Multidisciplinary treatment of two patients with cleft lip and palate using archwise distraction: A case report

Distraction osteogenesis is usually performed in cleft lip and palate patients with severe maxillary sagittal discrepancies, considering the stability of surgical maxillary advancement and the limited complications of velopharyngeal valve insufficiency. Moreover, interdental distraction osteogenesis is a successful treatment protocol for repairing large clefts. Herein, we report a multidisciplinary approach for the treatment of two patients with cleft lip and palate using an archwise distraction appliance (AWDA). AWDA is a tooth-supported, custom-made appliance for closing the alveolar cleft and providing sagittal correction of the maxilla. Using it, the curve of the dental arch is maintained during distraction, and there is no need for a second operation to activate and remove the appliance. Few cases in which archwise distraction was performed have been reported so far. AWDA is a functional and inexpensive appliance used to reduce the alveolar cleft width and produce maxillary advancements in patients with cleft lip and palate. (C) 2018 Published by Elsevier Masson SAS.