Maxillary hypoplasia in CLP deformities results from congenital reduction in midfacial growth and the effects of the surgical scar from CLP repair.Turvey et al. suggested that this disproportionate jaw growth is the biologic consequence of prior surgical intervention for closure of the soft tissues and is not related to the congenital cleft deformity, Midfacial hypoplasia is commonly treated by performing conventional Le Fort surgery to displace the maxilla anteriorly and stabilization afterward with rigid fixation along with orthodontics treatment. .

Midface hypoplasia cleft patient has the following characteristics: concave facial profile, inverted nasal tip, wide alar base, acute nasolabial angle, and excessive exposure of sclera. Intraoral findings are anterior and posterior crossbite, CLP, accentuated curve of Spee, Class III dental malocclusion, multiple missing teeth, oronasal communication, and residual cleft. Speech disturbances are also usually present due to velopharyngeal incompetency and oronasal communication.

Inclusion Criteria:

• Cleft patients either cleft alveolus or cleft alveolus and palate.
• Surgically fit patients.
• Patients ready for orthognathic assessment undergoing either surgical or orthodontics correction.

Exclusion Criteria:

• Non- cleft cases .
• Previous correction.
• History of active infection or underlying disease such as hematologic disorders neoplasm, and immune deficiency.
• Patient refused to sign an informed consent.