Effect of Low-Intensity Pulsed Ultrasound on Osseointegration of Endosseous Dental Implants: A Split-Mouth Clinical Study

Abstract

Introduction Dental implants are a predictable modality for oral rehabilitation, with successful outcomes largely dependent on rapid and stable osseointegration. However, achieving optimal early bone–implant integration remains a clinical challenge, particularly in compromised bone conditions. Low-Intensity Pulsed Ultrasound (LIPUS), a non-invasive modality known to stimulate osteogenesis and angiogenesis, has shown promising results in fracture healing, but its clinical role in enhancing dental implant osseointegration is not yet well established.

Objectives To evaluate the effect of Low-Intensity Pulsed Ultrasound (LIPUS) therapy on implant stability and peri-implant bone density in endosseous dental implants using a split-mouth clinical design.

Methods A prospective split-mouth clinical study was conducted on 25 partially edentulous patients requiring bilateral mandibular implants, yielding 50 implant sites. Each patient received one test implant exposed to postoperative LIPUS and a contralateral control implant without adjunctive ultrasound, minimizing inter‑individual variability. Implant stability was measured at 1, 2, and 3 months using Resonance Frequency Analysis and expressed as Implant Stability Quotient (ISQ) values, while peri‑implant bone density was assessed at the same intervals using Cone Beam CBCT. Paired t‑tests were used to compare test and control implants at each time point.

Results: Mean ISQ values increased over time in both groups, but were consistently higher for LIPUS-treated implants. At 1, 2, and 3 months, mean ISQ values were 64.9, 71.7, and 77.8 in the LIPUS group and 62.1, 68.2, and 73.3 in the control group, respectively, with statistically significant differences at all time points (p = 0.004, 0.001, and <0.001, respectively). CBCT analysis similarly showed progressive increases in peri‑implant bone density from 1 to 3 months in both groups, with higher mean values and a steeper upward trend for LIPUS-treated sites, indicating enhanced bone formation and maturation.

Conclusions: LIPUS therapy significantly improves early osseointegration of dental implants by increasing implant stability and peri‑implant bone density during the initial healing period. These findings support LIPUS as a safe, non‑invasive adjunct to conventional implant therapy, particularly when accelerated or enhanced early osseointegration is desired.