Treatment of severe maxillary hypoplasia with oligodontia and complete bilateral cleft lip and palate by maxillary anterior segmental distraction osteogenesis

Effective maxillary advance treatment is difficult to achieve without impairing velopharyngeal function in patients with severe maxillary deficiency. We describe successful orthodontic treatment using maxillary anterior segmental distraction osteogenesis (MASDO) in a patient with cleft lip and palate. A 20-year-old woman with bilateral cleft lip and palate, multiple congenitally missing teeth, reduced maxilla, concave soft-tissue profile, and skeletal Class III jaw relationship was treated with a combination of orthodontic treatment and MASDO. After treatment, the anterior maxilla was displaced forward with new bone formation induced in the distraction gap for insertion of dental implants. Maxillary hypoplasia was successfully treated while preserving the velopharyngeal function with MASDO. We suggest that MASDO is useful for patients with severe maxillary hypoplasia.