Intraoral Maxillary Protraction Technique vs Facemask Using Alt-RAMEC Protocol for Treatment Class III Growing Patients

Intraoral Maxillary Protraction Technique With ALT-RAMEC ( Alternate Rapid Maxillary Expansion and Constriction) Protocol Versus Facemask With Maxillary Expansion in Treating Class III Growing Patients With Maxillary Deficiency: A Randomized Clinical Trial

The study compares use of intraoral technique for maxillary advancement and extra oral technique with hep of protocol called Alt-RAMEC which depends on repeated expansion and constriction of maxilla to help in maxillary protraction

Delivering hybrid expander supported by 2 miniscrews in palate to perform Alt-RAMEC protocol for 9 weeks then intervention group will start protraction using class iii elastics on modified lingual arch with hooks in canine area and 2 miniscrews labially between lower lateral and canine while control group use face mask for protraction of maxilla

Inclusion Criteria:

• Male or Female Growing Patient ( CVM2-CVM3 )
• Skeletal class III (ANB ≤ 0 , A-NV≤ -2 and wits appraisal < -0.3mm)
• Erupted upper and lower first permanent molars and permanent incisors
• Reverse overjet up to -4 mm

Exclusion Criteria:

• History of previous orthodontic treatment
• Cleft lip/palate patients
• Patients with habits that are detrimental to dental occlusion (thumb sucking, tongue thrusting).
• Patients with syndromes