This case report presents an early clinical evaluation of a bilateral cleft lip and palate patient treated with Archwise Distraction Osteonegesis Technique and Appliance. A 21-year-old patient with a bilateral CLP had a chief complaint of missing upper anterior teeth and poor esthetics. The patient had Class III skeletal and dental relationships, maxillary hypoplasia, maxillary posterior arch constriction, premaxillary deficiency due to an alveolar cleft and a concave profile. Treatment plan consisted of, leveling and aligning of the arches with fixed orthodontic appliances and archwise distraction osteogenesis. Osteotomies were performed to mobilize the posterior lateral segments. Activation of the distractors was continued until the lateral segments had contacted each other. The Patient was referred to the oral surgeon for the docking side surgery and to the prosthodontist for the final restorations. A very large defect area was successfully repaired using this protocol whilst maintaining the ideal arch form and generating new bone behind the distracted segments.
