Bioactive glass granules and plates in the reconstruction of defects of the facial bones.

Non-vascularised bone grafts that are used for reconstruction of skeletal deformities of the face after trauma or tumour surgery are prone to resorption. The outcome may, therefore, not be what was expected. Bone was reconstructed with bioactive glass S53P4 granules and plates at 36 sites in 13 patients. The behaviour of the material was compared with that of bone grafts at 16 sites in the same patients. Bioactive glass granules were used in facial bone defects in subperiosteal pockets and to obliterate frontal sinuses, whereas bioactive glass plates were used mostly in orbital wall reconstruction. Clinical examination, middle face radiographs, and computed tomograms (CT) showed that the material was well tolerated. A third of the glass granules and a quarter of the membranous bone grafts that were fixed with miniplates retained their original size. The glass plates did not change in size. Bone contact to the host bone was found more often with the bioactive glass plates than with the bioactive glass granules or the bone grafts. Both the glass plates and the bone grafts retained their density, but there was a reduction in density of the glass granules. The clinical outcome showed no relapses after one year's follow up. No further operations were needed because of the material used.