Reconstruction of orbital floor fractures using bioactive glass

Introduction: The management of orbital floor fractures continues to be deb ated. Bioactive glasses and glass-ceramics are in the new group of material s developed for the repair of bone defects which are beyond any innate heal ing capacity due to their size, Objective: We compared the use of alloplast ic implants (bioactive glass) with conventional autogenous grafts (cartilag e - plus or minus lyophilized dura) for the repair of orbital floor defects after trauma. Material and Methods: Twenty-eight patients having orbital f loor fractures with persistent diplopia, enophthalmos, and/or infraorbital nerve paraesthesia were operated on from 1991 to 1995 at Turku University C entral Hospital. Reconstruction was either with bioactive glass (S93P4) or autogenous cartilage implants. Results: Postoperative tomograms in the 28 p atients showed adequate maintenance of orbital and maxillary sinus volume w ithout any evidence of resorption in either group. None of 14 patients in t he study group had any evidence of dystopia or complications relating to im plants follow-up. One had infraorbital nerve paraesthesia and another had e ntropion postoperatively. Among the 14 control subjects there were three ca ses of persistent diplopia, two of infraorbital nerve paraesthesia and one of enophthalmos. Conclusion: Bioactive glass implants are well-tolerated an d seem to be a promising repair material for orbital floor fractures. Their use leads to less morbidity as no donor site operation is needed. Also it provides favourable healing as it is bioactive, biocompatible and causes ne w bone formation. (C) 2000 European Association for Cranio-Maxillofacial Su rgery.