Dentofacial Effects of Modified Alt-RAMEC Protocol Combined with the Facial Mask for Treatment of Preadolescent Caucasian Class III Patients

Abstract

IntroductionIn this study we analyzed dentoskeletal effects of orthopedic therapy with rapid palatal expander (RME), used according to modified Alt-RAMEC protocol, followed by facial mask in preadolescent patients with class III malocclusion.Materials and methodsThe sample consisted of 10 patients treated consecutively with the alternate rapid maxillary expansions and constrictions (Alt-RAMEC) protocol and facial mask before the pubertal growth spur the patients were re-evaluated after about one year of treatment. We compared the cephalometric analyses at T0 (before the treatment) and T1 (just after the end of the treatment—about 1 year), evaluating 18 parameters. The normality of each distribution was assessed with D’Agostino-Pearson normality test and significative differences between T0 and T1 were assessed with paired t test (p < 0.05).ResultsSagittal measurements of the maxilla (SNpSNa distance) showed significant improvements (p < 0.0001) with protraction effect at point A. Significant improvements were recorded also at Wits appraisal and overjet. Measures of the mandibular growth (Co-Gn) showed increased values at T1, as well as vertical dimension (SNpSNa-GoGn). No significant variations were recorded at the dental parameters.ConclusionThis protocol induces important skeletal effects, like advancement of the maxilla, also in preadolescent patients, while dental changes are minimal. Alt-RAMEC protocol seem to modulate maxillary development in patients near the pubertal growth spurt.How to cite this articleRota E, Ferrari M, et al. Dentofacial Effects of Modified Alt-RAMEC Protocol Combined with the Facial Mask for Treatment of Preadolescent Caucasian Class III Patients. Int J Clin Pediatr Dent 2019;12(3):222–228.

Effects of Alt-RAMEC protocol with facemask therapy in cleft lip palate patients in a sample of Pakistani population

“…When the maxillary sutures were activated using the Alt-RAMEC approach, the maxilla advanced approximately twice as much as with typical RME or FM therapy. When assessed, the maxilla extended forward, anteriorly, significantly further, which relieved the patients from needing a future orthodontic and orthognathic surgery by overcompensating the maxilla's position [ 26 , 27 ]. A CBCT study evaluated the effects of the Alt-RAMEC procedure on the maxilla, soft tissue, and airway indicated a slight forward (0.89 mm) and downward (0.92 mm) movement of point A [ 28 ].…”