Alt-RAMEC Expansion and Protraction by EDO in Cleft Lip and Palate Patient

Inclusion Criteria: * Patients of both sexes. * Cleft lip and palate patients. * All patient age ranges from 8 to 12 years. * All the cases showed maxillary arch constriction and deficiently * All patients had maxillary permanent first molars. * Primary lip adhesion and palatal closure. Exclusion Criteria: * Patients had received any surgical assisted expansion or maxillary protraction or fixed orthodontics before. 2\. Maxillary dentition unsuitable to bond the expander (less than two dental unit bedside first permanent molar) . 3\. Absent maxillary permanent first molars. 4. Uncooperative patients/parents