Many patients with facial differences, including cleft lip and palate, have changes to their jaws that result in the top jaw being behind the bottom jaw, resulting in an underbite. Potential treatment options include headgear, braces and surgery. One novel treatment option is bone anchored maxillary protraction, also known as bollard plates.

A common step in early orthodontic treatment is use of a palate expander. The way that palatal expanders can guide development makes them an effective tool for children, whose mouths and jaws are still growing.