There are a multitude of appliances that compete for our attention in today's orthodontic marketplace - early and late, fixed and functional, and orthodontic and surgical. In the absence of long-term outcome data, a clinician's choice of treatments often boils down to a practice management decision that may have little to do with either the patient's chief concerns (looks, cost, stability) or chief complaint. It will be the purpose of this presentation to examine the impact and efficiency of a number of popular treatment alternatives and to assess their place in contemporary clinical practice.

Distraction osteogenesis of the craniofacial skeleton has become increasingly popular in recent years. For patients with mild to severe abnormalities of the craniofacial skeleton, distraction techniques have expanded the number of treatment alternatives. As in traditional surgical/orthodontic procedures, the orthodontist plays a role in the preoperative assessment of craniofacial form, evaluation of occlusal function, planning the pre and post-distraction orthodontics and the distraction procedure. The use of intermaxillary elastics during the active phase of distraction and questions of relapse, stability, and growth following distraction will be presented.