ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2019, 4(6): 9–15
Medicine. Reviews

Modern Physical Methods of Stimulating the Bone Tissue Healing Processes

Vares Y. E., Shtybel N. V.

Restoring the integrity and volume of bone loss has been a major medical problem for decades. Today, all methods focused on solving this problem can be divided into two groups: biological and physical. Among physical stimulation therapies are the following: low–intensity pulsating ultrasonic vibrations, extracorporeal shock–wave therapy, low–level laser therapy, electrical stimulation, and magnetotherapy. In preclinical trials, all of them have demonstrated potential ability to enhance the bone healing. Despite this, physical stimulation therapies in the context of bone healing are poorly described. The purpose of the study was to determine the feasibility of the clinical application of physical stimulation therapies to enhance bone healing, particularly in the maxillofacial area. Material and methods. This research was performed in the PubMed, Elsevier, and Google Scholar databases using a combination of keywords ‘bone healing’ and ‘electrical stimulation’, ‘low–intensity pulsating ultrasonic vibrations’, ‘extracorporeal shock–wave therapy’, ‘magnetotherapy’, ‘low–level laser therapy’ and their synonyms respectively. Publications had to meet the following inclusion criteria: systematic reviews, meta–analyzes and original studies focused on bone healing enhancement using physical stimulation therapies, published between 2010 and 2019. Exclusion criteria were: the impact on bone healing was secondary; clinical cases; physical methods were positioned as additional in treatment; studies were published by Ukrainian authors. Thus, 50 publications were selected that met these criteria. The results of the published studies were systematized and presented in the form of proposed literature review in a logical sequence: the essence of the method, its biological mechanism and the effectiveness of its application. Conclusion. The presence of a variety of physiotherapeutic methods used to enhance bone healing processes and the constant searching for ways to improve them for more effect indicates the urgent need to solve this challenge in the most optimal way. Contradictory results of clinical studies, insufficient number of controlled studies and, as a consequence, lack of evidence base, today call into question the feasibility of clinical application of such physical stimulation therapies as electrical stimulation, low–intensity pulsating ultrasonic vibrations, low–intensity laser therapy and magnetotherapy. A major disadvantage of the above methods is the large number of sessions required to achieve the effect. In the other hand, extracorporeal shock–wave therapy shows to be the only common physical stimulation therapy that has evidenced its effectiveness. In addition, the flexibility of using this method allows to extend the indications for its application, in particular in the maxillofacial area.

Keywords: bone healing, MFA, physiotherapy, extracorporeal shock–wave therapy

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