International Journal of Oral and Craniofacial Science ISSN: 2455-4634 DOI CC By 046 Citation: Saluja H, Sachdeva S, Shah S, Dadhich A, Tandon P, et al. (2017) Autogenous Grafts for Orbital Floor Reconstruction: A review. Int J Oral Craniofac Sci 3(2): 046-052. DOI: http://doi.org/10.17352/2455-4634.000031 Clinical Group Abstract Orbital fractures are relatively common midfacial injuries encountered in urban areas. Patients usually are seen with periorbitaloedema and restricted eye movements with or without changes in vision. A wide range of autogenous materials can be used in the reconstruction of orbital defects including bone grafts, cartilages and fascia each having its own strengths and weaknesses. The purpose of this paper is to provide a systematic literature review on various autogenous materials used for orbital floor reconstruction. Review Article Autogenous Grafts for Orbital Floor Reconstruction: A review Harish Saluja 1 *, shivani sachdeva 2 , Semmit shah 3 , Anuj Dadhich 4 , Parul Tandon 5 and Vinayak More 5 1 Reader, Department of oral & maxillofacial surgery, Rural dental college, PIMS, loni Maharashtra, India. 2 Reader, Department of periodontics, India. 3 Professor & Head Department of oral & maxillofacial surgery, India. 4 Reader, Department of oral & maxillofacial surgery, India. 5 Senior lecturer Department of oral & maxillofacial surgery, India. Received: 25 September, 2017; Accepted: 24 October, 2017; Published: 25 October, 2017 *Corresponding author: Dr. Harish Saluja, Reader, Department of Oral and Maxillofacial Surgery, Rural Dental College, PIMS, Loni, Maharashtra (413736), India, Tel: +919766921178; E-mail: harry_saluja@yahoo.co.in Keywords: Graft; Orbital floor; Fracture; Reconstruc- tion https://www.peertechz.com Introduction Orbital floor reconstruction is usually carried out in patients with defects caused by facial trauma or tumor ablation. Orbital floor fractures are relatively common midfacial injuries encountered in urban areas [1], and were first described by Smith and Regan in 1957 [2]. It can occur as a part of zygomatico-maxillary complex fracture (57.4%) or as an isolated orbital floor fracture-the term coined as ‘blow out fracture’ up to 21.4% [3]. These orbital defects when big in size may hamper the function of the eye, mostly associated with double vision. The goal of surgical repair in orbital floor fractures is two-fold: to reposition herniated orbital fat and tissue back in the orbit; and to reconstruct the traumatic defect [4]. The reconstruction should release herniation of orbital contents, should avoid enophthalmia, diplopia [5], and should prove as a barrier against infection from the antrum [6]. Repair of the orbital floor defect is mandatory if the defect measures at least 50% of the size of the orbital floor bone. Two points are to be kept in mind in case of orbital floor defects, that is identification of cases which needs exploration and reconstruction and the other is selection & placement of appropriate materials for reconstruction. The ideal implant must be nonreactive, provide good structural support, be easily positioned, readily available, biocompatible, noncarcinogenic, and easy to place in position and free of any potential for disease transmission [1,2,4,7]. Reconstruction of the floor will avoid entrapment of fat as well as herniation of orbital fat. Even along with restoration of function; final form, shape and volume restoration of bony orbit will provide acceptable esthetics [8]. Lot of allogenic materials like hydroxyapetite, nylon, marlexmesh, porous polythene are in the market which are widely used for reconstruction of orbital floor, but still autogenous bone consider to be the best reconstructive material. Multiple autogenous bone grafts can be used for orbital floor reconstruction ranging from anterior ileac crest, clavicular graft, calvarial, antral wall, coronoid process, and lateral plate of mandibular ramus, body, lingual cortex and parasymphysis of mandible. Despite, autogenous grafts require a second surgical procedure to harvest, which may increase the morbidity , postoperative discomfort and sometimes loss of function related to donar site 5 ,autologous bone grafts remain the ‘‘gold standard’’ for orbital floor reconstruction [9,10]. Benefits arise from inherent characteristics that promote their use in repairing defects of the orbital floor. They provide rigidity and molding capacity, vascularity, biocompatibility, and minimal immune reactivity [11], Autogenous bone has been the important material of choice for the last 30-40 years for the reconstruction of orbital blow out fracture. Some investigators have advocated the use of rib grafts and tibial grafts [12,13]. The choice of autogenous graft depends on many factors including surgical access, the size of the defect to be repaired, and donar site morbidity and depending on quality and quantity of available bone. While opting for a graft we should also keep in mind the basic principles of to harvest bone from areas you are familiar and contour of graft should fit the defect.