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Distraction or osteotomy for the correction of maxillary cleft deformities: which is better?

The application of distraction osteogenesis in the maxillofacial region is gaining popularity. However, it remains controversial whether distraction osteogenesis can produce better outcomes than the conventional orthognathic surgery particularly in cleft lip and palate (CLP) patients. This paper presents the two treatment methods--conventional orthognathic surgery and distraction osteogenesis in the management of maxillary hypoplasia in CLP patients. One clinical case was selected for illustration on each method. The discussion is based on the current literature focusing on the differences in indications, surgical techniques, morbidities, relapse, speech and velopharyngeal changes.