Nonsurgical Treatment of a Class III Patient with Alt-RAMEC Protocol and Facemask Therapy.

Class III malocclusion has been the subject of interest in many investigations because of the challenges in its treatment. The skeletal manifestation can be due to mandibular anterior positioning (prognathism) or growth excess (macrognathia), maxillary posterior positioning (retrognathism) or growth deficiency (micrognathia), or a combination of mandibular and maxillary discrepancies. A 15-year-old Asian with a skeletal Class III malocclusion and a severe anterior crossbite was treated with Alt-RAMEC protocol designed to loosen the sutures that connect the maxilla to the surrounding bones via rapid expansion and contraction on an alternating weekly basis and facemask therapy. An Angle Class I molar relationship was achieved with canine protected occlusion and incisal guidance. A wrap-around retainer was placed on the maxillary arch and a lingual bonded retainer on the mandibular arch. Treatment time was 30 months. [ABSTRACT FROM AUTHOR]