Early orthopaedic correction of class III malocclusion with alternate rapid maxillary expansion and Constriction (ALT-RAMEC) and face mask: case report

Class III malocclusion cases are challenging so it has been subject of interest for many orthodontists. It is always advantage to treat at growing stage otherwise camouflage or surgery is required. It has multiple etiological factors like mandibular prognathism or growth excess (macrognathia), maxillary retrognathism or growth deficiency (micrognathia), or a combination of mandibular and maxillary discrepancies. A 12-year-old female patient with a skeletal Class III malocclusion and anterior crossbite without posterior crossbite was treated with Alt-RAMEC protocol which was published by Liou. According to this protocol rapid expansion and contraction of maxilla on an alternating week, this results in loosening of the sutures that connect the maxilla to the surrounding bones without expansion of maxillary arch. Than face mask was used for skeletal class III corrections which was achieved by this protocol within 6 months which is faster compared to contemporary protocol of only expansion.