Five-year follow-up of intraoral maxillary distraction with tooth-borne distractor in unilateral cleft lip and palate: A case report

This case report presents long-term treatment stability of a patient with unilateral cleft lip and palate who was treated with a modified intraoral tooth-borne distraction appliance. The chief complaints of this 12-year-old patient were poor facial aesthetics, crowding, and forwardly placed lower jaw. Severe maxillary retrognathism was treated via distraction osteogenesis of the maxilla performed using an intraoral tooth-borne appliance. Treatment continued to completion with a fixed mechanotherapy. At a 5-year review following the distraction procedure, long-term results were determined cephalometrically. Following the distraction, ANB became −1° from pretreatment, which was −6°, 1° relapse was seen after 5-year follow-up. After the end of the active treatment, the patient's skeletal and dental class III relationship improved to class I, which was preserved at the long-term review. The profile was markedly improved by distraction osteogenesis. In cases of severe maxillary retrognathism as a result of a cleft lip and palate, maxillary distraction osteogenesis provides a viable alternative to orthognathic surgery with good long-term stability.