Abstract
Standard treatment of mandibular nonunion includes debridement and application of
maxillomandibular or rigid internal fixation techniques, with adjunctive bone grafting
when necessary. Frequently described in the orthopaedic literature, low-intensity
pulsed ultrasound therapy (LIPUS) is a noninvasive treatment modality used to accelerate
healing of fresh fractures and established nonunions. The purpose of this study was
to conduct a systematic review to determine the extent of LIPUS study in the treatment
of mandibular nonunions to identify whether LIPUS represents an effective nonsurgical
alternative or adjunct for nonunion management. A literature review was conducted
to investigate published reports on the utilization of LIPUS in treating mandible
fracture nonunions. The search yielded two randomized controlled trials demonstrating
favorable healing parameters in fresh human mandible fractures treated with LIPUS,
two randomized controlled trials demonstrating osteogenic differentiation in human
mandibular fracture cellular components, and one study reporting improved healing
at rabbit mandibular osteotomy sites. No articles published reports studying LIPUS
in facial fracture nonunion were identified. This report reviews published literature
on mandibular nonunions, and the evidence of LIPUS use in long bone nonunions. There
are no known studies presenting LIPUS treatment of mandible fracture nonunions. However,
on the basis of published orthopaedic data, LIPUS therapy could be considered as an
adjunct or alternative to traditional surgical management of select mandible fracture
nonunions.
Keywords
LIPUS - mandibular fractures - fracture - abnormal union
