Abstract
Maxillary deficiency is a common problem in orthodontic patients. A possibility to increase the skeletal effects of Class III treatment on the maxillae is the Alternative Rapid Maxillary Expansion and Constriction (Alt-RAMEC) method introduced by Liou, that progresses maxillae's effectiveness in relation to the adjacent sutures and its enhancement. Likewise, MARPE has become gradually popular in the management of transverse discrepancies compared to the traditional expansion approach, due to its amplified skeletal effects. The present study aims at reviewing the existing literature on the AltRAMEC protocol and Maxillary skeletal expansion, or Mini-screw-assisted rapid palatal expansion (MARPE) Appliance, and at evidencing relevant differences between them. A search of relevant evidence was undertaken using SCOPUS, EMBASE and PUBMED (MEDLINE) databases, and most appropriate key terms were used to retrieve rhe suitable studies. The results obtained indicate that MARPE is a valid substitute to surgery in patients with multifaceted craniofacial discrepancies, while securing the stability and safety of the transverse correction. To avoid surgery, nonsurgical maxillary developments can be done to accomplish both dentoalveolar as well as skeletal expansion for transverse correction. Literature suggests positive indication on the efficacy of the early treatment with the Alt-RAMEC protocol in individuals with Class III malocclusion, but further studies are required to confirm its effectiveness over long-term.