Advancements in Design and Application of Absorbable Materials for Orbital Fracture Reconstruction

Abstract

Orbital fractures are a common type of maxillofacial trauma, and their functional and aesthetic reconstruction has long posed challenges in surgical repair. Traditional implant materials (such as autogenous bone, titanium mesh, and porous polyethylene) carry risks of long-term foreign body retention and associated complications. Absorbable materials overcome the drawbacks of permanent implants by providing temporary mechanical support during healing while gradually degrading, representing a significant advancement in orbital fracture repair. This article systematically reviews the design advancements and current applications of resorbable materials in orbital fracture reconstruction. It covers material classification (including properties of poly-L lactic acid [PLLA], polyglycolic acid, polycaprolactone [PCL], and their composites), biomechanical performance, degradation mechanisms, and their integration with precision technologies such as 3D printing, computer navigation, and external endoscopy for preoperative planning and intraoperative procedures. Clinical studies indicate that absorbable implants achieve repair outcomes comparable to permanent implants in small-to-medium and some complex orbital fractures, with the unique advantage of avoiding interference with growth and development in pediatric patients. Despite challenges including delayed inflammatory responses, mechanical strength limitations, and inadequate radiopacity, novel material designs (e.g., uncalcined hydroxyapatite/PLLA composites) and hybrid technologies (e.g., incorporating functional factors such as bone morphogenetic protein-2) are continuously enhancing their performance. Future directions encompass developing smart biomaterials, deepening digital technology integration, advancing long-term multicenter clinical studies, and optimizing cost-effectiveness strategies. Absorbable materials are poised to become a mainstream choice for orbital fracture repair.

Impact Statement

This review highlights the transformative role of absorbable materials in orbital fracture reconstruction. By providing temporary support and then degrading, they eliminate long-term risks of permanent implants. The integration of advanced composites (e.g., u-HA/PLLA) and precision technologies such as 3D printing enables superior, patient-specific outcomes. This research consolidates evidence for their efficacy, particularly in pediatric cases, and charts a future course toward smart biomaterials and deeper digital integration, establishing them as a potential new standard of care and significantly advancing the field of maxillofacial surgery.