Early Treatment of Class III Malocclusion Using Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) Protocol with Facemask Therapy: A Case Report

Abstract

Orthodontists face difficulty when it comes to treating Class III malocclusion. It is best to treat it at the growing stage with dentofacial orthopedics. Maxillary protraction using the Alternate Rapid Maxillary Expansion and Contraction (Alt-RAME) technique is an effective approach for treating skeletal Class III malocclusion at an early age. A 9-year-old female patient came to the Department of Orthodontics with a complaint of backwardly placed upper teeth and un-aesthetic dental as well as facial appearance. Intraoral examination revealed an anterior cross-bite of 1 mm. Molar relation was class III on the right side and super Class I on the left side. Slight crowding in lower arch and spacing in maxillary arch due to unerupted teeth was seen. The patient was diagnosed with Class III skeletal pattern associated with maxillary retrusion, average growth pattern, Class III molar relation on right side, super Class I molar relation on left side and a protrusive lower lip. The early treatment of such cases is essential, so that maxillary retrusion can be corrected with the help of orthopedic intervention. It was decided that the correction of skeletal Class III malocclusion will be done using Alt-RAMEC protocol along with facemask. Use of Alt-RAMEC protocol for correction of Class III malocclusion due to maxillary retrusion can help in early correction of Class III skeletal pattern and helps improving overall profile of the patient. This case report shows the result of using a hyrax bonded maxillary expander with Alt-RAMEC protocol along with a facemask to treat a Class III malocclusion associated with maxillary hypoplasia. A 9-year-old patient with skeletal class III malocclusion and anterior crossbite was treated using this protocol.