Forward traction of the maxilla with cleft lip and palate in mixed and permanent dentitions

The effect of forward maxillary protraction with the Delaire type facial mask was studied in fourteen patients with cleft lip and palate. Traction on the maxilla was initiated between 9 and 15 years of age and the duration ranged from 5 go 36 months, averaging 19 months. The average magnitude of the traction forces was 300-400 gm. Parallel or downward direction of the forces in relation to the occlusal plane were used from the first molars and the precanine loops of the arch wire. Forward movement of the maxilla was observed in five 9-11-year-old patients. No movement was observed in nine patients over 11-years of age. In spite of the poor results of forward movement of the maxilla in the older patients, the facial mask therapy proved to be successful in correction of the anterior crossbite, spacing of the dental arch, and as an anchor in widening the upper dental arch.