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Three-Dimensional Reconstruction of Orbital Fractures
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Patient-Specific Implants in Post-traumatic Orbital Reconstruction: A Systematic Review.

Michael V Joachim1, Farangis Farsio2, Michael R Markiewicz3

  • 1Senior Faculty, Department of Oral and Maxillofacial Surgery, Gray Faculty of Medical and Health Sciences, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel; Attending Surgeon, Unit of Oral and Maxillofacial Surgery, Shamir (Assaf ha-Rofeh) Medical Center, Tzrifin, Israel.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|November 2, 2025
PubMed
Summary

Patient-specific implants (PSIs) significantly improve orbital volume restoration and globe position compared to conventional methods for orbital fractures. PSIs also reduce complications and revision rates, supporting their use in complex reconstructions.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Biomedical Engineering

Background:

  • Orbital fractures cause functional and esthetic deficits requiring precise reconstruction.
  • Patient-specific implants (PSIs) are emerging solutions, but their benefits are debated.

Purpose of the Study:

  • Compare orbital volume restoration between PSIs and conventional reconstruction.
  • Evaluate and compare globe position, functional outcomes, and complications.

Main Methods:

  • Systematic literature search of major databases (PubMed, Embase, Cochrane, Web of Science) up to May 2025.
  • Included 23 studies comparing PSIs with conventional orbital reconstruction in adults with post-traumatic orbital defects.
  • Excluded studies on technical aspects, pediatric, or nontraumatic defects.

Main Results:

  • PSIs showed superior orbital volume restoration (0.73 cm³ vs 1.54 cm³).
  • PSI groups had better globe position, with less enophthalmos (7.3% vs 18.2%).
  • PSIs led to significantly lower persistent diplopia (11.7% vs 30.1%) and revision rates (5.9% vs 13.7%).

Conclusions:

  • PSIs provide superior outcomes for orbital volume, globe position, and complication rates in post-traumatic orbital reconstruction.
  • Findings support PSI use, especially with intraoperative navigation.
  • Further prospective studies are needed to confirm long-term benefits.