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A cone beam computed tomography (CBCT) scan was acquired before commencing treatment (T1). All participants were treated with a tooth-bone-borne rapid maxillary expansion (hybrid MARME) appliance that was activated by the Alt-RAMEC protocol for 9\u2009weeks. This was followed by full-time class III elastics, delivering 400\u2009g\/side, to protract the maxilla. When a positive overjet was achieved, protraction was ceased and a post-treatment CBCT scan (T2) was taken. The 3D analysis of pre- and post-treatment CBCT scans was blinded. The scans were registered on the anterior cranial base. The Euclidean distance between the two extracted surface models of the pre- and post-treatment scans was displayed as a color surface map.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All participants completed the intervention successfully. The majority of the participants showed protraction of the anterior maxillary region (71.4%) and in the zygomatic processes (64.2%). The maxilla significantly protracted (SNA 1.87\u00b0\u2009\u00b1\u20091.06\u00b0; Vert.T-A 3.29\u2009\u00b1\u20091.54\u2009mm), while the mandibular base significantly redirected posteriorly (SNB \u2212\u20092.03\u00b0\u2009\u00b1\u20090.85\u00b0, Vert.T-B \u2212\u20093.43\u2009\u00b1\u20094.47\u2009mm) and that was reflected on the ANB and Wits measurements. No adverse effects were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Class III elastics combined with the Alt-RAMEC activation protocol of the hybrid MARME appliance is an effective treatment method for mild\/moderate class III malocclusions. A long-term follow-up and comparisons with other treatment modalities are required.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40510-019-0290-0","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:02:27Z","timestamp":1568764947000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["3D effects of a bone-anchored intra-oral protraction in treating class III growing patient: a pilot study"],"prefix":"10.1186","volume":"20","author":[{"given":"Mohammed","family":"Almuzian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anas","family":"Almukhtar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aman","family":"Ulhaq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2083-1528","authenticated-orcid":false,"given":"Fahad","family":"Alharbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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