Treatment of a skeletal class iii malocclusion using alternate rapid maxillary expansion and constriction (alt-ramec) protocol and facemask- a case report

Alternate rapid maxillary expansion and constriction (Alt-RAMEC) is a very effective procedure before facemask therapy as it loosens the palatal suture very efficiently and prevent unnecessary over-expansion of maxilla. A 12 years old patient reported with retrognathic maxilla with anterior crossbite. Posterior arch width was normal. Alternate rapid maxillary expansion and constriction was done followed by facemask therapy. Forward movement of maxilla has occurred. After skeletal correction fixed mechanotherapy was carried out to correct minor dental discrepancy.