Advancement of the cleft maxilla using distraction osteogenesis--surgical and orthodontic considerations.

The distraction osteogenesis principle that was originally developed by orthopedists for purposes of limb lengthening can now be used successfully for bones of the craniofacial region, including cleft palate deformities. Advancement of the cleft maxilla by means of distraction is based on the concept of using stretching forces to separate two bony elements at the midface region. The role of orthodontists in skeletal treatment of the maxilla utilizing distraction osteogenesis should be collaborative and adjunctive as part of a team approach to rehabilitate the patient. Advances over traditional techniques are mainly because of simultaneous adaptation of the surrounding soft-tissue envelope which contributes to the stability of the reconstruction, thus lessening the risk of relapse.