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.