CC BY-NC-ND 4.0 · Eur J Dent 2008; 02(04): 254-262
DOI: 10.1055/s-0039-1697389
Original Article
Dental Investigation Society

Effects of Low-Intensity Pulsed Ultrasound on Dental Implant Osseointegration: A Preliminary Report

Yakup Ustun
a   Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
Ozgur Erdogan
a   Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
Mehmet Kurkcu
a   Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
Tolga Akova
b   Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
Ibrahim Damlar
a   Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
27 September 2019 (online)


Objectives: The aim of this pilot study was to evaluate the effects of low intensity pulsed ultrasound (LIPU) on dental implant osseointegration in a rabbit model using mechanical-histomorphometric methods and resonance-frequency analysis (RFA).

Methods: Twelve skeletally mature, male New Zealand rabbits (3.4 kg±0.5) were included in the study. A total number of 24 implants were placed bilaterally into the tibiae of the subjects. The right tibia of each rabbit received LIPU application (20 min/day) while the left side received sham treatment. The study was carried on for six weeks and the rabbits were sacrificed in 7 days intervals (two rabbits for each week). The rabbits were categorized in the early or late osseointegration period according to their sacrification date. Comparisons between the groups were made using statistical analysis of histomorphometric analysis, resonance frequency analysis and mechanical tests.

Results: The histomorphometry parameters showed that the bone area and the bone volume values have significantly increased in the early osseointegration period and the bone-implant contact values have significantly increased in the late osseointegration period in the LIPU treated subjects when compared to the control group. RFA scores had mild increase in the LIPU group. However the difference was not statistically significant. Mechanical test results suggest an increased mechanical stability in the LIPU group as well.

Conclusions: Results of this pilot study indicate that low intensity pulsed ultrasound may have positive effects on osseointegration and stability of dental implants. (Eur J Dent 2008;2:254-262)


  • 1 Branemark PI, Zarb G, Albreksson T. Tissue-integrated prosthesis. In: Branemark PI. ed Osseointegration in clinical dentistry. Chicago, II: Quintessence Publishing Co.; 1985: 11-76
  • 2 Buser D, Schenk RK, Steinmann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res 1991; 25: 889-902
  • 3 Ericsson I, Johansson CB, Bystedt H, Norton MR. A histomorphometric evaluation of bone-to-implant contact on machine-prepared and roughened titanium dental implants. A pilot study in the dog. Clin Oral Implan Res 1994; 5: 202-206
  • 4 Klokkevold PR, Johnson P, Dadgostari S, Caputo A, Davies JE, Nishimura RD. Early endosseous integration enhanced by dual acid etching of titanium: a torque removal study in the rabbit. Clin Oral Implan Res 2001; 12: 350-357
  • 5 Nakamura H, Saruwatari L, Aita H, Takeuchi K, Ogawa T. Molecular and biomechanical characterization of mineralized tissue by dental pulp cells on titanium. J Dent Res 2005; 86: 515-520
  • 6 Liu Y, DE Groot K, Hunkizer EB. BMP-2 liberated from biomimetic implant coatings induces and sustains direct ossification in an ectopic rat model. Bone 2005; 36: 745-757
  • 7 Fini M, Giavaresi G, Setti S, Martini L, Torricelli P, Giardino R. Current trends in the enhancement of biomaterial osteointegration: Biophysical stimulation. Biomaterials 2004; 27: 681-690
  • 8 Tanzer M, Kantor S, Bobyn JD. Enhancement of bone growth into porous intramedullary implants using non-invasive low intensity ultrasound. J Orthop Res 2001; 19: 195-199
  • 9 Rubin C, Bolander M, Ryabi JP, Hadjiargyrou M. The use of low-intensity ultrasound to accelerate the healing of fractures. J Bone Joint Surg Am 2001; 83: 259-270
  • 10 Warden SJ, Bennell KL, Mcmeeken JM, Wark JD. Acceleration of fresh fracture repair using the sonic accelerated fracture healing system (SAFHS): a review. Calcif Tissue Int 2000; 66: 157-163
  • 11 Erdoḡan Ö, Esen E, Üstün Y, Kürkçü M, Akova T, Gônlüçen G, Uysal H, Çevlik F. Effects of low-intensity pulsed ultrasound on healing of mandibular fractures: An experimental study in rabbits. J Oral Maxillofac Surg 2006; 64: 180-188
  • 12 Chapman I, Macnally NA, Tucker S. Ultrasound-induced changes in the rates of influx and efflux of potassium ions in rat thymocytes in vitro. Ultrasound Med Biol 1980; 6: 47-58
  • 13 Li JK, Chang WH, Lin JC, Ruaan RC, Liu HC, Sun JS. Cytokine release from osteoblasts in response to ultrasound stimulation. Biomaterials 2003; 24: 2379-2385
  • 14 Yang KH, Parvizi J, Wang SJ, Lewallen DG, Kinnick RR, Greenleaf JF, Bolander ME. Exposure to low-intensity ultrasound increases aggrecan gene expression in a rat femur fracture model. J Orthop Res 1996; 14: 802-809
  • 15 Barzelai S, Sharabani-Yosef O, Holbova R, Castel D, Walden R, Engelberg S, Scheinowitz M. Low-intensity ultrasound induces angiogenesis in rat-limb ischemia. Ultrasound Med Biol 2006; 32: 139-145
  • 16 Hadjiargyrou M, Mcleod K, Ryaby Jp, Rubin C. Enhancement of fracture healing by low intensity ultrasound. Clin Orthop Relat Res 1998; 355: 216-229
  • 17 Hisatake M, Manabe M, Kurachi Y, Nagumo M. Osseointegration of dental implants in rabbit bone with low mineral density. J Oral Maxillofac Surg 1997; 55: 351-361
  • 18 Park JW, Park KB, Suh JY. Effects of calcium ion incorporation on bone healing of TÎ6AL4V alloy implants in rabbit tibiae. Biomaterials 2007; 28: 3306-3313
  • 19 Suh JY, Jeung OC, Choi BJ, Park JW. Effects of a novel calcium titanate coating on the osseointegration of blasted endosseous implants in rabbit tibiae. Clin Oral Implants Res 2007; 18: 362-369
  • 20 Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998; 11: 491-501
  • 21 Nedir R, Bischof M, Szmukler-Moncler S, Bernard JP, Samson J. Predicting osseointegration by means of implant primary stability. A resonance frequency analysis study with delayed and immediately loaded ITI SLA implants. Clin Oral Implants Res 2004; 15: 520-528
  • 22 Friberg B, Sennerby L, Linden B, Grondahl K, Lekholm U. Stability measurements of one-stage Branemark implants during healing in mandibles. A clinical resonance frequency analysis study. Int J Oral Maxillofac Surg 1999; 28: 266-272
  • 23 Friberg B, Sennerby L, Meredith N, Lekholm U. A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20- month clinical study. Int J Oral Maxillofac Surg 1999; 28: 297-303
  • 24 Martinez-Gonzalez JM, Garcia-Saban F, Ferrandiz-Bernal J, Gonzalo-Lafuente Jc, Cano-Sanchez J, Barona-Dorado C. Removal torque and physico-chemical characteristics of dental implants etched with hydrofluoric and nitric acid. An experimental study in Beagle dogs. Med Oral Patol Oral Cir Bucal 2006; 11: E281-E285
  • 25 Nakamura T, Nishiguchi S. Tensile testing of bone implant interface. In: An YH, Draughn RA. eds. Mechanical testing of bone and the bone-implant interface. Washington D. C.: CRC Press LLC.; 2000: 489-497
  • 26 Weinstein RS. Human bone biopsy. In: Yuehuei HA, Kylie LM. eds Handbook of histology methods for bone and cartilage. Totowa-New Jersey: Humana Press Inc; 2003: 129-143
  • 27 Hahn M, Vogel M, Pompesius-Kempa M, Delling G. Trabecular bone pattern factor-a new parameter for simple quantification of bone microarchitecture. Bone 1992; 13: 327-330
  • 28 Suba Z, Takacs D, Matusovits D, Barabas J, Fazekas A, Szabo G. Maxillary sinus flooe grafting with ß-tricalcium phosphate in humans: density and microarchitecture of the newly formed bone. Clin Oral Implants Res 2006; 17: 102-108
  • 29 Wang SJ, Lewallen DG, Bolander ME, Chao EY, Ilstrup DM, Greenleaf JF. Low intensity ultrasound treatment increases strength in a rat femoral fracture model. J Orthop Res 1994; 12: 40-47
  • 30 Hantes ME, Mavrodontidis AN, Zalavras CG, Karantanas AH, Karachalios T, Malizos KN. Low-intensity transosseous ultrasound accelerates osteotomy healing in a sheep fracture model. J Bone Joint Surg Am 2004; 86: 2275-2282
  • 31 Saparado JA, Albanese SA, Chase SE. Electromagnetic effects on bone formation at implants in the medullary canal in rabbits. J Orthop Res 1990; 8: 685-693
  • 32 Duarte LR. The stimulation of bone growth by ultrasound. Arch Orthop Trauma Surg 1983; 101: 153-159
  • 33 Wang SJ, Lewallen DG, Bolander ME, Chao EY, Ilstrup DM, Greenleaf JF. Low intensity ultrasound treatment increases strength in a rat femoral fracture model. J Orthop Res 1994; 12: 40-47
  • 34 Reher P, Elbeshir ELNI, Harvey W, Meghji S, Harris M. The stimulation of bone formation in vitro by therapeutic ultrasound. Ultrasound Med Biol 1997; 23: 1251-1258
  • 35 Korstjens CM, Nolte PA, Burger EH, Albers GHR, Semeins CM, Aartman IHA, Goei SW, Klein-Nulend J. Stimulation of bone cell differentiation by low-intensity ultrasound - a histomorphometric in vitro study. J Orthop Surg 2004; 22: 495-500
  • 36 Tanzer M, Harvey E, Kay A, Morton P, Bobyne JD. Effect of noninvasive low intensity ultrasound on bone growth into porous-coated implants. J Orthop Res 1996; 14: 901-906