Repair of orbital floor fractures with bioactive glass implants.
OBJECTIVE
The ideal management of orbital floor fractures has been highly controversial. Many implants, both autogenous and alloplastic, have been used to span the defects. This study evaluated the use of bioactive glass implants (BAG-implant, S53P4; Abmin Technologies Ltd, Turku, Finland) for the repair of orbital floor defects caused by blunt facial trauma.


METHODS
This retrospective review of 36 patients was carried out from 1995 to 1999. All patients were diagnosed with an orbital floor fracture or a large orbital blowout fracture. The BAG-implant was placed over the defect, using a subciliary or transconjunctival approach. No screw fixation was used when the implant was the correct size. Follow-up examination was done at 1 and 3 months after surgery. Twenty-eight (82%) of the patients 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 postoperative 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 diplopia. Infraorbital nerve paresthesia was seen preoperatively in 9 patients (32%) and postoperatively in 5 patients (18%). The functional and cosmetic results were good at the 1-year follow-up.


CONCLUSIONS
The BAG-implant is a well-tolerated material in orbital floor reconstruction. It provides a favorable environment for an uncomplicated healing process because it is bioactive and biocompatible and because it causes new bone formation.
Aitasalo
K
K
Turku University Central Hospital, Turku, Finland. kalle.aitasalo@tyks.fi
Kinnunen
I
I
Palmgren
J
J
Varpula
M
M
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D018786:Bone Substitutes; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005898:Glass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D020273:Orbital Implants; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001672:Biocompatible Materials; D018786:Bone Substitutes; C403922:bioactive glass S53P4