Am J Orthod Dentofacial Orthop. 2018 Feb;153(2):262-268. doi: 10.1016/j.ajodo.2017.06.022.
INTRODUCTION: The purpose of this study was to describe the skeletal and dentoalveolar changes in a group of growing skeletal Class III patients treated with hybrid rapid palatal expansion and facemask.
METHODS: Twenty-eight growing patients with skeletal Class III malocclusion were treated using a rapid maxillary expander with hybrid anchorage according to the ALT-Ramec protocol (SKAR III; E.P.), followed by 4 months of facemask therapy. Palatal miniscrew placement was accomplished via digital planning and the construction of a high-precision, individualized surgical guide. Pretreatment and posttreatment cephalometric tracings were analyzed, comparing dental and skeletal measurements.
RESULTS: Point A advanced by a mean of 3.4 mm with respect to the reference plane Vert-T. The mandibular plane rotated clockwise, improving the ANB (+3.41°) and the Wits appraisal (+4.92 mm). The maxillary molar had slight extrusion (0.42 mm) and mesialization (0.87 mm).
CONCLUSIONS: The use of a hybrid-anchorage expander followed by 4 months of facemask treatment improves the skeletal Class III relationship with minimal dental effects, even in older patients (mean age, 11 years 4 months, ± 2.5 years).