Preventing Relapse Following Distraction Osteogenesis for the Cleft Midface in Adults

Distraction osteogenesis is an accepted form of treatment in the management of midface deficiency in patients with cleft. However, it is well known that some amount of relapse is inevitable in patients who undergo this procedure (Cho and Kyung 2006). The problems are amplified in some patients because of growth-inhibiting severe fibrosis resulting from previous operations. This chapter discusses protocols to control long-term relapse rates and optimize results. It analyzes the mechanism and rate of relapse in adults and discusses inputs in terms of pre- and postoperative orthodontic management, treatment planning, operative and distraction techniques, as well as retention strategies to minimize and overcome the tendency to relapse.