scholarly journals Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review

2016 ◽  
Vol 21 (6) ◽  
pp. 34-42 ◽  
Author(s):  
Matheus Melo Pithon ◽  
Nathalia de Lima Santos ◽  
Camila Rangel Barreto dos Santos ◽  
Felipe Carvalho Souza Baião ◽  
Murilo Costa Rangel Pinheiro ◽  
...  

ABSTRACT Introduction: the treatment of Class III malocclusion in early age is one of the greatest challenges for orthodontists, and the establishment of more effective treatment method is a constant concern for these professionals. Thus, the objective of this systematic review is to verify the effectiveness of the therapy protocol for alternate rapid maxillary expansion and constriction (Alt-RAMEC) in the early treatment of Class III malocclusion. Methods: searches were performed in the following electronic databases: Cochrane Library, Medline (EBSCO and PubMed), SciELO, LILACS and Scopus. The following inclusion criteria were used: in vivo studies conducted with early intervention (patient in craniofacial development phase) with the use of the Alt-RAMEC protocol. Reviews, case reports, editorials, and studies with syndromic patients or under use of systemic drug were excluded. Duplicates were also excluded. The studies were assessed for methodological quality using the Cochrane tool for assessment of risk of bias, and classified as high or low risk of bias. Results: 53 articles were found. Duplicates exclusion was thus performed and 35 articles remained. After inclusion analysis, only 5 matched the criteria. Two articles were classified as low risk of bias and three as high risk of bias. It was observed that the Alt-RAMEC enable protraction in less time and with better results, promoting greater effectiveness in the protraction treatment of Class III malocclusion. Conclusions: Although there is positive evidence of the effectiveness of early treatment with the Alt-RAMEC protocol in patients with Class III malocclusion, further studies are needed to confirm its effectiveness using long-term methodology.

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.


2021 ◽  
Vol 3 (2) ◽  
pp. 30-33
Author(s):  
Sanjana Shetty ◽  
Shilpa Pharande ◽  
Naazia Shaikh

Treating Class III malocclusion is a challenge for orthodontists. It is best to treat it at growing stage with Dentofacial Orthopedics. 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 protocol is an efficient method for early treatment skeletal Class III malocclusion. The objective of this review is to explain to the clinicians a modified and efficient method for treatment of skeletal Class III malocclusion in growing patients.


Author(s):  
Tiziano Baccetti ◽  
Jean S. McGill ◽  
Lorenzo Franchi ◽  
James A. McNamara ◽  
Isabella Tollaro

2013 ◽  
Vol 5 (6) ◽  
pp. 169 ◽  
Author(s):  
Muthukumar Karthi ◽  
GobichettipalayamJagatheeswaran Anbuselvan ◽  
BhandariPawan Kumar

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.


2017 ◽  
Vol 22 (2) ◽  
pp. 35-44 ◽  
Author(s):  
Julia Garcia Costa ◽  
Thaís Magalhães Galindo ◽  
Claudia Trindade Mattos ◽  
Adriana de Alcantara Cury-Saramago

ABSTRACT OBJECTIVE: The aim of this systematic review was to evaluate the duration of the retention period in growing patients undergoing maxillary expansion and its relation with posterior crossbite stability. METHODS: Search strategies were executed for electronic databases Cochrane Library, Web of Science, PubMed and Scopus, which were completed on January 15, 2016. The inclusion criteria included randomized, prospective or retrospective controlled trials in growing subjects with posterior crossbite; treated with maxillary expanders; retention phase after expansion; post-retention phase of at least 6 months. The exclusion criteria were anterior crossbite, craniofacial anomalies, surgery or another orthodontic intervention; case reports; author’s opinions articles, thesis, literature reviews and systematic reviews. The risk of bias of selected articles was assessed with Cochrane risk of bias tool for RCTs and Downs and Black checklist for non-RCTs. RESULTS: A total of 156 titles/abstracts was retrieved, 44 full-texts were examined, and 6 articles were selected and assessed for their methodological quality. The retention period after maxillary expansion ranged between 4 weeks and 16 months. Fixed (acrylic plate, Haas, Hyrax and quad-helix) or removable (Hawley and Hawley expander) appliances were used for retention. CONCLUSIONS: Six months of retention with either fixed or removable appliances seem to be enough to avoid relapse or to guarantee minimal changes in a short-term follow-up.


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