| Summary: | Introduction: Various prostheses have been tried for intermediate restoration of esthetics, function, and speech in cleft patients but are usually associated with frequent breakages and oral hygiene problems. Hence, this modified arch holding appliance was designed to simultaneously replace the missing anterior teeth and stabilize the transverse changes in the maxillary arch, so as to restore the form and esthetics. Fabrication: Pickup impression with the molar bands was recorded; casts were poured in type III dental stone. Palatal arch holding appliance was fabricated and soldered to the molar bands on the first molars. Stainless steel wires were soldered vertically over labial aspect of the arch holding appliance forming plus (+)-shaped attachment, at positions of missing teeth. Acrylic teeth matching the patient's teeth were selected and adapted over this plus attachment and acrylized. Conclusion: This appliance may provide dual benefits to cleft lip and palate patients by restoration of esthetics while maintaining the transverse changes. It is easy to fabricate, durable, economical, and esthetically acceptable to the patient.
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