Characteristics and applications of synthetic exogenous materials used in surgery for reconstruction of the orbital cavity

Abstract

This study aims to provide the main features, indications, and contraindications of synthetic exogenous materials used to reconstruct defects in the orbital cavity. In addition, present the available clinical data on these biomaterials. This integrative literature review was carried out in the PubMed, Periódicos CAPES, and Virtual Health Library (VHL) databases in May and June 2022. At first, the search followed the following strategy on the PubMed and CAPES Periodicals platforms - (reconstructive surgical procedures AND orbit AND biomaterials). Then, in the VHL platform, with the combination - (orbit AND biomaterials). There were restrictions for articles published in the last five years. Titanium was the most frequently found material in this search, with 38% of the total number of articles. The material was also associated with Porous Polyethylene, Polyetheretherketone, and in the form of Titanium-Nickel alloy.  The following materials were also included: Hydroxyapatite; Non-sintered hydroxyapatite particles and a composite sheet of Poly L'Lactide with adhesion fixation; Porous Polyethylene; Polytetrafluoroethylene; Polyetheretheretherketone; Polydioxanone; Polymethylmethacrylate; and Polycaprolactone. Orbital reconstruction surgeries can be challenging because of the anatomical complexity of the region and the impact that repairing this structure has on the individual. The most common alloplastic materials used for orbit reconstruction are titanium mesh and porous polyethylene. The type of injury, the particularities of each patient, the operator's training, the material's availability, and the technological apparatus should be considered in the clinical decision of which to use. Good results in orbital reconstruction surgeries require more and more innovations in technologies, materials, and professional training.