Alveolar and anterior maxillary distraction in patients with orofacial clefts

Abstract

Distraction osteogenesis is a commonly used process in the treatment of patients with craniofacial disorders, especially in those with cleft lip and palate (CLP) having severe maxillary deficiency. This chapter discusses the use of alveolar distraction osteogenesis in the treatment of CLP with large defects. Major goals in the treatment of CLP include achieving labial, palatal, and velopharyngeal closure; a balanced profile; a harmonious facial appearance; and a good occlusion. One of the most critical aspects in the preparation of the dental arch for alveolar distraction osteogenesis is creating enough space to facilitate interdental vertical osteotomies. Compared to tooth-borne appliances, bone-anchored systems can present challenges in positioning the distraction device with the correct force vector. Bone-anchored distraction appliances are often preferred over tooth-borne systems when segmental anterior maxillary distraction is required and may also be used as an alternative to tooth-borne appliances in alveolar transport distraction. © 2023 John Wiley & Sons, Inc.