الفهرس 
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Abstract
Cleft lip and palate are one of the most common congenital craniofacial malformations. Treatment of patients with CLP represents a great challenge to the orthodontist. This is due to the diversity and complexity of the orthodontic problems they suffer from. Problems are seen in the skeletal structures, dentition and the facial soft tissues. Patients with CLP suffer from maxillary deficiency in both the antero- posterior and transverse planes. To reach a good profile and balanced occlusion, they will need both maxillary protraction and expansion. Growth modification at an early age is important for patients with CLP even if full correction of the skeletal problem will not be achieved.
The aim of the present study was to compare the Facemask therapy with the Modified Tandem Appliance in maxillary protraction of cleft palate patients using CBCT. The study was conducted on 20 growing children (10 boys and 10 girls) with cleft lip and palate patients with retruded maxilla.
CBCT records were taken before and after nine months of Facemask use. The patients were treated with Facemask therapy for nine months then the results were compared with the results of a study made by Abd el Ghafaar et al who treated cleft patients with the Modified Tandem Appliance.
Comparing the results of the current study revealed that; there were no significant difference in the effects of both appliances. The Facemask therapy and Modified Tandem Appliance had skeletal and dental effects, they stimulated forward maxillary growth, and there was improvement in the maxillomandibular relationship, also, the anterior facial heights significantly increased. Upper incisors
had significant anterior proclination, significant improvement in the overjet was noticed. There was a significant increase in the upper intermolar widths and upper inter-canine width.
According to the results of the current study the following could be concluded: The Facemask therapy and Modified Tandem Appliance are effective in treatment of skeletal Class III malocclusion. Both appliances produced very desirable dental and skeletal effect, which helped improve the patient’s appearance, and helped in decreasing the movement needed in maxillofacial surgery.