Evaluate skeletal, dental, and facial post-treatment changes in patients with class III malocclusion, due to maxillary deficiency treated with fixed appliances to create maxillary traction.
Method:
Three clinical cases treated with Alt-RAMEC Protocol and maxillary protraction are presented. Alt-RAMEC protocol involves placing an expansion screw to alternate contraction and expansion of the maxilla, rapid palatal expansion (RPE) took place during 7 days by activating the screw 1 mm per day, contraction then took place during 7 days activating 1 mm per day, this for a total of 7–9 weeks depending on the case. At the end of the last expansion a lingual splint was cemented and with SAIF springs a force of 300 gr. was applied on each side to traction the maxilla. In T1 (initial), T2 (when the expander was removed), and T3 (one month after Expander removal) x-rays (posteroanterior and lateral) and study models were taken to evaluate bone changes.
Result:
Skeletal tissue: A mild posteroanterior correction was obtained with good vertical control of the mandibular plane. Dental tissue: Dentoalveolar changes were obtained until reaching a class II overcorrection. Soft tissue: An outstanding esthetic improvement was achieved by increasing the facial convexity and upper lip protrusion.
Conclusion:
This protocol treatment represents a viable alternative to successfully treat class III malocclusions in growing patients, with mild cooperation.