Summary of current materials used in orbital bone fracture repair

Material typeAdvantagesDisadvantagesReferences
Bone grafts
(Calvarium, iliac crest, rib, maxillary sinus)

  • Cost-effective

  • Good stability

  • Maximal biocompatibility

  • Smooth surface

  • Variability in thickness

  • Radio-opacity

  • Limited availability

  • Variable resorption rate (unpredictable orbit volume)

  • Donor site morbidity

  • Increased surgical time

[112, 123–127]
Titanium meshes

  • Permanent and good fixation

  • Good compatibility and permeability

  • Good strength

  • Radio-opacity

  • Risk of late infections secondary to chronic sinusitis

  • Expensive

  • Not easily removable

  • Sharp edges and palpable

[112, 123–126, 128–130]
Porous polyethylene sheets

  • Allows for tissue integration

  • Lack of rigidity

  • Not visible on imaging

  • High cost

  • Risk of compartment syndrome

  • Less drainage

[112, 123–126, 129, 131, 132]
Composite of porous polyethylene and titanium meshes

  • Combines advantages from both biomaterial

  • Radio-opacity

  • Good stability and fixation

  • Can be used in three-wall fractures

  • Allows for tissue integration

  • Risk of compartment syndrome

  • High cost

  • No need for donor site

  • Less drainage

[112, 124–126, 128–130, 132]
Resorbable materials
(thermoplastic and non-thermoplastics)

  • Good availability

  • Smooth surface

  • Good malleability (thermoplastics only)

  • Not visible on imaging

  • Possibility of material degradation

  • Inflammatory response

  • Less drainage

[112, 123–126, 129, 132]
Preformed orbital implant

  • Smooth surface

  • Minimal countering needed

  • Radio-opacity

  • Very high cost

[112, 123–126, 129, 132]