The orthodontic treatment period with extractions is prolonged in many cases because of the limited rate of biological tooth movement. An approach using transport distraction osteogenesis was designed to reduce orthodontic and orthognathic treatment time. Overall management of selected alveolar cleft cases with wide defects may also be optimized and simplified through transport distraction of a tooth-bone segment. We will discuss our experience with 73 cases, both conventional orthodontic cases and orthognathic patients, in which dentoalveolar distraction was used to reduce orthodontic treatment time and to treat wide alveolar clefts with compromised soft tissues to facilitate optimal outcome. © 2011 American Association of Oral and Maxillofacial Surgeons.