Orthopedic expansion and protraction of the maxilla in cleft palate patients--a new treatment rationale

This preliminary report presents a treatment rationale for cleft lip and palate patients who display underdevelopment of the midfacial complex in the deciduous dentition. In order to create more favorable conditions for midfacial growth, transverse expansion followed by anterior orthopedic traction of the maxillary complex is performed in the deciduous dentition, applying principles introduced by Delaire. A clinical procedure, based on fixed appliances and compatible with edgewise technique has been developed. A treated patient with indicator implants is presented.