R_Bibb_Medical_Modelling_The_Application_of_Adv.pdf

Case studies 141
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6.5 Surgical applications case study 3: The
custom-made titanium orbital fl oor prosthesis
in reconstruction of orbital fl oor fractures
6.5.1 Acknowledgements
The work described in this case study was fi rst reported in the reference
below and is reproduced here in part or in full with the permission of the
British Association of Oral and Maxillofacial Surgeons.
• Hughes CW, Page K, Bibb R, Taylor J, Revington P (2003), ‘The
custom-made titanium orbital fl oor prosthesis in reconstruction for
orbital fl oor fractures’, British Journal of Oral and Maxillofacial Surgery,
41 (1), 50–53.
No fi nancial support was given. The National Centre for Product Design &
Development Research (PDR) supplied the stereolithography model used
in making the prosthesis.
6.5.2 Introduction
Few anatomical sites of such diminutive size have attracted so much variation
in treatment as the orbital fl oor (the bottom of the eye socket) and its
related fractures. The range of implant material in reconstruction following
blow out fracture of the orbit is extensive and the decision as to which
material is used remains debated (1).
Autologous materials (those derived from human tissues) offer clear
advantages with cartilage, calvarial bone, antral bone, rib and illium having
been described (1). These grafts offer uncertain longevity and result in
tissue damage at the donor site. Artifi cial materials such as Silastic ® (Dow
Corning Corporation, Auburn Plant, 5300 11 Mile Road, Auburn, MI
48611, USA) have the longest track record, but a well-documented complication
rate related in particular to extrusion of the graft (2). Other artifi cial
materials such as polyethylene sheeting (Medpor ® , Porex Surgical Products
Group USA, Porex Surgical, Inc, 15 Dart Road, Newnan, GA 30265-1017,
USA) are reported to give satisfactory results (3), and newer resorbable
materials such as polydioxanone are another option (4). The role of bioactive
glass is more recently reported, but its use is limited by the size of the