A Comparative Study of 2 Implants Used to Repair Inferior Orbital Wall Bony Defects: Autogenous Bone Graft Versus Bioresorbable Poly-L/DL-Lactide [P(L/DL)LA 70/30] Plate

Abstract

The purpose of this study was to compare our clinical findings on the use of autogenous bone grafts and bioresorbable poly-L/DL-Lactide [P(L/DL)LA 70/30] implants to repair inferior orbital wall defects. Thirty-nine patients who suffered orbital blow-out fractures with >or=2 cm2 bony defect in the inferior orbital wall took part in the study. Each inferior orbital wall was reconstructed using either an autogenous bone graft or a triangle form plate of P(L/DL)LA 70/30. Computed tomography scans were taken before the operation and at 2 and 36 weeks postoperatively. To describe the distribution of complications and facilitate statistical analysis, we categorized our findings into diplopia, enophthalmos, numbness, gaze restrictions, size of bony defect after treatment, bone growth, and implant resorption. A comparative study was carried out using chi2 test and the Fisher exact test. We considered P < .05 to be statistically significant. The clinical outcome was excellent in 19 of the 24 (79%) cases treated with autogenous bone grafts and in 13 of the 15 (87%) cases treated with P(L/DL)LA 70/30. No statistically significant differences were found between the 2 groups in overall type or number of complications. The most frequent type of complication found in both groups was enophthalmos, with 5 cases (bone graft, 3; P(L/DL)LA plates, 2). Diplopia was the second most frequent type of complication; however, both complications caused no need for the removal of the implants in either group. Autogenous bone grafts and P(L/DL)LA 70/30 implant plates do not present statistically significant differences in the parameters studied. Taking into account the availability and the advantages of P(L/DL)LA 70/30 implants when compared with autogenous bone grafts, our results allow us to conclude that there is no compromise regarding successful bridging of orbital floor defects using biodegradable P(L/DL)LA 70/30 osteosyntheses.