Elvan Onem Ozbilen, Hanife Nuray Yilmaz, Nazan Kucukkeles

Comparison of the effects of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols followed by facemask therapy.

- Korean J Orthod 2019;49:49-58

Q1. The maxillary protraction achieved with use of facemask during the 12 month period was 2.53 mm for the rapid maxillary expansion (RME)/facemask group and 2.73 mm for the alternate rapid maxillary expansion and constriction protocol (Alt-RAMEC)/facemask group, indicating no increased protraction with Alt-RAMEC. When considering the normal growth pattern of the anterior cranial base and accompanying forward displacement of the nasomaxillary complex, the net treatment effect on the maxilla would be less than 2 mm. This may not be enough compensation for wearing facemask 16 hours/day for 12 months. Also, the long-term evaluation regarding the effectiveness of protraction RME/facemask treatment showed that no significant differences were found in the maxillary changes¹ with a lack of maxillary improvement. What is the best indication for RME/facemask or Alt-RAMEC/facemask treatment at the present time?

Q2. Anterior nasal spine moved 1 mm downward only in the Alt-RAMEC/facemask group. This may have affected the sinus volume. What is the reason for increased total and lower pharyngeal airways only in the Alt-RAMEC/facemask group?