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.