Long-term follow-up of late maxillary orthopedic advancement with the Liou-Alternate rapid maxillary expansion-constriction technique in patients with skeletal Class III malocclusion

Author(s):  
Maria Costanza Meazzini ◽  
Camilla Torre ◽  
Alessandro Cappello ◽  
Roberto Tintinelli ◽  
Elena De Ponti ◽  
...  
2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2007 ◽  
Vol 77 (5) ◽  
pp. 870-874 ◽  
Author(s):  
Roberto M. A. Lima Filho ◽  
Antonio C. O. Ruellas

Abstract Objective: To evaluate a 10-year follow-up of anteroposterior and vertical maxillary changes in skeletal Class II patients treated with slow and rapid maxillary expansion methods. Materials and Methods: The sample consisted of 70 patients divided into two groups: (1) treated with a cervical headgear with expansion of the inner bow (CHG) and (2) using a Haas-type rapid maxillary expansion appliance in conjunction with cervical headgear (RME-CHG). The CHG group consisted of 40 patients (18 males and 22 females; average age 10.6 years at pretreatment [T1], 13.6 years at posttreatment [T2], and 23.6 years at postretention [T3]). The RME-CHG group consisted of 30 patients (14 males and 16 females; average age 10.4 years at T1, 14.0 years at T2, and 24.6 years at T3). The profiles of SNA and SN-PP angles showed no significant differences in either group at T1, T2, and T3 phases. Results: For the entire sample, the profile analysis between the phases showed reduction in the SNA angle from T1–T2 and an increase from T2–T3. The SN-PP angle showed an increase from T1–T2 and a decrease from T2–T3. Treatment of skeletal Class II patients with slow and rapid maxillary expansions was efficient and stable over the long-term. Conclusions: The profiles of SNA and SN-PP at T1, T2, and T3 achieved with slow and rapid maxillary expansions were clinically equivalent.


2018 ◽  
Vol 20 (2) ◽  
pp. 31-37
Author(s):  
Hilda Alejandra Bedolla-Gaxiola DDS ◽  
David Garrigós-Esparza DDS ◽  
Juan Carlos Hernández-Cabanillas DDS, MS ◽  
Miguel Ángel Rosales-Berber DDS ◽  
Amaury Pozos-Guillén DDS, PhD ◽  
...  

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.


2018 ◽  
Vol 20 (2) ◽  
pp. 31-37
Author(s):  
Hilda Alejandra Bedolla-Gaxiola DDS ◽  
David Garrigós-Esparza DDS ◽  
Juan Carlos Hernández-Cabanillas DDS, MS ◽  
Miguel Ángel Rosales-Berber DDS ◽  
Amaury Pozos-Guillén DDS, PhD ◽  
...  

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.


2021 ◽  
Vol 11 (18) ◽  
pp. 8393
Author(s):  
Veronica Giuntini ◽  
Matteo Camporesi ◽  
Valeria Barone ◽  
Matilde Marino Merlo ◽  
Cosimo Nardi ◽  
...  

The aim of this study was to compare the efficacy of early treatment of Class III malocclusions with rapid maxillary expansion (RME) and facial mask (FM) versus the removable mandibular retractor (RMR) re-evaluated at a postpubertal observation on lateral cephalograms. All prepubertal patients with Class III malocclusion treated consecutively from 1986 to 2013 by means of RME/FM or RMR were analyzed. Twenty-nine patients treated with RME/FM therapy and 23 patients treated with RMR were selected. Lateral cephalograms were available at 3 time points, before treatment (T1), at the end of active treatment (T2), and at a postpubertal observation (T3). Statistical comparisons were performed with independent sample t tests or Mann–Whitney tests. During the T1–T3 interval, a significantly greater maxillary protraction (SNA +1.5 mm, p = 0.031) and significantly greater improvements in ANB and Wits appraisal (+1.9 degrees, p = 0.002, and +2.2 mm, p = 0.012, respectively) were recorded in the RME/FM group. No statistically significant changes could be found in vertical skeletal measurements. In the dentoalveolar region, the RME/FM group showed a significantly greater correction of the molar relationship (−1.5 mm, p = 0.021). Early treatment of Class III malocclusion with RME/FM protocol in comparison with RMR protocol showed a greater maxillary advancement and greater improvements in sagittal skeletal Class III relationships.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247027
Author(s):  
Wei-Cheng Lee ◽  
Yi-Shing Shieh ◽  
Yu-Fang Liao ◽  
Cho-Hao Lee ◽  
Chiung Shing Huang

Background Maxillary protraction with or without expansion is a widely known orthopedic treatment modality in growing skeletal Class III patients. However, limited data are available regarding the outcomes of long-term changes in the maxilla. Aim of this meta-analysis was to assess the effectiveness of the long-term maxillary anteroposterior changes following a facemask therapy with or without rapid maxillary expansion in growing skeletal Class III patients. Methods A comprehensive literature search was conducted using the databases of PubMed, Science Direct, Web of Science, and Embase. Randomized controlled trials and cohort studies, published up to Sep. 2020, with maxillary protraction and/or expansion as keywords were included in this meta-analysis. Risk of bias within and across studies were assessed using the Cochrane tools (RoB2.0 and ROBINS-I) and GRADE approach. Overall and subgroup comparisons with the random-effect model were performed in this meta-analysis. Meta-regression models were designed to determine potential heterogeneity. Results There was a statistically significant increase (Mean difference, 2.29°; 95% confidence interval, 1.86–2.73; and p < 0.001 after facemask (FM) protraction. Mean difference, 1.73°; 95% confidence interval, 1.36–2.11; and p < 0.001 after rapid maxillary expansion(RME) and facemask protraction) in the Sella-Nasion-A point (SNA) angle in the treatment groups as compared with the control groups, when measured during the less than 3-year follow-up period. However, no statistically significant changes (Mean difference, 0.28°; 95% confidence interval, -0.57–1.13; and p = 0.52 after facemask protraction. Mean difference, 0.34°; 95% confidence interval, -0.64–1.33; and p = 0.50 after rapid maxillary expansion and facemask protraction) were observed in the SNA angle in the groups, when measured after 3 years of follow-up. Meta-regression analysis also showed that with increased follow-up duration, the effectiveness of maxillary protraction decreased. Conclusion This meta-analysis revealed that maxillary protraction therapy could be effective for a short-term in correcting maxillary hypoplasia and the treatment result was not affected by mean age and sex. However, with increased follow-up duration, the sagittal maxillary changes gradually decreased. Limitations on this review were only the SNA angle was used and clinical heterogeneity was not discussed. The quality of evidence was moderate. Further long-term observational studies are necessary for a comprehensive evaluation of the effects on maxillary skeletal changes.


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