I actually read that surgeons shy away from doing CCW rotation because the history of the procedure was inherently unstable. Indeed, studies done in the 1970's and 80's showed a significant relapse, sometimes 100% full relapse. There was other studies that placed them somewhat stable, so there was a lot of conflicting theories and clinical study results. They were even using wire fixation as well as rigid fixation back then. The problem was the material, if indigenous bone was used, there was high chance of relapse, simply because people would use there jaw muscles for tough foods. But after the Porous HA blocks were used by Larry Wolford, and using rigid fixation with soft diet for 4 months, none of his patients (23 patients evaluated) exhibited any relapse more than .5mm over a long term study. The ha blocks harden up after 4 months and the first four months are crucial, and bone actually starts integrating into the pores, further stabilizing the material. I've called up many surgeons office and they all told me that any surgeon should know how to perform the procedure, but some don't do as much.
