The patients who underwent reconstruction of cleft lip and palate had clinically abnormal characteristics such as cicatricial contracture in the cleft area, narrow arches, missing teeth, and fistula. Most of those patients showed severe class III malocclusion with underdevelopment of the maxillary complex. In such patients, the treatment objectives in orthodontics were mainly anterior and lateral expansions of the maxillary arches, and inhibition of mandibular growth. In recent years, the maxillary protractor has been used positively in the treatment of the underdeveloped maxillary complex. In this study, we report on two patients with cleft lip and palate, and underdevelopment of the maxillary complex. Maxillary protractors were used beneficially at the period of the dento-craniofacial growth spurt. In these two cases, improvement of disharmony was obtained in the antero-posterior relationship between the maxilla and the mandible. The effects of the treatment were forward movement of the maxilla and growth inhibition of the mandible. Accordingly, the use of the maxillary protractor for cleft lip and palate patients with underdeveloped maxilla at the period of the dento-craniofacial growth spurt was shown to be important.
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