Orofacial anomalies are generally treated by a combination of orthodontics and oral and maxillofacial surgery. The application of distraction osteogenesis offers new possibilities for treatment such as mandibular widening in the transverse direction and lengthening of the vertical mandibular ramus. It has also become apparent that distraction osteogenesis is a very useful alternative treatment for conventional osteotomy for the lengthening of the horizontal mandibular ramus in case of retrognathia and for surgical midfacial advancement at Le Fort I, II or III level. Widening of the maxilla by means of distraction osteogenesis is probably the most common application. Distraction osteogenesis should not be seen as a replacement for conventional osteotomies, but as a valuable supplement. Advantages of distraction osteogenesis over conventional osteotomies which are often mentioned are application at a younger age, lower risk of nerve damage, the displacement of the jaw or parts of the jaw over a greater distance, better stability of the treatment result, no need for bridging bonegrafts, lower surgical risk and shorter surgery time. For many advantages of distraction osteogenesis, however, scientific evidence is still lacking.