Tissue engineering has been rapidly developed in oral and maxillofacial reconstruction. Biocompatible scaffold from chemically composites seeded with stem cells is essential and several growth factors for bone formation and angiogenesis are also required. To overcome limited activity of new bone formation with scaffolds, several biomechanical stimulation methods on cells have been made to grow cells in scaffold. Several bioreactors have been developed for real tissue growth in culture laboratory. In addition to biological stimulants like BMP, growth factors and exogenous drugs, biomechanical stimulation technique has also been known as an effective method in cell differentiation. We developed our own bioreactor with tensile mechanical strains. Then we tested with it for detection of suitable biomechanical effect on the cell differentiation and proliferation. And we also compared the results with the effect of low intensity pulsed ultrasound (LIPUS). Mechanical strain group showed more rapid reaction with cell differentiation and proliferation than non-mechanical strain group. Mechanical strain groups stimulated with 0.5∼0.7Hz for 6 hours and 8 hours showed more active cell differentiation than the group with 0.5∼0.7Hz for 2.5 hours tensile strain stimulation. Group of LIPUS also showed more rapid reaction in cell differentiation and proliferation. LIPUS with 3MHz showed more cell reaction than the LIPUS group with 1MHz. Our results showed the positive effect on differentiation and proliferation of cell with mechanical tensile strain, LIPUS both.

The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 and 500 ) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 and 500 until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 and 500 until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 and 500 until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 than the group with 500 (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 ultrasound intensity than those treated with 500 intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 to 500 is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.