title: A prospective multicenter study to compare the precision of posttraumatic internal orbital reconstruction with standard preformed and individualized orbital implants.
abstract: OBJECTIVE
  A variety of implants are available for orbital reconstruction. Titanium orbital mesh plates are available either as standard preformed implants or able to be individualized for the patient. The aim of this study was to analyze whether individualized orbital implants allow a more precise reconstruction of the orbit than standard preformed implants.
  
  
  METHODS
  A total of 195 patients treated between 2010 and 2014 were followed up to 12 weeks after surgery. Of the patients, 100 had received standardized preformed and 95 individualized implants. The precision of orbital reconstruction with the different implants was determined by comparing the variances in the volume difference between the reconstructed and the contralateral orbit on the postoperative computed tomographic scans. Clinical volume-related parameters including globe position, vision, motility, and diplopia and surgical details including approach, timing and technique of implant modification, use of navigation, duration of surgery, as well as adverse events were documented.
  
  
  RESULTS
  Orbital reconstruction was significantly more precise when individualized implants were used. The same was seen with intraoperative navigation. An overlap in the use of individualized implants and navigation makes it difficult to attribute the improved precision to a single factor.
  
  
  CONCLUSIONS
  This study demonstrated that individualization and navigation provide clinical benefit.
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany. Electronic address: Zimmerer.Ruediger@mh-hannover.de.
authors: Rüdiger M
authors: RM
authors: Zimmerer
authors: University of Texas Health Science Center, Department of Oral and Maxillofacial Surgery, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA.
authors: Edward
authors: E
authors: Ellis
authors: 12 de Octubre University Hospital, Cirurgia Maxillofacial, Av. De Cordoba s/n, 28041, Madrid, Spain.
authors: Gregorio Sanchez
authors: GS
authors: Aniceto
authors: Bundeswehrkrankenhauses Ulm, Department of Oral, Maxillofacial and Plastic Facial Surgery, Oberer Eselsberg 40, 89081, Ulm, Germany.
authors: Alexander
authors: A
authors: Schramm
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany.
authors: Maximilian E H
authors: ME
authors: Wagner
authors: Johns Hopkins Hospital, Wilmer Eye Institute, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors: Michael P
authors: MP
authors: Grant
authors: Klinikum der LMU Muenchen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Lindwurmstr. 2a, 80337, München, Germany.
authors: Carl-Peter
authors: CP
authors: Cornelius
authors: University of California Davis, Department of Otolaryngology-Head and Neck Surgery, 2521 Stockton Blvd., Suite 7200, Sacramento, 95817, CA, USA.
authors: Edward Bradley
authors: EB
authors: Strong
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany.
authors: Majeed
authors: M
authors: Rana
authors: National University Hospital, Division of Plastic Surgery, Lower Kent Ridge Road, 119074, Singapore, Singapore.
authors: Lim Thiam
authors: LT
authors: Chye
authors: 12 de Octubre University Hospital, Cirurgia Maxillofacial, Av. De Cordoba s/n, 28041, Madrid, Spain.
authors: Alvaro Rivero
authors: AR
authors: Calle
authors: Bundeswehrkrankenhauses Ulm, Department of Oral, Maxillofacial and Plastic Facial Surgery, Oberer Eselsberg 40, 89081, Ulm, Germany.
authors: Frank
authors: F
authors: Wilde
authors: University of Texas Health Science Center, Department of Oral and Maxillofacial Surgery, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA.
authors: Daniel
authors: D
authors: Perez
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany.
authors: Frank
authors: F
authors: Tavassol
authors: Albert-Ludwigs-Universität, Mund-, Kiefer- und Gesichtschirurgie, Hugstetter Straße 55, 79106, Freiburg i.Br., Germany.
authors: Gido
authors: G
authors: Bittermann
authors: Johns Hopkins Hospital, Wilmer Eye Institute, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors: Nicholas R
authors: NR
authors: Mahoney
authors: 12 de Octubre University Hospital, Cirurgia Maxillofacial, Av. De Cordoba s/n, 28041, Madrid, Spain.
authors: Marta Redondo
authors: MR
authors: Alamillos
authors: Bundeswehrkrankenhauses Ulm, Department of Oral, Maxillofacial and Plastic Facial Surgery, Oberer Eselsberg 40, 89081, Ulm, Germany.
authors: Joanna
authors: J
authors: Bašić
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany.
authors: Jan
authors: J
authors: Dittmann
authors: Medizinische Universitätsklinik Innsbruck, Universitätsklinik für Mund-, Kiefer- und Gesichtschirurgie, Zahn-, Mund- und Kieferheilkunde, Anichstrasse 35, 6020, Innsbruck, Austria.
authors: Michael
authors: M
authors: Rasse
authors: Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany.
authors: Nils-Claudius
authors: NC
authors: Gellrich
mesh_terms: D000328:Adult; D017076:Computer-Aided Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000601:surgery*; D020273:Orbital Implants; D011446:Prospective Studies; D019651:Plastic Surgery Procedures
keywords: Blow-out fracture; CAD/CAM; Comparative study; Intraoperative navigation; Orbital fracture; Orbital implant