Introduction: The aim of this study is to investigate the effect of maxillary skeletal protraction with skeletal versus dental protraction in unilateral cleft lip and palate patients. Methods: Patients from three cleft treatment centers were analyzed. A total of 33 unilateral cleft lip and palate (UCLP) patients treated with Bollard miniplates (BM) (mean age 11.72 years) and 33 UCLP patients treated with facemask therapy (FM) (mean age 8.90 years) were included for analysis. Radiographs were obtained from T1 (pretreatment) and T2 (upon the conclusion of active traction). Cephalometric radiographs were constructed from CBCT radiographs, lateral cephalograms were digitally landmarked and traced, and two-dimensional horizontal displacement of maxillary cephalometric landmarks were measured on tracing cranial base superimpositions. Results: Both groups presented with retrognathic maxillae pretreatment, but both differed significantly in T1 SNA angle (with the BM group beginning with more retrognathic maxillae), partially owing to the difference in age between the groups. The BM group experienced a significant, moderate improvement in SNA from T1 to T2, however SNA for the FM group did not significantly improve from T1 to T2. The groups did not differ significantly in SNA change or horizontal displacement of maxillary cephalometric landmarks. Conclusions: The BM group exhibited significant improvement in SNA, but this difference was not large enough to result in a significant difference from patients treated with FM therapy. Limitations of the current study are discussed.
