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Abstract
Introduction
Osteoporosis is a major health problem in the elderly that involves changes in the properties of bone as well as impaired bone healing around a titanium implant in both humans and animals. This study examined effect of low intensity pulsed ultrasound (LIPUS) on the bone healing process around a titanium implant in osteoporosis-induced rats.
Materials and Methods
Sixteen rats were divided into two groups. A control group with osteoporosis induced by removing both ovaries and an experimental group of rats that were applied with LIPUS after osteoporosis had been induced. A screw type titanium implant (diameter, 2.0 mm: length, 3.5 mm, Cowell-Medi, KOREA) was placed into the tibias of 16 rats. The control and experimental group contained 8 rats each. The rats were sacrificed at 1, 2, 4, and 8 weeks after implantation to examine the histopathology and immunochemistry.
Results
The histopathology examination revealed earlier new bone formation in the experimental group than the control group. In particular, at 1 week after implantation, more new bone matrix and collagen were observed around the implant of the experimental group compared to the control group. Immunochemistry analysis showed that the level of OPG expression of the experimental group was higher in the early stages than in the control group. After 8 weeks, the levels of OPG expression were similar in both groups. The expression level of receptor activator of nuclear factor kB ligand (RANKL) was stronger in the experimental group than the control group. After 4 weeks, the level of RANKL expression was similar in both groups.
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References
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 | Fig. 1.A: Microphotograph at 1 week after implantation in control rat.(H&E staining. Original magnification ×100) B: Microphotograph at 2 weeks after implantation in control rat.(H&E staining. Original magnification ×100) arrow: collagen bone matrix.(red staining) C: Microphotograph at 4 weeks after implantation in control rat.(H&E staining. Original magnification ×100) D: Microphotograph at 8 weeks after implantation in control rat.(H&E staining. Original magnification ×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 2.A: Microphotograph at 1 week after implantation in experimental rat.(H&E staining. Original magnification ×100) B: Microphotograph at 2 weeks after implantation in experimental rat.(H&E staining. Original magnification ×100) Arrow: collagen bone matrix.(red staining) C: Microphotograph at 4 weeks after implantation in experimental rat.(H&E staining. Original magnification ×100) Triangle indicators: osteocytes, arrows: osteoblasts. D: Microphotograph at 8 weeks after implantation in experimental rat.(H&E staining. Original magnification ×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 3.A: Microphotograph at 1 week after implantation in control rat.(Masson's trichrome staining. Original magnification ×100) B: Microphotograph at 2 weeks after implantation in control rat.(Masson's trichrome staining. Original magnification ×100) Arrows: collagen bone matrix(blue staining) C: Microphotograph at 4 weeks after implantation in control rat.(Masson's trichrome staining. Original magnification ×100) Triangle indicators: non-calcified bone; arrows: new bone matrix along implant interface D: Microphotograph at 8 weeks after implantation in control rat.(Masson's trichrome staining. Original magnification ×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 4.A: Microphotograph at 1 week after implantation in experimental rat.(Masson's trichrome staining. Original magnification ×100) B: Microphotograph at 2 weeks after implantation in experimental rat.(Masson's trichrome staining. Original magnification ×100) Arrows: collagen bone matrix(blue staining) C: Microphotograph at 4 weeks after implantation in experimental rat.(Masson's trichrome staining. Original magnification ×100) D: Microphotograph at 8 weeks after implantation in experimental rat.(Masson's trichrome staining. Original magnification ×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 5.A: Osteoproteogrin antibody reaction of regenerating bone at 1 week after implantation on tibia of the control rat. (×100) B: Osteoproteogrin antibody reaction of regenerating bone at 2 weeks after implantation on tibia of the control rat. (×100) Arrows:osteoclasts, triangle:osteocyte C: Osteoproteogrin antibody reaction of regenerating bone at 4 weeks after implantation on tibia of the control rat.(×100) D: Osteoproteogrin antibody reaction of regenerating bone at 8 weeks after implantation on tibia of the control rat.(×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 6.A: Osteoproteogrin antibody reaction of regenerating bone at 1 week after implantation on tibia of the experimental rat.(×100) B: Osteoproteogrin antibody reaction of regenerating bone at 2 weeks after implantation on tibia of the experimental rat.(×100) C: Osteoproteogrin antibody reaction of regenerating bone at 4 weeks after implantation on tibia of the experimental rat.(×100) D: Osteoproteogrin antibody reaction of regenerating bone at 8 weeks after implantation on tibia of the experimental rat.(×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 7.A: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 1 week after implantation on tibia of the control rat.(×100) B: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 2 weeks after implantation on tibia of the control rat.(×100) Arrows: osteoclasts, triangle indicators:osteocytes. C: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 4 weeks after implantation on tibia of the control rat.(×100) D: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 8 weeks after implantation on tibia of the control rat.(×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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 | Fig. 8.A: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 1 week after implantation on tibia of the experimental rat.(×100) Arrows:osteoclasts, triangle indicators:osteocytes. B: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 2 weeks after implantation on tibia of the experimental rat.(×100) Arrows:osteoclasts, triangle indicators:osteocytes. C: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 4 weeks after implantation on tibia of the experimental rat.(×100) D: Receptor activator of nuclear factor kB ligand antibody reaction of regenerating bone at 8 weeks after implantation on tibia of the experimental rat.(×100) Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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Table 1.
Osteoprotegerin expression after implantation
| Periods after implantation (wk) | Control | Experimental group |
|---|---|---|
| 1 | + | +/++ |
| 2 | +/++ | ++ |
| 4 | + | +/++ |
| 8 | + | + |
-: no immunoreactivity, +: weak but visible staining, ++: moderate staining, +++: strong staining intensity Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
Table 2.
Receptor activator of nuclear factor kB ligand expression after implantation
| Periods after implantation (wk) | Control | Experimental group |
|---|---|---|
| 1 | + | +/++ |
| 2 | +/++ | ++ |
| 4 | + | + |
| 8 | + | + |
-: no immunoreactivity, +: weak but visible staining, ++: moderate staining, +++: strong staining intensity Young-Seob Hwang et al: Effect of low intensity pulsed ultrasound (LIPUS) on bone healing around a titanium implant in the tibia of osteoporosis-induced rats. J Korean Assoc Oral Maxillofac Surg 2011
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