Orbital Reconstruction with Hydroxyapatite Ceramic Implants

Abstract

Thirteen patients with fractures of the orbital floor (inferior wall), medial and lateral walls, or so-called "blowout" fractures with or without fractures of the zygoma were treated with artificially made hydroxyapatite ceramic implants made entirely from limestone, some of which were made with computer aided design and computer aided machinery (CAD-CAM) from data obtained from helical computed tomography. Orbital reconstruction with hydroxyapatite ceramic implants is a safe technique which is superior to previous ones in which autogenous or plastic materials were used.

Orbital Floor Restoration

“…The alloplastic materials are those receiving the best credit by ophthalmic surgeons, and there are many of them. Gelfilm Ò (Upjohn Co, Kalamazoo, Ml), Medpor Ò (Porex Surgical Inc. College Park, Ga), Silastic Ò (Dow Corning, Auburn, MI), Teflon Ò (DuPont DeNemours and Co, Wilmington, Del), methylmethacrylate, polyamide, titanium, vitallium, Marlex Ò (Phillips Chemical Co, Houston, Tex), hydroxyapatite, ceramics and BAG-implant [24][25][26][27][28][29][30][31] are only some among the most famous; the main disadvantages are represented by long-term infections which may lead to the removal of the implant, its extrusion or migration, foreign-body reactions and encapsulation (the latter occurrence often gives a false sense of security to the surgeon). Beside these contraindications of generic type, several authors noticed that some of these materials are inflammable (PTFE), develop excessive heat (methylmethacrylate), or are very difficult to remove in case of adverse reaction (titanium and vitallium).…”

Materialien in der rekonstruktiven Orbitachirurgie

“…Zur Rekonstruktion im Bereich der Orbita kommt Hydroxylapatit zur Anwendung, eine Kalziumphosphatkeramik, die die gleiche chemische Zusammensetzung wie mineralisierter Knochen hat [29]. Bewährt haben sich auch Glaskeramiken, z.…”

Reconstruction of orbital wall defects with calcium phosphate cement: clinical and histological findings in a sheep model

“…Other frequently applied treatment methods 4,18 , such as insertion of polyethylene sheets 3,14 , hydroxylapatite ceramic 19 , titanium mesh 9 , cancellous bone 2 , polydioxanone sheets 1 and polylactic acid/ polyglycolic acid implants, have also been reported. The use of calcium phosphate cement for reconstruction of calvaria defects 6 and fracture repair of extremities 5 has been described previously but its value in the management of orbital fractures has not yet been determined.…”