Korean J Orthod.  2023 Jan;53(1):54-64. 10.4041/kjod21.337.

Correction of late adolescent skeletal Class III using the Alt-RAMEC protocol and skeletal anchorage

• Büyükçavuş MH
• Sari
• Findik Y

• KMID: 2538713
• DOI: http://doi.org/10.4041/kjod21.337

Abstract

This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

Keyword

Face mask; Class III treatment; Miniplate; Alt-RAMEC

Figure

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  Figure 1 Facial and intraoral photographs taken at the initial visit (age: 16 years, 7 months).

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  Figure 2 Lateral and posteroanterior cephalographs, and panoramic radiograph taken at the initial visit (age: 16 years, 7 months).

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  Figure 3 Growth-development period (hand-wrist and cervical vertebrae) at the patient’s initial visit.

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  Figure 4 Post-protraction lateral cephalograph and panoramic radiograph.

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  Figure 5 Post-protraction facial and intraoral photographs.

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  Figure 6 Treatment stages. Alt-RAMEC, alternate rapid maxillary expansion and constriction; RME, rapid maxillary expansion.

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  Figure 7 Facial and intraoral photographs taken at the debond visit (age: 17 years, 9 months).

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  Figure 8 Lateral and posteroanterior cephalographs, and panoramic radiograph taken at the debond visit (age: 17 years, 9 months).

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  Figure 9 Initial (A) and post-protraction (B) three dimensional (3D) photographs and (C) 3D volumetric tracing on the 3D photographs.

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  Figure 10 Facial and intraoral photographs taken 6 months after debonding (age: 18 years, 3 months).

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  Figure 11 Facial and intraoral photographs taken 2 years after debonding (age: 19 years, 9 months).

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  Figure 12 Lateral cephalograph, hand wrist radiograph, and panoramic radiograph taken 2 years after debonding (age: 19 years, 9 months).

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  Figure 13 Cephalometric superimpositions.

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