Autogenous Ramus Graft Versus Alloplastic Titanium Mesh in Orbital Floor Reconstruction

Document Type : Original Article


1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Department of Biostatistics, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Background and Objective: The management of orbital fractures is one of the most challenging area in facial trauma. No consensus exists on the choice of implants to be used for orbital floor reconstruction. Here we present the short term results of the outcome of autogenous ramus graft versus alloplastic materials in a randomized prospective clinical trial.
Subjects and Methods: A total of 22 patients with orbital floor fracture were entered in our study in two groups randomly. Patients of first group were treated by autograft of lateral cortex from mandibular ramus, and the patients of second group by titanium mesh as an alloplastic material. All patients were followed for 6 months and enophthalmos, diplopia, cheek paresthesia and infection rate were assessed.
Results: There were no significant differences between two groups in respect to enophthalmos(p > 0.8), diplopia, vertical dystopia (p > 0.5) cheek paresthesia and infection rate. Both mandibular ramus and alloplastic titanium mesh can be used in orbital floor reconstruction regardless of size of defect.
Conclusion: Both mandibular ramus autograft and alloplastic titanium mesh are reliable and successful techniques to address the orbital floor fracture. Ramus region provides an appropriate volume of bone with vascularization, low extrusion rate and so inert, but donor site morbidity and more time-consuming are disadvantages. Highly biocompatibility, minimal resorption potential,     well-recognized osseointegration and contouring, no donor site morbidity and less time consuming are advantages of titanium mesh; but the risk of graft extrusion or anticipated difficulty while insertion and removing the material if needed because of fibrous ingrowth and also additional cost required ,are its drawbacks.


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