Low-intensity pulsed ultrasound stimulates proliferation of stem/progenitor cells: what we need to know to translate basic science research into clinical applications / 亚洲男科学杂志(英文版)

Low-intensity pulsed ultrasound (LIPUS) is a promising therapy that has been increasingly explored in basic research and clinical applications. LIPUS is an appealing therapeutic option as it is a noninvasive treatment that has many advantages, including no risk of infection or tissue damage and no known adverse reactions. LIPUS has been shown to have many benefits including promotion of tissue healing, angiogenesis, and tissue regeneration; inhibition of inflammation and pain relief; and stimulation of cell proliferation and differentiation. The biophysical mechanisms of LIPUS remain unclear and the studies are ongoing. In recent years, more and more research has focused on the relationship between LIPUS and stem/progenitor cells. A comprehensive search of the PubMed and Embase databases to July 2020 was performed. LIPUS has many effects on stem cells. Studies show that LIPUS can stimulate stem cells in vitro; promote stem cell proliferation, differentiation, and migration; maintain stem cell activity; alleviate the problems of insufficient seed cell source, differentiation, and maturation; and circumvent the low efficiency of stem cell transplantation. The mechanisms involved in the effects of LIPUS are not fully understood, but the effects demonstrated in studies thus far have been favorable. Much additional research is needed before LIPUS can progress from basic science research to large-scale clinical dissemination and application.

Hypotension and bradycardia produced by transthoracic application of low-intensity ultrasound therapy in hearts of healthy rats - a preclinical study

Abstract Objective: To investigate the cardiovascular effects produced by transthoracic application of low-intensity pulsed ultrasound therapy (LIPUST). Methods: Three-month-old male Wistar rats (± 300 g, N=16) were randomly allocated in two groups, namely SHAM (control group, faked procedures) and UST (animals treated with LIPUST). These animals, under anesthesia, were instrumented (femoral artery and vein catheterization) for hemodynamic recordings (mean blood pressure [MBP], heart rate [HR]) and blood biochemical profile (lipids, creatine kinase-myocardial band [CK-MB]). Then, LIPUST (spatial average-temporal average [ISATA] 1-MHz, power 0.1 to 1.2 W/cm2, pulsed 2:8 ms, cycle at 30%, for three minutes) was applied to animals from the UST group, externally to their thorax. SHAM animals were equally manipulated, but without application of ultrasound energy. After the hemodynamic and biochemical measurements, animals were sacrificed, and their hearts were mounted in a Langendorff apparatus for coronary reactivity evaluation. Standard histology techniques were employed to analyze the hearts. Results: LIPUST application caused statistically significant reductions in MBP (92±4 vs. 106±1 mmHg) and HR (345±14 vs. 380±17 rpm) when compared with SHAM procedures. UST rats exhibited higher CK-MB levels (318±55 vs. 198±26 U/dL) and lower plasma triglycerides levels (38±7 vs. 70±10 mg/dL) than SHAM animals. Coronary reactivity was not significantly changed by LIPUST. Cardiac histopathology showed an increase in capillary permeability in treated animals when compared with SHAM animals. Conclusion: Noninvasive LIPUST induces significant metabolic and hemodynamic changes, including intensity-dependent bradycardia and hypotension, indicating a possible therapeutic effect for cardiac events.

Influence of sonic vibration and cement type on the bond strength of fiberglass posts after aging / Influencia de la vibración sónica y el tipo de cemento en la fuerza de unión de los postes de fibra de vidrio después del envejecimiento

Introduction: This study evaluated the influence of sonic vibration and thermocycling on the bond strength of fiberglass posts using conventional dual-cured and self-adhesive resin cements. Material and Methods: Ninety-six single-rooted endodontically treated teeth were divided randomly into eight groups according to the cement used (dual-cured or self-adhesive resin cement), use of sonic vibration during post accommodation, and aging conditions (24h in distilled water or 5,000 thermal cycles). The fiberglass posts (White Post DC1, FGM) were cleaned with alcohol, treated with silane and cemented with dual-cured (Allcem Core, FGM) or with self-adhesive resin cement (seT, SDI). For groups in which sonic vibration was used, the posts were accommodated, and sonic vibration was applied for 10 s using a special tip placed on top of the post (Sonic Smart Device, FGM). Pull-out tests were performed after storage in distilled water for 24h at 37°C or after thermocycling (5000 cycles, at 5°C and 55°C). The results were evaluated using three-way ANOVA and Tukey's test (α=0.05). Results: Significant differences were not observed between the bond strengths of dual-cured (87.93±41.81 N) and self-adhesive cement (82.53±41.43 N). Bond strength for the sonic vibration groups (100.36±42.35 N) was significantly higher than for groups without sonic vibration (70.13±34.90 N). There were significant differences between specimens subjected to thermocycling (98.33±39.42 N) and those stored for 24h in distilled water (72.16±39.67 N). Conclusion: It can be concluded that both sonic vibration and thermocycling significantly improved bond strength of fiberglass posts with the two evaluated resin cements.

Introducción: Este estudio evaluó la influencia de la vibración sónica y el termociclado en la fuerza de unión de los postes de fibra de vidrio utilizando cementos de resina autoadhesivos y de curado dual convencionales Material y Métodos: Se dividieron aleatoriamente noventa y seis dientes tratados endodónticamente de raíz única en ocho grupos según el cemento utilizado (cemento de resina de curado dual o autoadhesivo), el uso de vibración sónica durante la acomodación posterior y las condiciones de envejecimiento (24 horas agua destilada o 5.000 ciclos térmicos). Los postes de fibra de vidrio (White Post DC1, FGM) se limpiaron con alcohol, se trataron con silano y se cementaron con cemento de curado dual (Allcem Core, FGM) o con cemento de resina autoadhesivo (seT, SDI). Para los grupos en los que se utilizó vibración sónica, se acomodaron los postes y se aplicó la vibración sónica durante 10 s utilizando una punta especial colocada en la parte superior del poste (Sonic Smart Device, FGM). Las pruebas de extracción se realizaron después del almacenamiento en agua destilada durante 24 horas a 37ºC o después del termociclado (5000 ciclos, a 5ºC y 55ºC). Los resultados se evaluaron mediante ANOVA de tres vías y la prueba de Tukey (α = 0.05). Resultados: No se observaron diferencias significativas entre las resistencias de adhesión del cemento de curado dual (87,93 ± 41,81 N) y el cemento autoadhesivo (82,53 ± 41,43 N). La fuerza de unión para los grupos de vibración sónica (100,36 ± 42,35 N) fue significativamente mayor que para los grupos sin vibración sónica (70,13 ± 34,90 N). Hubo diferencias significativas entre los especímenes sometidos a termociclado (98,33 ± 39,42 N) y los almacenados durante 24 h en agua destilada (72,16 ± 39,67 N). Conclusión: Se puede concluir que tanto la vibración sónica como el termociclado mejoraron significativamente la fuerza de unión de los postes de fibra de vidrio con los dos cementos de resina evaluados.

Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dogs

Abstract Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. Objective The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. Methodology The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. Results At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. Conclusions Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.

Effect of conditioning protocols and ultrasonic application of an infiltrant resin in white spot lesions

Abstract The aim of this study was to evaluate different conditioning protocols and sonic/ultrasonic application of an infiltrant resin (IR) in artificial white spot lesions (AWSL). the V/L surfaces of 48 molars were induced to an AWSL and divided in 6 groups, according to the conditioning protocols and application technique: 15% hydrochloric acid (HA) + manual application of the IR; HA + 37% phosphoric acid (PA) + manual application of the IR; HA + ultrasonic application (U) of the IR; HA + sonic application (S) of the IR; PA+HA+S; and PA+HA+U. For the Penetration Depth (PD), the crowns were etched with HA for 120s. The IR Icon® (DMG) was applied according to the manufacturer`s instructions. The crowns were dye penetrated (0.1% red fluorophore rhodamine B isothiocyanate for 12h) and bleached with 30% hydrogen peroxide for 12 h. The discs were immersed in a 50% ethanol solution, containing 100 µM of sodium fluorescein. The PD (in µm) was measured using confocal laser scanning microscopy (20x). The bond strength (BS) was performed by michoshear test (0.5 mm/min). Data were submitted to 2-way ANOVA and Tukey (α=0.05). For BS, the interaction was not significant (p>0.05). For PD, the main factors were significant (application - p<0.001; conditioning technique - p=0.003). The ultrasonic application showed the highest PD values. PA+HA presented higher results than HA. The sonic/ultrasonic applications and the use of phosphoric acid prior to hydrochloric acid improved PD of the infiltrant resin. Conditioning protocols or application techniques did not influence BS values.

Resumo: O objetivo deste estudo foi avaliar diferentes protocolos de condicionamento e a aplicação sônica/ultrassônica de uma resina infiltrante (RI) em lesões de mancha branca produzidas artificialmente (LMBA). As superfícies vestibulares/linguais de 48 molares foram induzidas à formação de LMBA e divididas em 6 grupos, de acordo com os protocolos de condicionamento e técnica de aplicação da resina infiltrante: ácido hidroclorídrico 15% (AH) + aplicação manual da RI; AH + ácido fosfórico 37% (AF) + aplicação manual da RI; AH + aplicação ultrassônica da RI (U); AH + aplicação sônica da RI (S); AF + AH + S; e AF + AH + U. para o grau de penetração (GP), condicionou-se as coroas com AH por 120 s. A RI Icon® (DMG) foi aplicada de acordo com as instruções do fabricante. As coroas foram coradas (rodamina B 0,1% por 12 h) e clareadas com peróxido de hidrogênio 30% por 12 h. os discos foram imersos em solução de etanol 50%, contendo 100 µM de fluoresceína sódica. O GP (em µm) foi mensurado por meio de microscopia confocal a laser (20´). A resistência de união (RU) foi calculada pelo teste de microcisalhamento (0,5 mm/min). Os dados foram submetidos ao teste ANOVA 2 fatores e Tukey (α=0,05). Para RU, a interação não foi significante (p>0,05). Para GP, os fatores principais foram significantes (técnica de aplicação - p<0,001; protocolos de condicionamento - p=0,003). A aplicação U mostrou os maiores valores de GP. AF+AH demonstrou resultados superiores ao grupo AH. As aplicações sônica/ultrassônica e o uso do ácido fosfórico antes do ácido hidroclorídrico aumentaram o GP da resina infiltrante. Os protocolos de condicionamento ou as técnicas de aplicação não influenciaram os valores de RU.

Effect of sonic and ultrasonic activation on physicochemical properties of root canal sealers

Abstract Objective: To evaluate the effect of ultrasonic and sonic activation on physicochemical properties of AH Plus, MTA Fillapex, ADSeal, GuttaFlow Bioseal, and GuttaFlow 2 sealers. Methodology: Three experimental groups were formed: no activation (NA), ultrasonic activation (UA), and sonic activation (SA). The sealers were manipulated according to the manufacturers' instructions. A 3-mL syringe was adapted to receive 1 mL of sealer. Activation was performed with a 20/.01 ultrasonic insert (20 s/1W) in the UA group. A size 35.04 sonic tip was used (20 s/10,000 cycles/min-1) in the SA group. The molds for physicochemical analysis were filled and evaluated according to ANSI/ADA specification no. 57: setting time (ST), flow (FL), dimensional change (DC), solubility (SB), and radiopacity (RD). Statistical analysis was performed by Kruskal-Wallis, one-way ANOVA, and Tukey's tests (P<0.05). Results: Regarding ST, only AH Plus and GuttaFlow 2 in the NA group met the ANSI/ADA standards. All FL values were greater than 20 mm in diameter, as determined by ANSI/ADA. The tested sealers and protocols did not comply with the ANSI/ADA standards for DC. As for SB, only MTA Fillapex, regardless of the activation protocol, did not follow the ANSI/ADA standards. All of the investigated sealers, regardless of the activation protocol, presented radiographic density higher than 3 mm Al, as proposed by ANSI/ADA. Conclusions: UA and SA promoted changes in the physicochemical properties of the evaluated root canal sealers, mainly in ST and F. Thus, it is important to evaluate the physicochemical properties of endodontic sealers associated with activation techniques prior to clinical application in order to determine whether the properties follow the parameters set by ANSI/ADA, ensuring safety and quality of root canal filling.

Low-intensity pulsed ultrasound promotes tissue regeneration in rat dental follicle cells in a porous ceramic scaffold

Abstract The aim of this study was to investigate the effects of low-intensity pulsed ultrasound (LIPUS) on the osteogenic differentiation of dental follicle cells (DFCs) in vitro and on the regenerative effects of DFC-OsteoBoneTM complexes in vivo. DFCs were isolated and characterized. In the in vitro study, DFCs were cultured in an osteogenic medium in the presence or absence of LIPUS. The expression levels of ALP, Runx2, OSX, and COL-I mRNA were analyzed using real-time polymerase chain reaction (RT-PCR) on day 7. Alizarin red staining was performed on day 21. The state of the growth of the DFCs that were seeded on the scaffold at 3, 5, 7, and 9 days was detected by using a scanning electron microscope. In our in vivo study, 9 healthy nude mice randomly underwent subcutaneous transplantation surgery in one of three groups: group A, empty scaffold; group B, DFCs + scaffold; and group C, DFCs + scaffold + LIPUS. After 8 weeks of implantation, a histological analysis was performed by HE and Mason staining. Our results indicate that LIPUS promotes the osteogenic differentiation of DFCs by increasing the expression of the ALP, Runx2, OSX, and COL-I genes and the formation of mineralized nodules. The cells can adhere and grow on the scaffolds and grow best at 9 days. The HE and Mason staining results showed that more cells, fibrous tissue and blood vessels could be observed in the DFCs + scaffold + LIPUS group than in the other groups. LIPUS could promote the osteogenic differentiation of DFCs in vitro and promote tissue regeneration in a DFCs-scaffold complex in vivo. Further studies should be conducted to explore the underlying mechanisms of LIPUS.

Application of mechanosensitive channels in sonogenetics / 浙江大学学报·医学版

As a non-invasive approach, sonogenetics is applied to control neuronal activity. The mechanosensitive channel(MSC), which has low threshold of responding to ultrasound, may be the alternative solution. Sonogenetics is the technique that activates the MSC expressed in targeted neurons by low intensity ultrasound, thus achieve the neuromodulation. In this review, we introduce the mechanosensitive channel of large conductance, transient receptor potential, channels of the two-pore-domain potassium family, Piezo and the recent progress on their application in sonogenetics.

Effects of low-intensity pulsed ultrasound on hematopoietic function in rats after combined chemotherapy with doxorubicin and cyclophosphamide / 南方医科大学学报

OBJECTIVE@#To investigate the effect of low-intensity pulsed ultrasound (LIPUS) on hematopoietic function in rats after combined chemotherapy with doxorubicin and cyclophosphamide.@*METHODS@#Eighty rats were randomized into control group and LIPUS group (=40) for treatment with intraperitoneal injection of doxorubicin (2 mg/kg)+cyclophosphamide (20 mg/kg) for 4 consecutive days and continuous irradiation with LIPUS for 7 days following the injections, respectively. The white blood cells, red blood cells and platelets counts in each group were measured at 0, 4, 7, 9, 11, 14 and 18 days after the start of drug administration. The pathological sections of the bone marrow were examined at 0, 4 and 11 days, and the flow cytometry was performed for detecting the cell apoptosis; qPCR was performed for detecting the expressions of SCF, ICAM-1, and VCAM-1 mRNAs, and ELISA was used to detect the expressions of IL-3 and GM-CSF.@*RESULTS@#The white blood cell count was significantly higher in LIPUS group than in the control group ( < 0.05). Histopathological examination of the bone marrow revealed significantly increased hematopoietic tissue in LIPUS group ( < 0.05). Flow cytometry demonstrated an obviously lower cell apoptosis rate in the bone marrow in LIPUS group than in the control group ( < 0.05). Compared with those in the control group, the mRNA expression levels of ICAM-1 and VCAM-1 as well as the protein levels of IL-3 and GM-CSF were significantly increased in LIPUS group ( < 0.05).@*CONCLUSIONS@#LIPUS can alleviate the hematopoietic damage after combined chemotherapy with doxorubicin with cyclophosphamide probably by increasing the expressions of ICAM- 1, VCAM-1, IL- 3, and GM-CSF.

Introduction of an Educational Accreditation System for Abdominal Ultrasonography / 대한소화기학회지

Abdominal ultrasonography uses the transmission and reflection of ultrasound waves to observe the internal organs through the abdominal wall and can visualize various abdominal anatomical structures. Abdominal ultrasound examinations are performed by gastroenterologists or other specialists in internal medicine and radiologists trained for this procedure. Thus far, abdominal ultrasonography has not been included in the standard education of gastroenterologists in Korea. On the other hand, abdominal ultrasonography is being used increasingly, making it necessary to establish a training program in Korea. Abdominal ultrasonography was established as an essential part of education for the resident training program in 2017. In addition, an educational accreditation system for the trainers of ultrasonography in the field of internal medicine, including gastroenterology, was developed in 2018. This article describes the development process of the educational accreditation system for trainers of ultrasonography.

Low-intensity pulsed ultrasound promotes proliferation and migration of HaCaT keratinocytes through the PI3K/AKT and JNK pathways

Although the effects of low-intensity pulsed ultrasound (LIPUS) on diverse cell types have been fully studied, the functional role of LIPUS in keratinocytes remains poorly understood. This study aimed to investigate the effects of LIPUS on proliferation and migration of HaCaT cells as well as the regulatory mechanisms associated with signaling pathways. Human HaCaT cells were exposed or not to LIPUS, and cell proliferation and migration were measured by BrdU incorporation assay and Transwell assay, respectively. Expression of proteins associated with proliferation and migration was evaluated by western blot analysis. Expression of key kinases in the PI3K/AKT and JNK pathways was also evaluated by western blot analysis. Effects of LIPUS on the PI3K/AKT and JNK pathways, and whether LIPUS affected HaCaT cells via these two pathways were finally explored. When the parameter of LIPUS (number of cycles) was set at 300, cell viability was the highest after LIPUS stimulation. We then found that the percentage of BrdU positive cells was enhanced by LIPUS, along with up-regulation of cyclinD1, CDK6, CDK4, and VEGF. LIPUS promoted migration, as well as up-regulation of MMP-2 and MMP-9. Phosphorylation levels of key kinases in the PI3K/AKT and JNK pathways were increased by LIPUS. Inhibition of either PI3K/AKT pathway or JNK pathway attenuated effects of LIPUS on HaCaT cells, and co-inhibition of these two pathways showed augmented effects. LIPUS promoted proliferation and migration of HaCaT cells through activating the PI3K/AKT and JNK pathways.

Practical Approach of Laryngeal Ultrasonography

Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.

Effects of combined therapy of alendronate and low-intensity pulsed ultrasound on metaphyseal bone repair after osteotomy in the proximal tibia of glucocorticoid-induced osteopenia rats

OBJECTIVES: Glucocorticoid (GC) treatment inhibits activation of runt-related transcription factor 2 (Runx2), which is essential for osteoblast differentiation from stem cells. As a result, GC treatment results in bone loss, GC-induced osteoporosis (GIO), elevated fracture risk, and delayed bone healing. Bisphosphonates such as alendronate (ALN) are recommended for treating or preventing GIO, and lowintensity pulsed ultrasound (LIPUS) facilitates fracture healing and maturation of regenerated bone. Combined therapy with ALN and LIPUS may stimulate cancellous bone healing in GIO rats. Here, we examined the effect of ALN and LIPUS on cancellous bone osteotomy repair in the proximal tibia of GIO rats. METHODS: Prednisolone (10 mg/kg body weight/day) was administered for 4 weeks to induce GIO in 6-month-old female Sprague-Dawley rats. Tibial osteotomy was then performed and daily subcutaneous injection of ALN (1-µg/kg body weight) was subsequently administered alone or in combination with LIPUS (20 min/day) for 2 or 4 weeks. RESULTS: ALN significantly increased bone mineral density (BMD) at 2 and 4 weeks, and ALN + LIPUS significantly increased BMD at 4 weeks. Bone union rates were significantly increased after 2 and 4 weeks ALN and ALN + LIPUS treatment. Lastly, ALN and ALN + LIPUS significantly increased the proportion of Runx2 positive cells at 4 weeks. CONCLUSIONS: ALN monotherapy and combined ALN and LUPUS treatment augmented BMD and stimulated cancellous bone repair with increased Runx2 expression at the osteotomy site in GIO rats. However, the combined treatment had no additional effect on cancellous bone healing compared to ALN monotherapy.

Clinical application of high-intensity focused ultrasound ablation for uterine fibroids

HIFU (high-intensity focused ultrasound) ablation is an emerging therapeutic modality that induces thermal coagulative necrosis of biological tissues by focusing high-energy ultrasound waves onto one small spot. This technique is at various stages of clinical applications in several organs. However, it has increasingly been used in the treatment of symptomatic uterine fibroids, a common condition affecting women. Since its first clinical use for symptomatic uterine fibroids, this technique has been recognized for safety, satisfactory therapeutic efficacy in symptom control, uterus-preserving ability, radiation-free nature, and because of the fact that it does not require hospitalization. Owing to its numerous benefits, HIFU ablation is currently one of the major therapeutic options for symptomatic uterine fibroids. In this review, several aspects ranging from the physical principle of HIFU to the long-term outcomes are summarized from the perspective of the clinical application for uterine fibroids.

Microinfiltração em restaurações de resina composta e sua relação com o ultrassom / Microleakage of composite resin restorations and its relationship with ultrasonic devices

As microinfiltrações em restaurações de resina composta constantemente são referidas como principal motivo de insucesso do procedimento restaurador. Com a necessidade de otimizar o tempo de atendimento aos pacientes e torná-lo menos desconfortável, passou-se a utilizar os aparelhos de ultrassom como instrumentos atuantes no auxílio de procedimentos de raspagem periodontal. Este artigo discorre sobre estudos na literatura que abordam a relação entre o uso da instrumentação ultrassônica em procedimentos periodontais e as deficiências no selamento marginal das restaurações em resina composta(AU)

Microleakage of composite resin restorations is consistently reported as the main reason for failure of this restorative procedure. Ultrasonic devices have been developed to reduce patient's chair time and to make periodontal scaling procedures less uncomfortable. This article discusses studies that address the relationship between the use of ultrasonic instrumentation used for periodontal procedures and failure of the marginal sealing of composite resin restorations(AU)

In vivo standardization of bone ultrasonometry of the clavicle

OBJECTIVE: The assessment of fracture union includes physical examination and radiographic imaging, which depend on the examiner’s experience. The development of ancillary methods may avoid prolonged treatments and the improper removal of implants. Quantitative bone ultrasonometry has been studied for this purpose and will soon be included in clinical practice. The aims of the present study were to assess the feasibility of using this technique on the clavicle and to standardize its in vivo application. METHODS: Twenty adult volunteers, including 10 men and 10 women without medical conditions or a previous history of clavicle fracture, underwent axial quantitative ultrasonometric assessment using transducers in various positions (different distances between the transducers and different angulations relative to the clavicle). RESULTS: Similar values of wave propagation velocity were obtained in the different tested set-ups, which included distinct distances between the transducers and angular positions relative to the clavicle. There were significant differences only in the transducers positioned at 0° and at 5 or 7 cm apart. CONCLUSIONS: The use of bone ultrasonometry on the clavicle is feasible and the standardization of the technique proposed in this study (transducers placed at 45° and at 7 cm apart) will allow its future application in clinical trials to evaluate the healing process of diaphyseal fractures of the clavicle.

Effect of low-intensity therapeutic ultrasound on wound healing in rats subjected to third-degree burns

PURPOSE: To determine the effectiveness of low-intensity therapeutic ultrasound (LITUS) on wound healing in rats with third-degree burns. METHODS: Twenty rats were divided into the Control Group that comprised four rats without third-degree burns that did not undergo LITUS, the Burned Group (BG), comprising eight rats with third-degree burns that did not undergo LITUS, and the Burned with Treatment Group (BTG), comprising eight rats with third-degree burns that were administered LITUS. LITUS began 24 h after injury and involved daily applications for 8 min at 0.1 W/cm2 for 14 days. RESULTS: The BTG lost less weight than the BG (Q=2.75; p<0.05). No visible differences were apparent among the groups' lesions on day 4. By the end of treatment, wound healing was more evident in the BTG. No statistically significant differences were found between the BG and the BTG in relation to the parameters measured using the histological changes in burn wound healing scoring system. CONCLUSION: The LITUS protocol applied to the animals with third-degree burns accelerated the formation of fibrin-leukocyte crusts and significantly reduced weight loss. However, burn wound healing was not accelerated.

Retrieval of multiple separated endodontic instruments using ultrasonic vibration: Case report

This report describes the management of a complicated clinical case with three instruments fractured in one tooth. A 32-year-old patient presented with three Pro- Taper rotary files fractured in the upper right second molar [S2 and F2 in the disto-buccal canal and S1 in the mesio-buccal canal]. A staging platform was prepared in the distal canal coronal to the fragments. Under dental microscope magnification, an Endo-4 ultrasonic tip was activated to dislodge the more coronal fragment [S2] by trephining dentine around the coronal aspect of the fragment. After 11 min, the fragment became loose and was removed. Following the same protocol and using an Endo-5 ultrasonic tip, the second fragment [F2] was removed in approximately 17 min. The first attempt to remove the S1 fragment from the mesio-buccal canal was not successful. An attempt to bypass this fragment using a K-file also failed. A second attempt using the ultrasonic technique resulted in a secondary fracture of the coronal aspect of the fragment. An Endo-5 ultrasonic tip was used to dislodge the fragment, which was successfully removed in 7 min. This report concludes that once a fractured file is bypassed, the instrumentation of a root canal is best completed with hand files. Clinicians should identify their limitations and consider referring cases that are beyond their abilities. Good experience and an appropriate armamentarium enable successful management of complicated cases. Ultrasonic vibration and dental microscope magnification contribute to successful removal of fractured instruments

Dissolution of a mineral trioxide aggregate sealer in endodontic solvents compared to conventional sealers

Abstract The aim of this study is to evaluate the solubility of a Mineral Trioxide Aggregate sealer (MTA-Fillapex) compared with five other sealers, calcium hydroxide (Sealapex), resin (Realseal), zinc oxide-eugenol (Tubli-Seal), and two epoxy resins (AH-26 and AH-Plus), in chloroform and eucalyptoil in static and ultrasonic environments. Samples of each sealer were prepared (n = 180) and then divided into 12 groups that were immersed in solvents for 5 and 10 min in static and ultrasonic environments. The mean weight loss was determined, and the values were compared using Student's t-test, One-way ANOVA, and Tukey's HSD post-hoc test (p < 0.05). In chloroform, MTA-Fillapex, AH-26, and Sealapex displayed moderate solubility with no significant difference in dissolution (p = 0.125); however, their dissolution was significantly lower than that of AH-Plus (p < 0.001), which was almost fully dissolved after 10 minutes. Realseal was significantly less soluble than all sealers (p < 0.001). In eucalyptoil, MTA-Fillapex showed low solubility, as all of the sealers did, but Tubli-Seal was significantly more soluble than other sealers (p < 0.001). Using ultrasonic activation resulted in a significantly higher dissolution rate in chloroform for all sealers except MTA-Fillapex after 10 min (p = 0.226). In eucalyptoil, ultrasonic activation significantly increased the dissolution rate of all sealers except MTA-Fillapex after 5 and 10 min, Sealapex at 10 min, and AH-Plus at 5 min (p > 0.05). In conclusion, MTA-Fillapex was not sufficiently dissolved in either solvent. Ultrasonic activation had limited effectiveness on MTA-Fillapex dissolution, whereas it significantly increased the efficiency of solvents in dissolving a number of endodontic sealers.

Effects of pulsed ultrasound and pulsed electromagnetic field on the extracellular matrix secretion of rat bone marrow mesenchymal stem cell pellets in chondrogenesis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effects of pulsed ultrasound (PUS) and pulsed electromagnetic fields (PEMF) on the secretion of extracellular matrix from a culture complex during in vitro chondrogenesis.</p><p><b>METHODS</b>All the rat bone marrow mesen- chymal stem cell pellets were cultured in achondrogenic medium. Different intensities of PUS (100, 150, and 200 mW · cm⁻²) and PEMF (1, 2, and 5 mT) were applied to the cell pellets for 2 weeks. Group N was cultured without PUS and PEMF stimu- lation as control. The culture medium was collected after 2 weeks of culture. Enzyme-linked immunosorbent assay (ELISA) was used to detect the type of collagen and glycosaminoglycan (GAG) in the culture medium.</p><p><b>RESULTS</b>PUS increased the secreting-type collagen and GAG from cell pellets compared with group N (P < 0.05), whereas there was no difference in different intensities (P > 0.05). PEMF had no significant effect on the secretion of the type of collagen (P > 0.05). A PEMF of 1 mT had no significant effect on the secretion of GAG (P > 0.05). A PEMF 2 and 5 mT decreased the secretion of GAG (P < 0.05).</p><p><b>CONCLUSION</b>To prevent the secretary of extracellular matrix may play a role in chondrogenic effect of PEMF.</p>