Inclusion Criteria:  All cases showed maxillary skeletal deficiency. (Antero-posterior, or Transverse unilateral/ bilateral posterior cross bite). No history of facial orthopedic or orthognathic treatment before. No craniofacial anomaly or had history of serious craniofacial injuries. No history of serious medical illness such as (heart conditions, organ transplants, immune-compromised health issues, or cancer in patients undergoing chemotherapy or radiation treatments) or chronic diseases such as (Diabetes mellitus). As they are patients highly susceptible to infection which may result in worsening their medical status or even in a fatality in case of absence or inadequacy of precautions and proper pre/post medication coverage. Good oral hygiene and non-smoking habit.  Exclusion Criteria:  Patient with missing or impacted 1st molars Patients with chronic gingival inflammation, gingival recession, or bone resorption. High gag reflex patients