Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class III malocclusion: a controlled study

Orthod Craniofac Res. 2014 Nov;17(4):259-69. doi: 10.1111/ocr.12051. Epub 2014 Jul 7.

Abstract

Objectives: To assess the effects of a modified alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol in combination with facemask (FM) in Class III growing patients.

Setting and sample population: Thirty one Class III patients (17 males, 14 females) were treated with a modified Alt-RAMEC/FM protocol at the Department of Orthodontics of the University of Florence.

Material and methods: All patients were evaluated at the beginning (T1, mean age 6.4 ± 0.8 years) and at the end of orthopedic therapy (T2, mean age 8.1 ± 0.9 years), and they were compared to a matched sample of 31 Class III patients (16 males and 15 females) treated with rapid maxillary expansion and facemask (RME/FM) and to a matched control group of 21 subjects (9 males and 12 females) with untreated Class III malocclusion. The three groups were compared with anova with Benjamini-Hochberg correction for multiple tests.

Results: Both the Alt-RAMEC/FM and the RME/FM protocols showed significantly favorable effects leading to correction of the Class III malocclusion. The Alt-RAMEC/FM protocol produced a more effective advancement of the maxilla (SNA +1.2°) and greater intermaxillary changes (ANB +1.7°) vs. the RME/FM protocol. No significant differences were recorded as for mandibular skeletal changes and vertical skeletal relationships.

Conclusion: The Alt-RAMEC/FM protocol induced more favorable skeletal short-term effects compared with RME/FM therapy in Class III growing patients.

Keywords: Angle Class III malocclusion; cephalometry; interceptive treatment.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Case-Control Studies
  • Cephalometry / methods
  • Child
  • Extraoral Traction Appliances*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Malocclusion, Angle Class III / therapy*
  • Mandible / pathology
  • Maxilla / pathology
  • Nasal Bone / pathology
  • Orthodontic Appliance Design
  • Palatal Expansion Technique* / instrumentation
  • Patient Compliance
  • Retrospective Studies
  • Sella Turcica / pathology
  • Treatment Outcome
  • Vertical Dimension