The technique of effective maxillary orthopedic protraction was developed for the maxillary protraction in growing Class III patients at the early permanent dentition. This technique includes seven weeks of the alternate rapid maxillary expansions and contractions (Alt-RAMEC) with the double-hinged expander for the opening of the circumaxillary sutures, and a pair of intraoral springs for the non-compliant maxillary protraction. Experimentally, it has been revealed that Alt-RAMEC opens the circumaxillary sutures wider with more osteoid formation, fibroblasts and collagen fibers oriented in the direction of Alt-RAMEC. Clinically, the maxillae were revealed for an average of 5 to 6 mm of maxillary protraction in six months. This presentation will present both the clinical and experimental evidence for the rationales, treatment timing, devices and long-term results of the effective maxillary orthopedic protraction.
The strategy is to combine the maxillary protraction through alternate rapid maxillary expansions and constriction, extraction of mandibular first premolars, and anterior downward tilt of the maxillary occlusal plane for the backward rotation of the mandible to decrease chin prominence.