title: Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review.
abstract: 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.
  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.
  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.
  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.
authors.affiliation: Professor, Department of Orthodontics, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Matheus Melo
authors.initials: MM
authors.lastname: Pithon
authors.affiliation: Graduation student in Dentistry, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Nathalia de Lima
authors.initials: NL
authors.lastname: Santos
authors.affiliation: Graduation student in Dentistry, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Camila Rangel Barreto Dos
authors.initials: CR
authors.lastname: Santos
authors.affiliation: Graduation student in Dentistry, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Felipe Carvalho Souza
authors.initials: FC
authors.lastname: Baião
authors.affiliation: Professor, Dental Prosthesis Department, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Murilo Costa Rangel
authors.initials: MC
authors.lastname: Pinheiro
authors.affiliation: Professor, Department of Endodontics, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Manoel
authors.initials: M
authors.lastname: Matos
authors.affiliation: Professor, Dental Prosthesis Department, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Ianderlei Andrade
authors.initials: IA
authors.lastname: Souza
authors.affiliation: Professor of Physical Therapy, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil.
authors.forename: Rafael Pereira de
authors.initials: RP
authors.lastname: Paula
mesh_terms: D006801:Humans; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D010155:Palatal Expansion Technique; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome