Treatment of skeletal class III malocclusion with the Alt-RAMEC protocol and intermaxillary elastics : A retrospective cohort study.

Abstract

Purpose: This study aimed to evaluate the effects of the use of class III elastics with fixed appliances and the Alt-RAMEC procedure on dentofacial structures in patients diagnosed with skeletal class III malocclusion.

Methods: The retrospective cohort study was performed on lateral cephalometric radiographs of 20 individuals (7 girls, 13 boys; mean chronological age 12.41 years) with skeletal class III malocclusion because of maxillary deficiency or maxillary deficiency and mandibular excess which were treated by using the Alt-RAMEC protocol and class III elastics. The patients were chosen from the archive of Gazi University Faculty of Dentistry, Department of Orthodontics. In order to distinguish between growth-related changes and the effects of treatment, results were compared with a control group consisting of 20 individuals (8 girls, 12 boys; mean chronological age 12 years) with similar skeletal characteristics.

Results: In the treatment group, there were significant increases of 2.2°, 4.2° and 1° in the SNA, ANB and SN/GoGN angles, respectively, in contrast to the control group (p < 0.001). There was also a significant decrease of 1.9° in the SNB angle within the treatment group in contrast to the control group (p < 0.001). While the U1/SN angle increased by 1.4° in the treatment group, the L1-NB distance decreased by 0.7 mm (p < 0.01).

Conclusions: The results of this study showed that application of the Alt-RAMEC protocol and class III elastics with fixed appliances showed successful results in the management of skeletal class III malocclusions, while avoiding undesirable dental effects, such as excessive lingual tipping of the lower incisors.