10.6084/m9.figshare.7128539.v2 Mohammed Almuzian Mohammed Almuzian Elise McConnell Elise McConnell M. Ali Darendeliler M. Ali Darendeliler Fahad Alharbi Fahad Alharbi Hisham Mohammed Hisham Mohammed The effectiveness of alternating rapid maxillary expansion and constriction combined with maxillary protraction in the treatment of patients with a class III malocclusion: a systematic review and meta-analysis Taylor & Francis Group 2018 Systematic review meta-analysis Alt-RAMEC protraction facemask palatal expansion class III RCTs 2018-12-07 09:05:52 Journal contribution https://tandf.figshare.com/articles/journal_contribution/The_effectiveness_of_Alt-RAMEC_combined_with_maxillary_protraction_in_the_treatment_of_patients_with_a_class_III_malocclusion_a_systematic_review_and_meta-analysis/7128539 <p><b>Objectives:</b> To establish the effectiveness of Alternate Rapid Maxillary Expansion and Constriction combined with Protraction Facial Mask (Alt-RAMEC/PFM) approach in treating Class III growing patients compared with PFM combined with conventional Rapid Maxillary Expansion (RME/PFM).</p> <p><b>Search sources</b>: Unrestricted search in five electronic databases and manual searching were undertaken up to February 2018.</p> <p><b>Data selection</b>: Randomised clinical trials (RCTs) evaluating the effectiveness of Alt-RAMEC/PFM were selected.</p> <p><b>Data extraction</b>: Screening of references, data extraction and assessment of bias risk were evaluated independently by two reviewers.</p> <p><b>Results:</b> Five RCTs comparing the Alt-RAMEC/PFM with RME/PFM met the inclusion criteria. Small but statistically significant mean differences favouring Alt-RAMEC/PFM protocol as measured by SNA angle (1.16°; 95% CI 0.65 to 1.66), SNB angle (0.67°; 95% CI 0.32 to 1.02) and ANB angle (0.66°; 95% CI 0.08 to 1.25) were noted. Alt-RAMEC/PFM exhibited a more favourable overjet correction when compared to RME/PFM, however, differences in other dental changes were insignificant.</p> <p><b>Conclusion:</b> There is limited evidence with high risk of bias that Alt-RAMEC/PFM can result in a statistically significant increase in maxillary protraction compared with RME/PFM in Chinese subjects over the short-term. High-quality long-term RCTs with inclusion of patient-reported outcomes are required.</p>