Evaluate the treatment outcome of slow maxillary expansion protocol on patients with cleft lip and palate, using a differential opening expander and face mask which will be measured and recorded by cone beam computed tomography (CBCT).

Cleft lip and palate are among the most common deformities in children. Cleft patients are usually having orofacial problems as missing or unerupted permanent teeth, alveolar bone defect, speech difficulty. Patients with cleft lip and palate (CLP) commonly have maxillary arch constriction (maxillary hypoplasia) and Class III malocclusions due to deficient of maxillary growth. The upper jaw of patients with cleft palate will be expanded using maxillary Expander with Differential Opening (EDO) which has two screws; one anterior and one posterior. This will be done with slow expansion protocol, which is one 1/4 turn three times weekly. Petit facemask will be used to protract the retracted maxilla. The differences in measurements between before and after treatment will be assessed by cone beam computed tomography (CBCT).

Inclusion Criteria:

• All patient age ranges from 8 to 12 years.
• Patients of both sexes.
• Cleft lip and palate patients.
• All the cases showed maxillary arch constriction and deficiency.
• All patients had maxillary permanent first molars.
• Primary lip adhesion and palatal closure.

Exclusion Criteria:

• Patients had received any surgical assisted rapid maxillary expansion or maxillary protraction of fixed orthodontics before.
• Maxillary dentition unsuitable to bond the expander (less than two dental units beside permanent first molar).
• Absent maxillary permanent first molars.
• Uncooperative patients/parents.

Evaluation of EDO, Slow maxillary expansion and facemask in patients with cleft lip and palate (CLP) using Cone Beam Computed Tomography (CBCT)