title: Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class III malocclusion: a controlled study.
abstract: OBJECTIVE
  To assess the effects of a modified alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol in combination with facemask (FM) in Class III growing patients.
  
  
  METHODS
  Thirty one Class III patients (17 males, 14 females) were treated with a modified Alt-RAMEC/FM protocol at the Department of Orthodontics of the University of Florence.
  
  
  METHODS
  All patients were evaluated at the beginning (T1, mean age 6.4 ± 0.8 years) and at the end of orthopedic therapy (T2, mean age 8.1 ± 0.9 years), and they were compared to a matched sample of 31 Class III patients (16 males and 15 females) treated with rapid maxillary expansion and facemask (RME/FM) and to a matched control group of 21 subjects (9 males and 12 females) with untreated Class III malocclusion. The three groups were compared with anova with Benjamini-Hochberg correction for multiple tests.
  
  
  RESULTS
  Both the Alt-RAMEC/FM and the RME/FM protocols showed significantly favorable effects leading to correction of the Class III malocclusion. The Alt-RAMEC/FM protocol produced a more effective advancement of the maxilla (SNA +1.2°) and greater intermaxillary changes (ANB +1.7°) vs. the RME/FM protocol. No significant differences were recorded as for mandibular skeletal changes and vertical skeletal relationships.
  
  
  CONCLUSIONS
  The Alt-RAMEC/FM protocol induced more favorable skeletal short-term effects compared with RME/FM therapy in Class III growing patients.
authors.affiliation: Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Masucci
authors.forename: L
authors.initials: L
authors.lastname: Franchi
authors.forename: V
authors.initials: V
authors.lastname: Giuntini
authors.forename: E
authors.initials: E
authors.lastname: Defraia
mesh_terms: D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002648:Child; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology; D009295:Nasal Bone / Q000473:pathology; D016382:Orthodontic Appliance Design; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010349:Patient Compliance; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology; D016896:Treatment Outcome; D014716:Vertical Dimension
keywords: Angle Class III malocclusion; cephalometry; interceptive treatment