Segmental unilateral transpalatal distraction in cleft patients.

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.