Cleft maxillary distraction versus orthognathic surgery-which one is more stable in 5 years?

Objective. The objective of this study was to compare the long-term stability of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) in patients with cleft lip and palate (CLP). Study design. CLP patients requiring maxillary advancement of 4 to 10 mm were randomized and assigned to either CO or DO. In the CO group, the maxilla was fully mobilized to the preplanned position and fixed using titanium miniplates. In the DO group, the maxilla was mobilized to a limited extent and distractors were fixed on each side of the maxilla. Serial lateral cephalographs were taken for the assessment of stability at different postoperative periods up to 5 years. Results. In the CO group, the maxilla relapsed backward and upward, whereas in the DO group, it advanced more forward and downward over 5 years. Conclusions. Distraction of the cleft maxilla can achieve better long-term skeletal stability in maintaining its advanced position than CO. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 803-814)