Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis.

The effective maxillary orthopedic protraction is an innovative technique for maxillary protraction in Class III growing patients. It includes three components: a new 2-hinged rapid maxillary expander for a greater amount of anterior displacement of maxilla, repetitive weekly protocol of Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) for disarticulating the maxilla, and intraoral maxillary protraction springs for non-compliant protraction. On average, the maxilla could be protracted for 5.8 mm in 3 months and the result remains stable at least 2 years later. The rationale for this technique is sutural expansion/ protraction osteogenesis. Sutural expansion/ protraction osteogenesis is a form of distraction osteogenesis. However, it still needs to be scrutinized experimentally for the sutural reactions corresponding to the effective maxillary orthopedic protraction.