Case Report
Treatment of a Patient with Maxillary Retrognathism and Mandibular Prognathism Using Alt-RAMEC and Facemask Followed by Fixed Orthodontic Therapy: A Case Report
Abstract
This case report presents the treatment of a 10-year and 2-month-old male patient with skeletal Class III malocclusion and anterior crossbite using the Alt-RAMEC protocol combined with facemask protraction followed by fixed orthodontic therapy. The facemask protraction was initiated while the maxillary expansion and constriction phases of the Alt-RAMEC protocol were ongoing. Clinical findings and cephalometric analyses were evaluated before and after treatment. The treatment results showed that Class I canine and molar relationships were achieved on both sides, with normal overjet and overbite. Additionally, improvements were observed in the patient’s profile, occlusion, and aesthetic appearance. This case report demonstrates that the Alt-RAMEC protocol combined with facemask is an effective method for treating skeletal Class III malocclusion.
Keywords
References
- 1. Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod. 1986;56(1):7-30. doi:10.1043/0003-3219(1986)056<0007:COCIMI>2.0.CO;2
- 2. Ngan PW, Hagg U, Yiu C, Wei SH. Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod. 1997;3(4):255-264. doi:10.1016/s1073-8746(97)80058-8
- 3. Liou EJW. Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis. Prog Orthod. 2005;6(2):154-171.
- 4. Isci D, Turk T, Elekdag-Turk S. Activation-deactivation rapid palatal expansion and reverse headgear in Class III cases. Eur J Orthod. 2010;32(6):706-715. doi:10.1093/ejo/cjq006
- 5. da Luz Vieira G, de Menezes LM, de Lima EMS, Rizzatto S. Dentoskeletal effects of maxillary protraction in cleft patients with repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2009;46(4):391-398. doi:10.1597/07-144.1
- 6. Masucci C, Franchi L, Giuntini V, Defraia E. Short‐term effects of a modified A lt‐ RAMEC protocol for early treatment of C lass III malocclusion: a controlled study. Orthod Craniofac Res. 2014;17(4):259-269. doi:10.1111/ocr.12051
- 7. Do-deLatour TB, Ngan P, Martin CA, Razmus T, Gunel E. Effect of alternate maxillary expansion and contraction on protraction of the maxilla: a pilot study. Hong Kong Dent J. 2009;6(2):72-82.
- 8. Wilmes B, Ngan P, Liou EJ, Franchi L, Drescher D. Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol. J Clin Orthod. 2014;48:84-93.
- 9. Liu W, Zhou Y, Wang X, Liu D, Zhou S. Effect of maxillary protraction with alternating rapid palatal expansion and constriction vs expansion alone in maxillary retrusive patients: a single-center, randomized controlled trial. Am J Orthod Dentofacial Orthop. 2015;148(4):641-651.
- 10. Canturk BH, Celikoglu M. Comparison of the effects of face mask treatment started simultaneously and after the completion of the alternate rapid maxillary expansion and constriction procedure. Angle Orthod. 2015;85(2):284-291.
- 11. Castrillón-Marín RA, Barbosa-Liz DM, Ardila CM. Treatment of Class III malocclusion using Hybrid Hyrax, Face Mask and Alt-RAMEC Protocol: A Case Report in a Latin-American patient. J Clin Exp Dent. 2019;11(7):e665-e669. doi:10.4317/jced.55939
- 12. Kaya D, Kocadereli I, Kan B, Tasar F. Effects of facemask treatment anchored with miniplates after alternate rapid maxillary expansions and constrictions; a pilot study. Angle Orthod. 2011;81(4):639-646. doi:10.2319/081010-473.1
- 13. Vardimon AD, Graber TM, Voss LR, Lenke J. Determinants controlling iatrogenic external root resorption and repair during and after palatal expansion. Angle Orthod. 1991;61(2):113-122.
- 14. Pithon MM, Santos N de L, Santos CRBD, et al. Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review. Dent Press J Orthod. 2016;21(6):34-42. doi:10.1590/2177-6709.21.6.034-042.oar
- 15. Meazzini MC, Zappia LB, Tortora C, Autelitano L, Tintinelli R. Short- and Long-Term Effects of Late Maxillary Advancement With the Liou-Alt-RAMEC Protocol in Unilateral Cleft Lip and Palate. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2019;56(2):159-167. doi:10.1177/1055665618772395
Maksiller Retrognatik ve Mandibular Prognatik Hastanın Alt-RAMEC ve Yüz Maskesini Takiben Sabit Ortodontik Tedavisi: Vaka Sunumu
Abstract
Bu vaka sunumunda, iskeletsel sınıf III ve anterior çaprraz kapanışlı 10 yıl 2 ay yaşındaki bir erkek hastanın henüz Alt-RAMEC protokolündeki maksiller genişletme ve daraltmalar devam ederken başlatılan yüz maskesi ile protraksiyonu ve takiben yapılan sabit ortodontik tedavisi sunulmaktadır. Tedavi öncesi ve sonrası klinik bulgular ile sefalometrik analizler değerlendirilmiştir. Tedavi sonucunda, sağ ve sol kaninler ve molarların sınıf I ilişkiye getirildiği, normal overjet ve overbite sağlandığı ve hastanın profilinin, oklüzyonunun ve estetik görünümünün iyileştirildiği gözlenmiştir. Bu vaka sunumu, Alt-RAMEC ile birlikte yüz maskesi protokolünün iskeletsel sınıf III maloklüzyon tedavisinde etkili bir yöntem olduğunu göstermektedir.
Anahtar Kelimeler
Alt-RAMEC, yüz maskesi, anterior çapraz kapanış
Keywords
References
- 1. Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod. 1986;56(1):7-30. doi:10.1043/0003-3219(1986)056<0007:COCIMI>2.0.CO;2
- 2. Ngan PW, Hagg U, Yiu C, Wei SH. Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod. 1997;3(4):255-264. doi:10.1016/s1073-8746(97)80058-8
- 3. Liou EJW. Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis. Prog Orthod. 2005;6(2):154-171.
- 4. Isci D, Turk T, Elekdag-Turk S. Activation-deactivation rapid palatal expansion and reverse headgear in Class III cases. Eur J Orthod. 2010;32(6):706-715. doi:10.1093/ejo/cjq006
- 5. da Luz Vieira G, de Menezes LM, de Lima EMS, Rizzatto S. Dentoskeletal effects of maxillary protraction in cleft patients with repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2009;46(4):391-398. doi:10.1597/07-144.1
- 6. Masucci C, Franchi L, Giuntini V, Defraia E. Short‐term effects of a modified A lt‐ RAMEC protocol for early treatment of C lass III malocclusion: a controlled study. Orthod Craniofac Res. 2014;17(4):259-269. doi:10.1111/ocr.12051
- 7. Do-deLatour TB, Ngan P, Martin CA, Razmus T, Gunel E. Effect of alternate maxillary expansion and contraction on protraction of the maxilla: a pilot study. Hong Kong Dent J. 2009;6(2):72-82.
- 8. Wilmes B, Ngan P, Liou EJ, Franchi L, Drescher D. Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol. J Clin Orthod. 2014;48:84-93.
- 9. Liu W, Zhou Y, Wang X, Liu D, Zhou S. Effect of maxillary protraction with alternating rapid palatal expansion and constriction vs expansion alone in maxillary retrusive patients: a single-center, randomized controlled trial. Am J Orthod Dentofacial Orthop. 2015;148(4):641-651.
- 10. Canturk BH, Celikoglu M. Comparison of the effects of face mask treatment started simultaneously and after the completion of the alternate rapid maxillary expansion and constriction procedure. Angle Orthod. 2015;85(2):284-291.
- 11. Castrillón-Marín RA, Barbosa-Liz DM, Ardila CM. Treatment of Class III malocclusion using Hybrid Hyrax, Face Mask and Alt-RAMEC Protocol: A Case Report in a Latin-American patient. J Clin Exp Dent. 2019;11(7):e665-e669. doi:10.4317/jced.55939
- 12. Kaya D, Kocadereli I, Kan B, Tasar F. Effects of facemask treatment anchored with miniplates after alternate rapid maxillary expansions and constrictions; a pilot study. Angle Orthod. 2011;81(4):639-646. doi:10.2319/081010-473.1
- 13. Vardimon AD, Graber TM, Voss LR, Lenke J. Determinants controlling iatrogenic external root resorption and repair during and after palatal expansion. Angle Orthod. 1991;61(2):113-122.
- 14. Pithon MM, Santos N de L, Santos CRBD, et al. Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review. Dent Press J Orthod. 2016;21(6):34-42. doi:10.1590/2177-6709.21.6.034-042.oar
- 15. Meazzini MC, Zappia LB, Tortora C, Autelitano L, Tintinelli R. Short- and Long-Term Effects of Late Maxillary Advancement With the Liou-Alt-RAMEC Protocol in Unilateral Cleft Lip and Palate. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2019;56(2):159-167. doi:10.1177/1055665618772395
There are 15 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Orthodontics and Dentofacial Orthopaedics |
| Journal Section | Case Report |
| Authors | |
| Publication Date | April 21, 2025 |
| Submission Date | August 1, 2024 |
| Acceptance Date | October 15, 2024 |
| Published in Issue | Year 2025 Volume: 12 Issue: 1 |
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