Treatment of retruded maxilla in cleft lip and palate-orthognathic surgery versus distraction osteogenesis: The case for orthognathic surgery

In summary, orthognathic surgery is safe, generally predictable, relatively accurate, time efficient, and cost efficient; in addition, it has a long history. Distraction osteogenesis is also safe, and it provides a method by which a significantly greater magnitude of advancement is produced; however, it is less "patient friendly," more time consuming, and more costly than orthognathic surgery. Orthognathic surgery consists of a constellation of corrective procedures to which should be added distraction osteogenesis. Distraction osteogenesis should not be thought of as a standalone, all-inclusive treatment modality. The acid test for both orthognathic surgery and distraction osteogenesis is the extent to which either can restore the "normal" development of a once "pathologic" pattern of facial growth. Unfortunately, this issue remains largely unresolved. © 2007 American Association of Oral and Maxillofacial Surgeons.