Palatal Wound healing: The effects of scarring on growth

Cleft palate patients often develop growth disturbances of the midfacial region after primary surgery. Factors such as intrinsic developmental deficiencies
and functional distortions are initially involved but palatal repair seems to be a main factor in these growth disturbances. A strong indication for the involvement of iatrogenic factors is the largely undisturbed maxillary growth in untreated patients. In treated patients, the healing of surgical wounds originating from palatal repair is probably responsible for the growth disturbances. This chapter gives an overview of the wound healing process
with emphasis on wound contraction and scar formation since they are considered to be key events. Some specific features of the palatal wound healing process are highlighted. Further, the effects of palatal repair on growth of the maxilla and development of the dentition are reviewed, as well as possible means to improve the clinical outcome.
This review is based on clinical evaluations, experimental research in animal models, and on in vitro experiments using cell culturing and tissue engineering techniques.