy in the TMJ region bilaterally for 20 minutes daily for first 10 days and thereafter at least 3 times per week until complete mandibular advancement was achieved. Three-dimensional images obtained with a cone beam computed tomographic scanner were used to analyze the changes in the TMJ complex at the prefunctional stage and after completion of functional appliance therapy. Direct intragroup and intergroup comparisons for different morphometric variables were conducted with the Student t test. RESULTS The 40 patients included 20 male and 20 female patients between the ages of 12 and 16 years (mean age ± SD, 13.2 ± 1.8 years). Both the test groups and the control groups showed statistically significant variable changes in condylar head position and morphometric changes in relation to the joint space analysis (mean differences, -1.000 and -1.080 mm; P < .05). However, no significant differences were found during the intergroup comparisons at the prefunctional and postfunctional stages for the variables examined, except for the measurements of the linear distance of the condyle to the external auditory meatus on both the right and left sides at the prefunctional phase. CONCLUSIONS Low-intensity pulsed ultrasound therapy positively affects the quantum of the joint space, thus proving to be a promising adjunct in enhancing treatment outcomes of functional jaw orthopedics in growing patients with skeletal class II malocclusions.
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Affiliation(s)
- Raj Kumar Maurya
- Department of Orthodontics and Dentofacial Orthopedics, Army Dental Center (Research and Referral), Delhi, India
| | - Balakrishna Jayan
- Department of Orthodontics and Dentofacial Orthopedics, Army Dental Center (Research and Referral), Delhi, India
| | - Harpreet Singh
- Department of Orthodontics and Dentofacial Orthopedics, Employees' State Insurance Corporation Dental College and Hospital, Delhi, India
| | - Oonit Nakra
- Department of Orthodontics and Dentofacial Orthopedics, Army Dental Center (Research and Referral), Delhi, India
| | - Poonam Sharma
- Department of Orthodontics and Dentofacial Orthopedics, Employees' State Insurance Corporation Dental College and Hospital, Delhi, India
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Sasaki K, Motoyoshi M, Horinuki E, Arai Y, Shimizu N. Effect of low-intensity pulsed ultrasound (LIPUS) on mandibular condyle growth in rats analyzed with micro-CT. J Oral Sci 2017; 58:415-22. [PMID: 27665982 DOI: 10.2334/josnusd.16-0010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the effects of a bite-jumping appliance combined with low-intensity pulsed ultrasound (LIPUS) stimulation on the mandibular condyle of growing rats using micro CT (mCT) and histological examinations. Twelve Wistar rats were divided into three groups of four individuals each: Group 1 was an untreated control group, Group 2 received bite-jumping appliances, and Group 3 received bite-jumping appliances and LIPUS stimulation (15 min/day, 2 weeks) to the temporomandibular region. We measured the length and three-dimensional bone volume of each rat's mandibular condyle using mCT. The condylar cartilage was observed after the rats had been sacrificed. There was no significant difference in condylar sagittal width among the groups. The bite-jumping appliance combined with LIPUS stimulation increased the condylar major axis, mandibular sagittal length and condylar bone volume to a greater degree than use of the bite-jumping appliance alone. Histological examination demonstrated hypertrophy of the condylar cartilage layers, the fibrous layer and hypertrophic cell layer of the rats treated with bite-jumping appliances combined with LIPUS stimulation in comparison to rats treated with bite-jumping appliances alone. (J Oral Sci 58, 415-422, 2016).
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Affiliation(s)
- Kyozo Sasaki
- Department of Orthodontics, Nihon University School of Dentistry
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Jang KW, Ding L, Seol D, Lim TH, Buckwalter JA, Martin JA. Low-intensity pulsed ultrasound promotes chondrogenic progenitor cell migration via focal adhesion kinase pathway. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1177-86. [PMID: 24612644 PMCID: PMC4034572 DOI: 10.1016/j.ultrasmedbio.2013.12.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 10/21/2013] [Accepted: 12/09/2013] [Indexed: 05/14/2023]
Abstract
Low-intensity pulsed ultrasound (LIPUS) has been studied frequently for its beneficial effects on the repair of injured articular cartilage. We hypothesized that these effects are due to stimulation of chondrogenic progenitor cell (CPC) migration toward injured areas of cartilage through focal adhesion kinase (FAK) activation. CPC chemotaxis in bluntly injured osteochondral explants was examined by confocal microscopy, and migratory activity of cultured CPCs was measured in transwell and monolayer scratch assays. FAK activation by LIPUS was analyzed in cultured CPCs by Western blot. LIPUS effects were compared with the effects of two known chemotactic factors: N-formyl-methionyl-leucyl-phenylalanine (fMLF) and high-mobility group box 1 (HMGB1) protein. LIPUS significantly enhanced CPC migration on explants and in cell culture assays. Phosphorylation of FAK at the kinase domain (Tyr 576/577) was maximized by 5 min of exposure to LIPUS at a dose of 27.5 mW/cm(2) and frequency of 3.5 MHz. Treatment with fMLF, but not HMBG1, enhanced FAK activation to a degree similar to that of LIPUS, but neither fMLF nor HMGB1 enhanced the LIPUS effect. LIPUS-induced CPC migration was blocked by suppressing FAK phosphorylation with a Src family kinase inhibitor that blocks FAK phosphorylation. Our results imply that LIPUS might be used to promote cartilage healing by inducing the migration of CPCs to injured sites, which could delay or prevent the onset of post-traumatic osteoarthritis.
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Affiliation(s)
- Kee W Jang
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Lei Ding
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA
| | - Dongrim Seol
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA
| | - Tae-Hong Lim
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Joseph A Buckwalter
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA; Veterans Affairs Medical Center, Iowa City, Iowa, USA
| | - James A Martin
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA.
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The effect of B-mode diagnostic ultrasound exposure on rabbit foetal bone mineral density (BMD). Radiography (Lond) 2012. [DOI: 10.1016/j.radi.2011.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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ELECTROPHYSICAL AGENTS - Contraindications And Precautions: An Evidence-Based Approach To Clinical Decision Making In Physical Therapy. Physiother Can 2011; 62:1-80. [PMID: 21886384 PMCID: PMC3031347 DOI: 10.3138/ptc.62.5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Barreto AA, Barreto RKA, Pereira HDR, Hosnne WS. Efeitos do ultra-som terapêutico sobre o crescimento longitudinal do fêmur e da tíbia em ratos. ACTA ORTOPEDICA BRASILEIRA 2011. [DOI: 10.1590/s1413-78522011000300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Estudar efeitos do ultra-som terapêutico sobre o crescimento do fêmur e da tíbia, em ratos jovens. MÉTODO: Ratus norvegicus com quatro semanas de vida, machos, totalizando 115 animais, divididos em quatro grupos, foram submetidos ao ultra-som terapêutico (0,8 MHz, cabeçote fixo, pulso contínuo, por dez minutos, durante dez dias), na face medial do joelho direito, nas potências de 0,0 W/cm2 (grupo controle), 0,5 W/cm2 (grupo G2), 1,0 W/cm2 (grupo G3), e 1,5 W/cm2 (grupo G4). Lâminas histológicas da epífise, placa de crescimento e metáfise e as medidas dos comprimentos do fêmur e da tíbia foram estudadas na sexta, décima terceira e vigésima sexta semanas de vida. Os dados foram submetidos à análise de variância - fatorial inteiramente aleatorizado. RESULTADO: Nenhuma alteração estatística do crescimento ósseo foi estabelecida entre quaisquer dos três grupos tratados e o grupo controle. Entretanto, alterações sugestivas de diminuição do crescimento do fêmur e da tíbia de G4 em relação a G2 e G3, foram evidenciadas. No grupo G4 alterações histopatológicas como necroses celulares e neoformação óssea, pós-necrose, foram encontradas. CONCLUSÃO: Quando comparados os grupos tratados com o grupo controle, não há evidência estatística de estímulo ou inibição ao crescimento ósseo pela aplicação do ultra-som terapêutico. Nível de Evidência: Nível II, estudo coorte transversal.
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KATANO M, NARUSE K, UCHIDA K, MIKUNI-TAKAGAKI Y, TAKASO M, ITOMAN M, URABE K. Low Intensity Pulsed Ultrasound Accelerates Delayed Healing Process by Reducing the Time Required for the Completion of Endochondral Ossification in the Aged Mouse Femur Fracture Model. Exp Anim 2011; 60:385-95. [DOI: 10.1538/expanim.60.385] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Motoaki KATANO
- Departments of Orthopedic Surgery, Kitasato University School of Medicine
| | - Kouji NARUSE
- Departments of Orthopedic Surgery, Kitasato University School of Medicine
| | - Kentaroo UCHIDA
- Departments of Orthopedic Surgery, Kitasato University School of Medicine
| | - Yuko MIKUNI-TAKAGAKI
- Department of Maxillofacial Diagnostic Science and Functional Biology, Kanagawa Dental College
| | - Masashi TAKASO
- Departments of Orthopedic Surgery, Kitasato University School of Medicine
| | | | - Ken URABE
- Departments of Orthopedic Surgery, Kitasato University School of Medicine
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Cressoni MDC, Giusti HHKD, Pião AC, de Paiva Carvalho RL, Anaruma CA, Casarotto RA. Effect of GaAlAs Laser Irradiation on the Epiphyseal Cartilage of Rats. Photomed Laser Surg 2010; 28:527-32. [PMID: 20201664 DOI: 10.1089/pho.2009.2572] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Antonio Carlos Pião
- Department of Applied Mathematics and Statistics, Institute of Geosciences and Exact Sciences, São Paulo State University Júlio de Mesquita Filho, Rio Claro, Brazil
| | | | - Carlos Alberto Anaruma
- Department of Physical Education, São Paulo State University Julio de Mesquita Filho, Rio Claro, Brazil
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Naruse K, Mikuni-Takagaki Y, Urabe K, Uchida K, Itoman M. Therapeutic ultrasound induces periosteal ossification without apparent changes in cartilage. Connect Tissue Res 2009; 50:55-63. [PMID: 19212853 DOI: 10.1080/03008200802419855] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Low intensity pulsed ultrasound (LIPUS) is an extremely useful noninvasive treatment which halves the duration of fracture healing when the bone is exposed once a day for 20 min. To elucidate the direct reactions of bone and cartilage, dissected rat femora were immobilized in culture dish wells, exposed to LIPUS from a certain angle every day, and the local pattern of ossification was analyzed in relation to the ultrasound. Daily 20-min exposures were started 24 hr after isolation of the femora, and at days 5, 10, and 15, samples were harvested for measurements, morphological, and histochemical analyses. While the gross features of the samples were identical to the untreated controls, extended mineralization of the periosteum was observed with alizarin red staining, antiosteocalcin immunohistochemical staining, and micro-three dimensional computed tomography. Interestingly, the newly deposited mineral was found perpendicular to the ultrasound path, strongly suggesting that LIPUS accelerates periosteal bone formation. Zones of epiphyseal cartilage and hypertrophic and calcified cartilage did not exhibit any differences with and without this exposure. LIPUS also did not influence the secreted proteoglycan components or amounts in the culture medium. The absence of any additional longitudinal growth of the femur demonstrated that LIPUS did not accelerate endochondral bone formation. We conclude that cartilage alone does not directly respond to therapeutic ultrasound, whereas the periosteum does.
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Affiliation(s)
- Kouji Naruse
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
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Doyle ND. Rehabilitation of fractures in small animals: Maximize outcomes, minimize complications. ACTA ACUST UNITED AC 2004; 19:180-91. [PMID: 15712463 DOI: 10.1053/j.ctsap.2004.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Successful fracture management accomplishes 2 major objectives: bony union and return to functional activities. For many years, Physical Therapy has routinely helped human patients recovering from fractures reach their functional goals by helping them regain movement, flexibility, strength, coordination, and balance. Rehabilitation is now commonly provided to small animals recovering from fractures to accomplish similar goals. Knowledge of tissue healing is critical when determining the appropriate stresses to apply throughout the healing timeline. The detrimental effects of immobilization, including the potential for development of fracture disease, must be considered when formulating a Rehabilitation plan of care. Many Rehabilitation interventions are readily amenable to application by both Veterinary professionals and owners of patients. Superficial thermal modalities, passive range of motion and stretching, soft tissue massage, therapeutic ultrasound, electrical stimulation, and therapeutic exercise can ensure a more complete patient recovery. Providing owners with education regarding appropriate patient handling and home modifications allows a safer return to the home environment. Detailed written instructions for rehabilitation at home promotes owner compliance and accurate completion.
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Affiliation(s)
- Nancy D Doyle
- Gulf Coast Veterinary Specialists, Houston, TX 77027, USA.
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