Repair of orbital floor fractures with bioactive glass implants

Purpose: The ideal management of orbital floor fractures has been highly co ntroversial. Many implants, both autogenous and alloplastic, have been used to span the defects. This study evaluated the use of bioactive glass impla nts (BAG-implant, S53P4; Abmin Technologies Ltd, Turku, Finland) for the re pair of orbital floor defects caused by blunt facial trauma. Patients and Methods: This retrospective review of 36 patients was carried out from 1995 to 1999. All patients were diagnosed with an orbital floor fr acture or a large orbital blowout fracture. The BAG-implant was placed over the defect, using a subciliary or transconjunctival approach. No screw fix ation was used when the implant was the correct size. Follow-up examination was done at I and 3 months after surgery. Twenty-eight (82%) of the patien ts were also seen at one-year follow-up (21 men and 7 women). Results: The implants did not cause a foreign body reaction in the bone or soft tissue. There was no sign of resorption or infection, nor postoperativ e extrusion, hemorrhage, or displacement of the implant. Diplopia was seen preoperatively in 17 cases (61%) and postoperatively in 5 cases (18%). In 1 patient, the implant was removed 3 months after operation because of diplo pia. Infraorbital nerve paresthesia was seen preoperatively in 9 patients ( 32%) and postoperatively in 5 patients (18%). The functional and cosmetic r esults were good at the 1-year follow-up. Conclusion: The BAG-implant is a well-tolerated material in orbital floor r econstruction. It provides a favorable environment for an uncomplicated hea ling process because it is bioactive and biocompatible and because it cause s new bone formation. (C) 2001 American Association of Oral and Maxillofaci al Surgeons.