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International Journal of Oral and Maxillofacial Surgery

Journal of Craniofacial Surgery, 2010

Reconstruction of the fractured orbit serves to prevent functional and aesthetic posttraumatic se... more Reconstruction of the fractured orbit serves to prevent functional and aesthetic posttraumatic sequels. In 2004, the surgical protocol at our unit was modified with respect to techniques for surgical access, types, and materials for reconstruction. The modifications were as follows: (a) introduction of medial orbital wall reconstructions through a bicoronal approach, (b) transconjunctival approach instead of the subciliary approach, and (c) porous polyethylene or porous polyethylene-titanium instead of autologous bone grafts. To evaluate the different surgical techniques and materials used, orbital reconstructions performed at our unit from 2000 to 2007 were retrospectively studied. In total, 177 primary or first-time secondary reconstructions were performed in 176 patients. The overall rate of early complications requiring medical or surgical intervention was 6.4%, and the reoperation rate was 3.4%. There were no statistically significant differences in the frequency of cicatricial eyelid complications between the subciliary and the transconjunctival approaches. There was a reduction in operative time with the use of implants compared with the use of bone. The overall rate of infections was 2%; however, there were no infections in the group treated with implants. Seven patients had secondary surgery for persistent enophthalmos, 4 of them due to defects in the medial orbital wall that had not been corrected at the time of primary reconstruction of the orbital floor. In conclusion, porous polyethylene/porous polyethylene-titanium is a safe material for orbital reconstructions. Reconstruction of the medial orbital wall is important to prevent posttraumatic enophthalmos, particularly in combined medial wall-orbital floor fractures.

Applied Sciences, 2020

The presence of non-sufficient bone height and width requires an increase in the amount of bone a... more The presence of non-sufficient bone height and width requires an increase in the amount of bone available to insert an implant. Different materials are described in the literature, and the “custom-made bone graft approach” is a modern option which currently requires a preoperative stage of studying the bone defect and designing the implant. SmartBone® (SB®) mimics the characteristics of healthy human bone. Thanks to the strong performance, high workability, resistance and shape retention of SB®, it is possible to obtain SmartBone® on DemandTM, a bone graft uniquely shaped exactly to patient specifications, produced by following the data precisely and contoured to the bone defect site. The aim of this study was to determine the success over 7 years following a customized SmartBone® on DemandTM, a xeno-hybrid bone graft and installation of implants in a maxillary horizontal and vertical atrophy. This case study presents the diagnosis for a 60-year-old male patient requesting the rehab...

Journal of Oral and Maxillofacial Surgery, 2004

Fractures of the internal orbit are common facial injuries. They can range in size from a small c... more Fractures of the internal orbit are common facial injuries. They can range in size from a small crack in the floor to extensive multiple wall defects. Their diagnosis and treatment planning have been greatly improved over the past 30 years because of the wide availability of computed tomography (CT). CT allows an assessment of the location of the fracture/defect and the amount of orbital soft tissue prolapse into the adjacent sinuses. When significant internal orbital defects are not reconstructed, malposition of the ocular globe can occur. Enophthalmos and hypoglobus are the most common consequences of internal orbital defects of the floor and/or medial wall. Surgical reconstruction of the fractured, displaced, or missing orbital walls has been shown to prevent these complications in the acute setting and restore globe position in the chronic setting.