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Chapter 12326added in this phase. Joint mobilization also can increase in intensity to grade III or even IV. The diet can now evolve from a soft to solid diet.(12,14,15,29,34,35)Fig. 6: Isometric exercise: attempting mouth opening from closed position. Opening the mouth is attempted while applying manual pressure against the lower jaw.Other Treatment OptionsThe effect of low-intensity pulsed ultrasound (LIPUS) was first highlighted in an animal trial by Byl et al.(46) who found that LIPUS application during the first postoperative week significantly improved tissue healing compared with animals who did not receive this therapy. Since this finding, many studies have reported the notable influence LIPUS exerts on soft tissue wound healing. A recent meta-analysis by Lou et al(47) concluded that LIPUS shortens the time to fracture union.(48,49) Tehranchi et al(50) came to a similar conclusion after conducting a comparative prospective study in which 9 patients who underwent orthognathic surgery were treated with LIPUS. They found that the use of this technique led to a significant increase in bone density and significantly decreased pain during the first 3 postoperative weeks. As such, the use of LIPUS can be Nikolas de Meurechy NW.indd 326 05-06-2024 10:15