title: Mechanical resistance of the periorbita and the orbital floor complex--are isolated orbital floor fractures only a soft tissue problem?
abstract: The primary aims of orbital floor reconstruction are to prevent enophthalmos and herniation of the orbital contents in order to achieve correct globe position. Theoretically, the mechanical load of the orbital floor is approximately 0.0005N/mm(2) (30g orbital content onto 600mm(2) of orbital floor area). Therefore, low mechanical stress from orbital floor reconstruction materials is expected. The periorbita and orbital floor complex (bony orbital floor with periorbita) of 12 human cadavers were investigated for their mechanical resistance to distortion and compared to different absorbable pliable reconstruction materials after modification with pores (Bio-Gide, Creos, and PDS). The human periorbita resistance (approximately 1.4N/mm(2)) was comparable to that of the absorbable membranes (Creos, Bio-Gide), and the resistance of PDS (approximately 2.3N/mm(2)) was comparable to that of the orbital floor complex. The periorbita has a higher stability than the bony orbital floor. Therefore, in isolated orbital floor fractures with a traumatized bony orbital floor and periorbita, reconstruction of the soft tissue as a periorbita equivalent with a resorbable membrane appears to be adequate to prevent enophthalmos and herniation of the orbital contents.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany. Electronic address: f.birkenfeld@mkg.uni-kiel.de.
authors.forename: F
authors.initials: F
authors.lastname: Birkenfeld
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Behrens
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Flörke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Rohnen
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wieker
authors.affiliation: Department of Prosthodontics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kern
authors.affiliation: Department of Anatomy, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lucius
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian-Albrechts University at Kiel, Kiel, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wiltfang
mesh_terms: D020341:Absorbable Implants; D001696:Biomechanical Phenomena; D002102:Cadaver; D003094:Collagen; D015841:Enophthalmos / Q000473:pathology; D006547:Hernia / Q000517:prevention & control; D006801:Humans; D009917:Orbital Fractures / Q000503:physiopathology* / Q000601:surgery*; D016687:Polydioxanone; D019651:Plastic Surgery Procedures; D013314:Stress, Mechanical
chemical_list: C106416:Bio-Gide; D016687:Polydioxanone; D003094:Collagen
keywords: PDS; collagen membrane; orbital floor fracture; periorbita