Distraction Osteogenesis and Orthognathic Surgery for Cleft Lip and Palate: A Literature Review

ABSTRACT Background Cleft lip and palate (CLP) is the most prevalent craniofacial malformation, frequently associated with maxillary hypoplasia, velopharyngeal dysfunction and aesthetic alterations that compromise quality of life. Among surgical strategies, orthognathic surgery (OS) and distraction osteogenesis (DO) remain the most widely applied techniques for correction of maxillary deficiencies in CLP patients. Objective This literature review focuses on analysing and synthesising the current evidence on the most commonly used OS and DO techniques in patients with CLP, highlighting their indications, results and limitations. Methods A systematic search was conducted in PubMed, Scopus, Cochrane Library and Taylor and Francis, including clinical studies, systematic reviews and meta‐analyses published in the last 15 years. Results OS provides immediate correction of moderate maxillofacial deformities and improves occlusion and facial harmony, but carries a considerable risk of relapse and velopharyngeal dysfunction. In contrast, DO enables gradual skeletal advancement with superior long‐term stability and better soft tissue adaptation, though it requires prolonged treatment and tolerance to distraction devices. Recent evidence indicates that hybrid and segmental distraction techniques may further enhance stability and reduce complications. Conclusion The choice between OS and DO should be individualised according to the severity of maxillary hypoplasia, patient age, and functional‐aesthetic objectives. While OS remains effective for moderate corrections, DO demonstrates advantages in severe cases. Multicenter studies with standardised protocols are needed to strengthen long‐term evidence and optimise surgical decision‐making in CLP management.