AN EVALUATION OF THE EFFECT OF LOW INTENSITY PULSED ULTRASOUND ON THE HEALING OF MANDIBULAR FRACTURES A RANDOMIZED CLINICAL TRIAL

INTRODUCTION: Mandibular fractures are considered a significant percentage of maxillofacial trauma. Multiple techniques, have been used to improve mandibular fracture healing over the years. Low Intensity Pulsed Ultrasound (LIPUS) has recently been used in orthopaedic surgery for improvement of bone union, but was rarely investigated for facial bones. OBJECTIVE: The aim is to compare the efficacy of the use of LIPUS in accelerating bone healing of jaw fractures after open reduction versus the use of conventional miniplates only, investigated both radiographically and clinically. MATERIALS AND METHODS: In an interventional study, 18 cases with jaw fractures were assigned to two groups at random: the study group and the control group, having 9 participants in each group. Both groups underwent open reduction and internal fixation using two conventional miniplates but only the study group received LIPUS stimulation (1.5MHz, 30W/cm2) for 20 minutes on postoperative days 4, 8, 14 and 20. The control group did not receive LIPUS. Clinical evaluation included wound healing, occlusion and pain intensity. Radiographic evaluation using immediate Cone Beam Computerized Tomography (CBCT) and postoperative CBCT after 12 weeks were used to determine the efficacy by measuring various variables, including bone density and radiographic fracture healing. Results After twelve weeks, both groups had normal occlusion and normal sensory function. The wound healing was measured using landry’s score index, there was a significant difference in both groups along the follow up period (p<0.001) and a statistically significant reduction in pain intensity (p<0.001). The average bone density improved statistically significantly in both groups A (p<0.001) and B (p<0.001) when comparing post-operative 12 week values to preoperative values. CONCLUSION: Based on the favourable clinical and acceptable radiographical outcomes of our study, it is concluded that the application of low intensity pulsed ultrasound in mandibular fractures could potentially speed up the healing process, decrease the pain and postoperative complications.