Document Type : original article
Authors
- Arezoo Jahanbin 1
- Fahimeh Farzanegan 2
- Amirreza Mashreghi 3
- Seyed Mohammad Ali Raisolsadat 4
- Hosein Hoseini Zarch 5
- neda Mostafaee 6
1 Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
2 Associate Professor of Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
3 Assistant professor of Department of Orthodontics, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
4 Assistant professor of Department of Pediatric Surgery, School of Medicine, Azad University of Mashhad, Mashhad, Iran
5 Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
6 Assistant professor of Department of Physical Therapy , School of Paramedical Sciences, Mashhad University of Medical Sciences , Mashhad, Iran
Abstract
Background: The aim of this study was to investigate the efficacy of the low intensity pulsed ultrasound in reconstruction of the alveolar cleft area after autologous bone grafting.
Methods: In this study, 14 patients with unilateral or bilateral cleft lip and palate aged between 9 to 13 years, were selected. Seven of the patients received only the autologous bone graft and the remaining seven underwent alveolar bone graft, and one week after transplantation were subjected to LIPUS waves for five minutes at a frequency of 1 MHz and 100 mW in the area of the graft for a period of five weeks (15 sessions). CBCT images were immediately taken after surgery and three months later. In CBCTs, bone mass was measured with two components of height and bone thickness and the quality was measured by evaluating the bone density by means of the Hounsfield Uniform (HU) mean. Data analysis was done via SPSS version 16 software and using paired t, independent t, and Mann-Whitney and Wilcoxon tests. A significance level of 0.05 was considered.
Results: The mean changes of the sagittal thickness (P=.944), sagittal height (P=.482), and axial thickness (P=.242) before and after surgery, in contrast to the axial height (P=.357) and density (P=.443), were less in the control group than the intervention group, but the differences were not significant for any of variables. In the intervention and control groups, in comparison to the immediate results after surgery, the mean values of the sagittal thickness, sagittal height, axial thickness, and axial height decreased significantly three months later; but the mean loss in density was not significant.
Conclusion: Ultrasound in repairing alveolar defect in patients with cleft palate has no significant effect on clinical success criteria.
Keywords
- Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: synthesizing genetic and environmental influences. Nature reviews Genetics. 2011; 12(3):167.
- Bishara SE. Textbook of orthodontics. 2001.
- Proffit WR, Fields Jr HW, Sarver DM. Contemporary orthodontics: Elsevier Health Sciences; 2014.
- Santiago PE, Grayson BH, Cutting CB, Gianoutsos MP, Brecht LE, Kwon SM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. The Cleft palate-craniofacial journal. 1998; 35(1):77-80.
- Robertson NR, Jolleys A. An 11-year follow-up of the effects of early bone grafting in infants born with complete clefts of the lip and palate. British journal of plastic surgery. 1983; 36(4):438-43.
- Steinberg B, Padwa BL, Boyne P, Kaban L. State of the art in oral and maxillofacial surgery: treatment of maxillary hypoplasia and anterior palatal and alveolar clefts. The Cleft palate-craniofacial journal. 1999; 36(4):283-91.
- Bajaj AK, Wongworawat AA, Punjabi A. Management of alveolar clefts. Journal of Craniofacial Surgery. 2003; 14(6):840-6.
- Boyne PJ, Sands NR. Combined orthodontic-surgical management of residual palato-alveolar cleft defects. American Journal of Orthodontics. 1976; 70(1):20-37.
- Boyne PJ. Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surgery. 1972; 30:87-92.
- Daskalogiannakis J, Ross RB. Effect of alveolar bone grafting in the mixed dentition on maxillary growth in complete unilateral cleft lip and palate patients. The Cleft palate-craniofacial journal. 1997; 34(5):455-8.
- Dempf R, Teltzrow T, Kramer F-J, Hausamen J-E. Alveolar bone grafting in patients with complete clefts: a comparative study between secondary and tertiary bone grafting. The Cleft palate-craniofacial journal. 2002; 39(1):18-25.
- Maxson BB, Baxter SD, Vig KW, Fonseca RJ. Allogeneic bone for secondary alveolar cleft osteoplasty. Journal of Oral and Maxillofacial Surgery. 1990; 48(9):933-41.
- Ma’amon AR, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. British Journal of Oral and Maxillofacial Surgery. 2008; 46(8):665-70.
- Denny AD, Talisman R, Bonawitz SC. Secondary alveolar bone grafting using milled cranial bone graft: a retrospective study of a consecutive series of 100 patients. The Cleft palate-craniofacial journal. 1999; 36(2):144-53.
- LaRossa D, Buchman S, Rothkopf DM, Mayro R, Randall P. A comparison of iliac and cranial bone in secondary grafting of alveolar clefts. Plastic and reconstructive surgery. 1995; 96(4):789-97.
- Freihofer HPM, Borstlap WA, Kuijpers-Jagtman AM, Voorsmit RA, van Damme PA, Heidbüchel KL, Borstlap-Engels VM. Timing and transplant materials for closure of alveolar clefts: a clinical comparison of 296 cases. Journal of Cranio-Maxillofacial Surgery. 1993; 21(4):143-8.
- Booij A, Raghoebar G, Jansma J, Kalk W, Vissink A. Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients. The Cleft palate-craniofacial journal. 2005; 42(5):533-8.
- Walker TW, Modayil PC, Cascarini L, Williams L, Duncan SM, Ward-Booth P. Retrospective review of donor site complications after harvest of cancellous bone from the anteromedial tibia. British Journal of Oral and Maxillofacial Surgery. 2009; 47(1):20-2.
- Chen YC, Chen CH, Chen PL, Huang I, Shen YS, Chen CM. Donor site morbidity after harvesting of proximal tibia bone. Head & neck. 2006; 28(6):496-500.
- Nadal E, Sabás M, Dogliotti P, Espósito R. Secondary alveolar bone grafting: our experience with olecranon bone graft. Journal of Craniofacial Surgery. 2010; 21(2):371-4.
- Bandow K, Nishikawa Y, Ohnishi T, Kakimoto K, Soejima K, Iwabuchi S, Kuroe K, Matsuguchi T. Low‐intensity pulsed ultrasound (LIPUS) induces RANKL, MCP‐1, and MIP‐1β expression in osteoblasts through the angiotensin II type 1 receptor. Journal of cellular physiology. 2007; 211(2):392-8.
- Ikeda T, Yoshizawa S, Tosaki M, Allen JS, Takagi S, Ohta N, Kitamura T, Matsumoto Y. Cloud cavitation control for lithotripsy using high intensity focused ultrasound. Ultrasound in medicine & biology. 2006; 32(9):1383-97.
- James SL, Ali K, Pocock C, Robertson C, Walter J, Bell J, Connell D. Ultrasound guided dry needling and autologous blood injection for patellar tendinosis. British journal of sports medicine. 2007; 41(8):518-21.
- Watson T. Ultrasound in contemporary physiotherapy practice. Ultrasonics. 2008; 48 (4):321-9.
- Tanaka E, Kuroda S, Horiuchi S, Tabata A, El-Bialy T. Low-intensity pulsed ultrasound in dentofacial tissue engineering. Annals of biomedical engineering. 2015; 43(4):871-86.
- Chen Q, Shi B, Zheng Q. Low intensity pulsed ultrasound therapy: A potential adjuvant treatment for osteonecrosis of alveolar bone grafting. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2013; 18 (3):270-1.
- Toy E, Ozturk F, Altindis S, Kozacioglu S, Toy H. Effects of low-intensity pulsed ultrasound on bone formation after the expansion of the inter-premaxillary suture in rats: a histologic and immunohistochemical study. Australian orthodontic journal. 2014; 30(2):176.
- Val Robertson, Alex Ward, John Low, Ann Reed. Electrotherapy Explained: Principles and Practice. 4th ed. London, United Kingdom: Elsevier Health Sciences; 2006.
- Alonso N, Tanikawa DYS, Freitas RdS, Canan Jr L, Ozawa TO, Rocha DL. Evaluation of maxillary alveolar reconstruction using a resorbable collagen sponge with recombinant human bone morphogenetic protein-2 in cleft lip and palate patients. Tissue Engineering Part C: Methods. 2010; 16 (5):1183-9.
- Mandracchia VJ, Nelson SC, Barp EA. Current concepts of bone healing. Clinics in podiatric medicine and surgery. 2001; 18(1):55-77.
- Yamada K. Biological effects of low power laser irradiation on clonal osteoblastic cells (MC3T3-E1). Nihon Seikeigeka Gakkai Zasshi. 1991; 65(9):787-99.
- Trelles M, Mayayo E. Bone fracture consolidates faster with low‐power laser. Lasers in surgery and medicine. 1987; 7(1):36-45.
- Whitecloud T, Cook S, Salkeld S, Ryaby J, editors. Acceleration of spine fusions with a low intensity pulsed ultrasound device. Transactions of the Annual Meeting-Orthopaedic Research Society; 1998: Orthopaedic Research Society.
- Tsunoda M. Treatment of non-union and delayed-union by low intensity pulsed ultrasound. Clinical calcium. 2003; 13(10):1293-6.
- Lu H, Qin L, Fok P, Cheung W, Lee K, Guo X, Wong W, Leung K. Low-intensity pulsed ultrasound accelerates bone-tendon junction healing: a partial patellectomy model in rabbits. The American journal of sports medicine. 2006; 34(8):1287-96.
- Emami A, Petrén-Mallmin M, Larsson S. No effect of low-intensity ultrasound on healing time of intramedullary fixed tibial fractures. Journal of orthopedic trauma. 1999; 13(4):252-7.
- Spadaro JA, Albanese SA. Application of low-intensity ultrasound to growing bone in rats. Ultrasound in medicine & biology. 1998; 24(4):567-73.
- Handolin L, Kiljunen V, Arnala I, Kiuru MJ, Pajarinen J, Partio EK, Rokkanen P. No long-term effects of ultrasound therapy on bioabsorbable screw-fixed lateral malleolar fracture. Scandinavian journal of surgery. 2005; 94(3):239-42.
- Handolin L, Kiljunen V, Arnala I, Kiuru MJ, Pajarinen J, Partio EK, Rokkanen P. Effect of ultrasound therapy on bone healing of lateral malleolar fractures of the ankle joint fixed with bioabsorbable screws. Journal of Orthopaedic Science. 2005; 10(4):391.
- Ryaby J, Bachner E, Bendo J, Dalton P, Tannenbaum S, Pilla A. Low intensity pulsed ultrasound increases calcium GP Gebauer et al. Journal of Orthopaedic Research. 2002:587-92.
- Claes L, Willie B. The enhancement of bone regeneration by ultrasound. Progress in biophysics and molecular biology. 2007; 93(1-3):384-98.
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