Modified Alt-RAMEC protocol for early treatment of Class III with the DAFI expander

Wanderson ITABORAHY, Rachel Itaborahy COSTA

Objective: This paper aims to describe the steps of the Modified Alt RAMEC Protocol for early correction of Class III malocclusion, as well as to present a case treated by the proposed technique. The protocol is indicated for patients with skeletal Class III, due to maxillary deficiency, in deciduous, mixed or young permanent dentition. Methods: After cementing the DAFI expander (Itaborahy opening and closing expander) on the upper molars, the activation/deactivation phase of the expander is initiated. The device consists of double-hinge expander, with a helicoid-type articulation center, with TMA wire, which maintains the parallelism of expansion, and a hook in the canines region to enable the use of extraoral elastics. After 7 weeks of opening and closure of the expander, the use of Petit reverse traction mask is started, which must be used until an overjet of 3 to 4 mm is reached. After completion of maximum protection, 4x2 leveling is placed using crossed elastics with Class III vector, for simultaneous maintenance of the Class I or II relationship, depending on each case and on the transverse expansion achieved. Retainer after the orthodontic phase is essential. Results: In the present clinical case, there was significant improvement in the SNA and ANB angles and Witts and Overjet measurements, as well as reduction in the inclination and protrusion of the upper and lower incisors. Conclusion: It was concluded that the Modified Alt RAMEC Protocol is an effective and minimally invasive therapy in the treatment of Class III in children.

Keywords: Malocclusion, Angle Class III. Palatal expansion technique. Orthodontics.

How to cite: Itaborahy W, Costa RI. Modified Alt-RAMEC protocol for early treatment of Class III with the DAFI expander. Clin Orthod. 2020 Oct-Nov;19(5):101-14.

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