Three-dimensional evaluation of treatment results of the Alt-RAMEC and facemask protocol in growing patients

Abstract

Purpose The aim of this retrospective study was to evaluate the skeletal, dental, and soft tissue effects of the alternating rapid maxillary expansions and constrictions (Alt-RAMEC) protocol combined with a facemask in prepubertal patients. Methods The study group (mean age 9.74 +/- 1.46 years) consisted of 20 patients with class III malocclusion characterized by maxillary retrognathism. They were treated with a facemask for 7 months following a 9-week Alt-RAMEC protocol. Cone-beam computed tomography (CBCT) records and three-dimensional (3D) photographs taken before (T0) and after the protraction and retention period (T1) were evaluated. The study group was compared with a well-matched control group of 16 untreated patients (mean age 9.44 +/- 0.79 years) with the same malocclusion. The records for the control group included cephalometric radiographs and 3D photographs. Results In the study group, significant forward movements of A point (3.49 mm), nasal (2.91 mm) and zygomatic bones were achieved. Intermolar, internasal, and interzygomatic widths increased. Soft tissue points followed the hard tissue movements, apart from b and pog. In the control group, A (0.97 mm), B (1.69 mm), Pog, and b points presented forward movement. Significant differences were found regarding the forward movement of the maxilla between the groups. Conclusion The Alt-RAMEC/facemask protocol was effective not only in the maxillary region but also in the midface.