Reconstruction 0f Orbital Floor #
with Polyglactin
910/Polydioxanon patch
(ETHISORB)
INDIAN DENTAL ACADEMY
Leader in conti...
PURPOSE
• To evaluate the effectiveness and the
complications related to the use of Ethisorb
(resorbable alloplastic mater...
INTRODUCTION
Orbital floor #’s can be broadly classified as pure
blow out #’s or Impure blow out #’s.
If improperly treate...
CHOICE OF IMPLANT FOR ORBITAL
FLOOR RECONTRUCTION
• AUTOLOGOUS MATERIALS: Periosteum, Naso
septal cartilage, Rib graft, Ma...
ETHISORB
• It’s a synthetic resorbable patch/mesh consisting
of a semiflexible membrane of 0.6 x 20 x30 mm.
• It’s compose...
www.indiandentalacademy.com
PATIENTS & METHODS
• Orbital floor was explored in all patients with
Enophthalmos, Restricted globe motility,Diplopia or
l...
www.indiandentalacademy.com
• In large floor #’s a posterior stable ledge of bone
was sometimes difficult to identify,so ETHISORB
was fashioned, trimm...
RESULTS
• Totally 87 Pts were treated for Orbital floor
reconstruction using ETHISORB.
• Cause for #’s ranged from RTA to ...
• Post operatively :
-66 Pts had no complication
-5 Pts had Diplopia in extreme gauze
-3 Pts had mild ectropions
-7 Pts In...
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
DISCUSSION
• The most important component of Orbital floor
reconstruction is the restoration of the pre trauma
volume of t...
• ETHISORB should be used only is small to moderate
orbital floor #,one must make sure that mesh spans the
entire defect a...
CONCLUSION
• This study demonstrates the effectiveness of
ETHISORB in the repair of small to
moderate orbital floor # defe...
THANK YOU

www.indiandentalacademy.com
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Reconstruction of orbital floor with ethisorb /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Reconstruction of orbital floor with ethisorb /certified fixed orthodontic courses by Indian dental academy

  1. 1. Reconstruction 0f Orbital Floor # with Polyglactin 910/Polydioxanon patch (ETHISORB) INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. PURPOSE • To evaluate the effectiveness and the complications related to the use of Ethisorb (resorbable alloplastic material) in the reconstruction of Orbital floor #’s. www.indiandentalacademy.com
  3. 3. INTRODUCTION Orbital floor #’s can be broadly classified as pure blow out #’s or Impure blow out #’s. If improperly treated, these #’s may lead to serious complications usually Diplopia, Enophthalmus and reduced globe mobility. Goals of treatment is to free the prolapsed orbital tissue from the # defect and to span the defect with an implant to restore the correct anatomy of the orbital floor and pre trauma orbital volume. www.indiandentalacademy.com
  4. 4. CHOICE OF IMPLANT FOR ORBITAL FLOOR RECONTRUCTION • AUTOLOGOUS MATERIALS: Periosteum, Naso septal cartilage, Rib graft, Mandibular bone,Cranial bone graft Etc… • ALLOGENIC MATERIALS: Lyophilized dura, Lyophilized cartilage. • ALLOPLASTIC MATERIALS: -Resorbable: Poly-L-Lactide, Polydioxanon (PDS), Vicryl mesh( polyglactin-910),Polyglycolic acid -Non Resorbable:Silicone,Teflon,Medpor,Titanium www.indiandentalacademy.com mesh.
  5. 5. ETHISORB • It’s a synthetic resorbable patch/mesh consisting of a semiflexible membrane of 0.6 x 20 x30 mm. • It’s composed of nondyed Vicryl polyglactin 910 and nondyed PDS. • This material completely resorbs after 3 months.During resorption its replaced by fibrous collagenous tissue with minimal inflammation. • It acts as a scaffold establishing a supporting structure on which the peri orbita will heal. • Also finds its use in bridging dura mater defects. www.indiandentalacademy.com
  6. 6. www.indiandentalacademy.com
  7. 7. PATIENTS & METHODS • Orbital floor was explored in all patients with Enophthalmos, Restricted globe motility,Diplopia or large floor defect as visualised on CT. • Exploration was carried in all cases through a trans conjunctival approach without lateral canthotomy,subperiosteal dissection was done to expose the defect and to free the prolapsed soft tissue. • Care was taken to protect Infra orbital nerve.Dislocated bone fragments were reduced if possible and defect exposed circumferentially.Stable bone was found all around the defect. www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. • In large floor #’s a posterior stable ledge of bone was sometimes difficult to identify,so ETHISORB was fashioned, trimmed with scissors and placed to bridge the floor defect. • In every case the Implant covered the whole defect and that it rested posterior to Infra orbital rim. • None of Implants were fixed. • In case of defects larger than Ethisorb membrane,Lyophilised cartilage was used.These Pts were not included for this study. • Forced Duction test was performed before wound closure to ensure normal motility. www.indiandentalacademy.com
  10. 10. RESULTS • Totally 87 Pts were treated for Orbital floor reconstruction using ETHISORB. • Cause for #’s ranged from RTA to altercations. • Time from trauma to surgery ranged from 7 hrs to 37 days. • Pre operatively: 26 Pts with Diplopia, 2 Pts with Enophthalmos, 34 Pts with Infra orbital nerve hyposthesia.74 Pts were investigated preoperatively by coronal and axial CT. • 28 Pts with Pure Blow out # and 59 Pts with Impure Blow out #( along with orbito-zygomatic # that needed exposure and fixation of the Infra orbital rim). www.indiandentalacademy.com
  11. 11. • Post operatively : -66 Pts had no complication -5 Pts had Diplopia in extreme gauze -3 Pts had mild ectropions -7 Pts Infra Orbital nerve hypesthesia -3 Pts had Epiphora -2 Pts had Symblepharon -1 Pts had lower lid edema, which improved with massage therapy www.indiandentalacademy.com
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  15. 15. DISCUSSION • The most important component of Orbital floor reconstruction is the restoration of the pre trauma volume of the internal orbit. • Advantages of resorbable alloplastic materials include: -unlimited availability of the material -decreased operative time -no donor site morbidity and complication -no risk of infectious disease transmission -avoidance of late complications associated with non resorbable alloplastic materials like infection, migration, extrusion. www.indiandentalacademy.com
  16. 16. • ETHISORB should be used only is small to moderate orbital floor #,one must make sure that mesh spans the entire defect and also rests on a stable bone all round the defect.If the mesh rests properly on a stable bone the risk of developing Enophthalmos post operatively after the resorption of the implant is negligible, because the reconstructed scar is stiff enough to support the globe. This can be confirmed by CT. • Use of more than one ETHISORB is not recommended,if the defect is larger than the mesh another type of implant should be used (ie lyophilised cartilage) www.indiandentalacademy.com
  17. 17. CONCLUSION • This study demonstrates the effectiveness of ETHISORB in the repair of small to moderate orbital floor # defects( upto a maximum size of 2 x 2 cm). www.indiandentalacademy.com
  18. 18. THANK YOU www.indiandentalacademy.com

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