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Patients with unilateral cleft lip and palate (UCLP) can present with an asymmetric transversal deficiency caused by collapse of the lateral maxillary segment at the cleft side. The surgical technique and orthodontic implications of segmental unilateral transpalatal distraction (TPD) after a posterior maxillary subapical osteotomy using the transpalatal distractor (TPD(R)) are described. The differences between unilateral posterior surgical-assisted rapid palatal expansion (SA-RPE) and segmental unilateral TPD are discussed. The proposed orthodontic-surgical treatment strategy certainly has to be validated by long-term studies in the future.

In comparison with the control group, both boys and girls with unilateral cleft lip and palate showed a significant retrusion and clockwise rotation of the mandible as well as a decreased vertical midfacial development.

The aim of this study was to compare the different treatment effects observed in Angle Class III patients treated either exclusively in the primary dentition or receiving treatment initiated during the early mixed dentition. 14 patients from five families were enrolled in this retrospective study. The treatment course, appliances, treatment length and treatment outcomes were compared. The skeletal changes were assessed by analyzing cephalometric radiographs taken prior to, during and after completion of orthodontic treatment. In those patients receiving treatment in the primary dentition only, the course of treatment was more continuous and only one appliance had to be used. Moreover, the treatment time was shorter compared to those patients starting treatment in the early mixed dentition (5.4 +/- 2.1 vs 21.1 +/- 9.7 months). Treatment exclusively in the primary dentition showed better dentoalveolar results.

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