Distraction osteogenesis of the cleft maxilla

Distraction osteogenesis is a method of enhancing bony deficiencies of the hypoplastic cleft maxilla. Whether it is the result of inherited growth deficiency or of iatrogenic causes from operative intervention, 20 to 25% of cleft maxilla patients require maxillary advancement. Traditionally, this has been done by standard orthognathic surgery at varying LeFort levels. Predictable results have been achieved with standard techniques in minor to moderate maxillary hypoplasia; however, limited advancement and relapse is common in severe cases. Distraction osteogenesis has improved results in these patients by allowing soft tissue relaxation and gradual bone generation. Therefore, greater movement of the craniofacial skeleton is possible in severe cases of maxillary retrusion with lower relapse rates.