Background: Several studies describe the orthopedic treatment of patients with cleft lip and palate, diagnosed with class III malocclusion; however, there is no standardization in the orthopedic treatment planning in these patients. Objective: To determine the effectiveness of treatment with facemask and a fixed intra-oral appliance for patients with cleft lip and palate and Class III malocclusion. Methods: A literature search conducted in several databases and print journals produced 199 articles. Inclusion criteria were: randomized clinical or open trials, English and Spanish language, patients with cleft lip and palate, 5-12 years of age, Class III malocclusion and/or facemask and/or maxillary protraction, assessment with lateral radiographs, cephalometric analysis, and clinical observation. Results: The sample consisted of eight articles that underwent quality analysis. Results indicate that treatment with facemask and intraoral appliance was effective in patients with cleft lip and palate to achieve maxillary protraction, of which a combination of facemask and Hyrax showed better skeletal results. Conclusion: Treatment with facemask with the intraoral appliance Hyrax, at 8-10 years of age, with 450-500 g forces and a 10º-30º inclination below the occlusal plane, used at least 12 hours/day for 9.2 months in patients with cleft lip and palate cleft and class III malocclusion, showed major skeletal changes in the maxilla and mandible.

KEYWORDS
malocclusion angle class III; cleft lip and palate; craniofacial anomalies; maxillary expansion;
facemask; maxillary protraction; hyrax