{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:05:54Z","timestamp":1780070754999,"version":"3.54.0"},"reference-count":62,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective:<\/jats:title>\n To evaluate the changes in pharyngeal airway dimensions and the position of the hyoid bone after maxillary protraction with different alternate rapid maxillary expansion and construction (Alt-RAMEC) protocols in patients with skeletal class III malocclusion as a result of maxillary retrusion.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n The patients with skeletal class III malocclusions were consecutively divided into two groups. Group 1 consisted of 17 patients (11 boys and 6 girls, mean age 11.31 \u00b1 1.71 years) who had the Alt-RAMEC protocol for 5 weeks, and group 2 consisted of 17 patients (10 boys and 7 girls, mean age 11.64 \u00b1 1.24 years) who had the Alt-RAMEC procedure for 9 weeks. In this study, 4 angular and 13 linear measurements were performed to evaluate the skeletal and pharyngeal airway changes that occurred after maxillary protraction.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A significant increase in the maxillary growth, inhabitation of mandibular growth, and clockwise rotation of the mandible caused the improvement of the maxillo-mandibular relationship in both groups. Those changes caused a significant increase in the upper pharyngeal airway dimension (\n P<\/jats:italic>\n < .01) and affected the vertical position of the hyoid bone in both groups (\n P<\/jats:italic>\n < .05 and\n P<\/jats:italic>\n < .01, respectively). However, changes that occurred in both groups were found to be similar for all airway variables (\n P<\/jats:italic>\n > .05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Upper pharyngeal dimension and vertical position of the hyoid bone were affected by the maxillary protraction with different Alt-RAMEC protocols. There were no statistically significant differences between the groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/082316-632.1","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T10:59:02Z","timestamp":1485860342000},"page":"519-525","source":"Crossref","is-referenced-by-count":25,"title":["Changes in pharyngeal airway dimensions and hyoid bone position after maxillary protraction with different alternate rapid maxillary expansion and construction protocols: A prospective clinical study"],"prefix":"10.2319","volume":"87","author":[{"given":"Mevlut","family":"Celikoglu","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammet Hilmi","family":"Buyukcavus","sequence":"additional","affiliation":[{"name":"Research Assistant, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-87-4-519-b01","series-title":"Eur J Orthod","first-page":"729","article-title":"Effects of the functional regulator III on profile changes in subjects with maxillary deficiency","volume":"32","author":"Kilic \n N,","year":"2010","unstructured":"Kilic \n N, \n \n \n Celikoglu \n M, \n \n \n Oktay \n H. \n \n \n Effects of the functional regulator III on profile changes in subjects with maxillary deficiency. Eur J Orthod. 2010;32:729\u2013734."},{"key":"i0003-3219-87-4-519-b02","series-title":"Am J Orthod","first-page":"377","article-title":"Orthopedic approach to severe skeletal Class III malocclusion","volume":"67","author":"Irie \n M,","year":"1975","unstructured":"Irie \n M, \n \n \n Nakamura \n S. \n \n \n Orthopedic approach to severe skeletal Class III malocclusion. Am J Orthod. 1975;67:377\u2013392."},{"key":"i0003-3219-87-4-519-b03","series-title":"Med Oral Patol Oral Cir Bucal","first-page":"e791","article-title":"The pattern of malocclusion in a sample of orthodontic patients from Turkey","volume":"15","author":"Celikoglu \n M,","year":"2010","unstructured":"Celikoglu \n M, \n \n \n Akpinar \n S, \n \n \n Yavuz \n I. \n \n \n The pattern of malocclusion in a sample of orthodontic patients from Turkey. Med Oral Patol Oral Cir Bucal. 2010;15:e791\u2013e796."},{"key":"i0003-3219-87-4-519-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"333","article-title":"Skeletal effects of early treatment of class III malocclusion with maxillary expansion and face-mask therapy","volume":"113","author":"Baccetti \n T,","year":"1998","unstructured":"Baccetti \n T, \n \n \n McGill \n JS, \n \n \n Franchi \n L, \n \n \n McNamara \n JA\n Jr, \n \n \n Tollaro \n I. \n \n \n Skeletal effects of early treatment of class III malocclusion with maxillary expansion and face-mask therapy. 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Clin Oral Investig. 2015;19:2115\u20132122."},{"key":"i0003-3219-87-4-519-b08","series-title":"Eur J Orthod","first-page":"86","article-title":"Effects of maxillary protraction for early correction of class III malocclusion","volume":"36","author":"Celikoglu \n M,","year":"2014","unstructured":"Celikoglu \n M, \n \n \n Oktay \n H. \n \n \n Effects of maxillary protraction for early correction of class III malocclusion. Eur J Orthod. 2014;36:86\u201392."},{"key":"i0003-3219-87-4-519-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"675","article-title":"The effectiveness of protraction face mask therapy: a meta-analysis","volume":"115","author":"Kim \n JH,","year":"1999","unstructured":"Kim \n JH, \n \n \n Viana \n MA, \n \n \n Graber \n TM, \n \n \n Omerza \n FF, \n \n \n BeGole \n EA. \n \n \n The effectiveness of protraction face mask therapy: a meta-analysis. 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Angle Orthod. 2009;79:660\u2013667."},{"key":"i0003-3219-87-4-519-b12","series-title":"Eur J Orthod","first-page":"61","article-title":"Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in class III malocclusion subjects","volume":"30","author":"Kilinc \n AS,","year":"2008","unstructured":"Kilinc \n AS, \n \n \n Arslan \n SG, \n \n \n Kama \n JD, \n \n \n Ozer \n T, \n \n \n Dari \n O. \n \n \n Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in class III malocclusion subjects. Eur J Orthod. 2008;30:61\u201366."},{"key":"i0003-3219-87-4-519-b13","series-title":"Angle Orthod","first-page":"43","article-title":"Effects of maxillary protraction on craniofacial structures and upper-airway dimension","volume":"72","author":"Hiyama \n S,","year":"2002","unstructured":"Hiyama \n S, \n \n \n Suda \n N, \n \n \n Ishii-Suzuki \n M, \n \n et al. \n Effects of maxillary protraction on craniofacial structures and upper-airway dimension. Angle Orthod. 2002;72:43\u201347."},{"key":"i0003-3219-87-4-519-b14","series-title":"Eur J Orthod","first-page":"184","article-title":"Sagittal airway dimensions following maxillary protraction: a pilot study","volume":"28","author":"Sayinsu \n K,","year":"2006","unstructured":"Sayinsu \n K, \n \n \n Isik \n F, \n \n \n Arun \n T. \n \n \n Sagittal airway dimensions following maxillary protraction: a pilot study. Eur J Orthod. 2006;28:184\u2013189."},{"key":"i0003-3219-87-4-519-b15","series-title":"Angle Orthod","first-page":"426","article-title":"Correlation between skeletal changes by maxillary protraction and upper airway dimensions","volume":"81","author":"Lee \n JW,","year":"2011","unstructured":"Lee \n JW, \n \n \n Park \n KH, \n \n \n Kim \n SH, \n \n \n Park \n YG, \n \n \n Kim \n SJ. \n \n \n Correlation between skeletal changes by maxillary protraction and upper airway dimensions. Angle Orthod. 2011;81:426\u2013432."},{"key":"i0003-3219-87-4-519-b16","series-title":"Eur J Orthod","first-page":"346","article-title":"Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in class III subjects","volume":"32","author":"Baccetti \n T,","year":"2010","unstructured":"Baccetti \n T, \n \n \n Franchi \n L, \n \n \n Mucedero \n M, \n \n \n Cozza \n P. \n \n \n Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in class III subjects. 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J Clin Orthod. 2005;39:68\u201375."},{"key":"i0003-3219-87-4-519-b19","series-title":"Eur J Orthod","first-page":"706","article-title":"Activation-deactivation rapid palatal expansion and reverse headgear in class III cases","volume":"32","author":"Isci \n D,","year":"2010","unstructured":"Isci \n D, \n \n \n Turk \n T, \n \n \n Elekdag-Turk \n S. \n \n \n Activation-deactivation rapid palatal expansion and reverse headgear in class III cases. Eur J Orthod. 2010;32:706\u2013715."},{"key":"i0003-3219-87-4-519-b20","series-title":"Cleft Palate Craniofac J","first-page":"121","article-title":"A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions","volume":"42","author":"Liou \n EJ,","year":"2005","unstructured":"Liou \n EJ, \n \n \n Tsai \n WC. \n \n \n A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. 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Am J Orthod Dentofacial Orthop. 2012;141:519\u2013521."},{"key":"i0003-3219-87-4-519-b23","series-title":"Orthod Craniofac Res","first-page":"259","article-title":"Short-term effects of a modified Alt-RAMEC protocol for early treatment of class III malocclusion: a controlled study","volume":"17","author":"Masucci \n C,","year":"2014","unstructured":"Masucci \n C, \n \n \n Franchi \n L, \n \n \n Giuntini \n V, \n \n \n Defraia \n E. \n \n \n Short-term effects of a modified Alt-RAMEC protocol for early treatment of class III malocclusion: a controlled study. Orthod Craniofac Res. 2014;17:259\u2013269."},{"key":"i0003-3219-87-4-519-b24","series-title":"J Clin Orthod","first-page":"601","article-title":"and facial mask protocol in class III malocclusion","volume":"45","author":"Franchi \n L,","year":"2011","unstructured":"Franchi \n L, \n \n \n Baccetti \n T, \n \n \n Masucci \n C, \n \n \n Defraia \n E. \n \n \n Early\n Alt-RAMEC \n \n \n and facial mask protocol in class III malocclusion. J Clin Orthod. 2011;45:601\u2013609."},{"key":"i0003-3219-87-4-519-b25","series-title":"Eur J Orthod","first-page":"381","article-title":"Sagittal airway changes: rapid palatal expansion versus Le Fort I osteotomy during maxillary protraction","volume":"34","author":"Cakirer \n B,","year":"2012","unstructured":"Cakirer \n B, \n \n \n Kucukkeles \n N, \n \n \n Nevzatoglu \n S, \n \n \n Koldas \n T. \n \n \n Sagittal airway changes: rapid palatal expansion versus Le Fort I osteotomy during maxillary protraction. 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Am J Orthod Dentofacial Orthop. 2014;145:780\u2013786."},{"key":"i0003-3219-87-4-519-b01","series-title":"Eur J Orthod","first-page":"729","article-title":"Effects of the functional regulator III on profile changes in subjects with maxillary deficiency","volume":"32","author":"Kilic \n N,","year":"2010","unstructured":"Kilic \n N, \n \n \n Celikoglu \n M, \n \n \n Oktay \n H. \n \n \n Effects of the functional regulator III on profile changes in subjects with maxillary deficiency. Eur J Orthod. 2010;32:729\u2013734."},{"key":"i0003-3219-87-4-519-b02","series-title":"Am J Orthod","first-page":"377","article-title":"Orthopedic approach to severe skeletal Class III malocclusion","volume":"67","author":"Irie \n M,","year":"1975","unstructured":"Irie \n M, \n \n \n Nakamura \n S. \n \n \n Orthopedic approach to severe skeletal Class III malocclusion. Am J Orthod. 1975;67:377\u2013392."},{"key":"i0003-3219-87-4-519-b03","series-title":"Med Oral Patol Oral Cir Bucal","first-page":"e791","article-title":"The pattern of malocclusion in a sample of orthodontic patients from Turkey","volume":"15","author":"Celikoglu \n M,","year":"2010","unstructured":"Celikoglu \n M, \n \n \n Akpinar \n S, \n \n \n Yavuz \n I. \n \n \n The pattern of malocclusion in a sample of orthodontic patients from Turkey. Med Oral Patol Oral Cir Bucal. 2010;15:e791\u2013e796."},{"key":"i0003-3219-87-4-519-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"333","article-title":"Skeletal effects of early treatment of class III malocclusion with maxillary expansion and face-mask therapy","volume":"113","author":"Baccetti \n T,","year":"1998","unstructured":"Baccetti \n T, \n \n \n McGill \n JS, \n \n \n Franchi \n L, \n \n \n McNamara \n JA\n Jr, \n \n \n Tollaro \n I. \n \n \n Skeletal effects of early treatment of class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop. 1998;113:333\u2013343."},{"key":"i0003-3219-87-4-519-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"38","article-title":"Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment","volume":"109","author":"Ngan \n P,","year":"1996","unstructured":"Ngan \n P, \n \n \n Hagg \n U, \n \n \n Yiu \n C, \n \n \n Merwin \n D, \n \n \n Wei \n SH. \n \n \n Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. 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Eur J Orthod. 2010;32:419\u2013424."},{"key":"i0003-3219-87-4-519-b07","series-title":"Clin Oral Investig","first-page":"2115","article-title":"Comparison of the soft and hard tissue effects of two different protraction mechanisms in class III patients: a randomized clinical trial","volume":"19","author":"Celikoglu \n M,","year":"2015","unstructured":"Celikoglu \n M, \n \n \n Yavuz \n I, \n \n \n Unal \n T, \n \n \n Oktay \n H, \n \n \n Erdem \n A. \n \n \n Comparison of the soft and hard tissue effects of two different protraction mechanisms in class III patients: a randomized clinical trial. Clin Oral Investig. 2015;19:2115\u20132122."},{"key":"i0003-3219-87-4-519-b08","series-title":"Eur J Orthod","first-page":"86","article-title":"Effects of maxillary protraction for early correction of class III malocclusion","volume":"36","author":"Celikoglu \n M,","year":"2014","unstructured":"Celikoglu \n M, \n \n \n Oktay \n H. \n \n \n Effects of maxillary protraction for early correction of class III malocclusion. Eur J Orthod. 2014;36:86\u201392."},{"key":"i0003-3219-87-4-519-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"675","article-title":"The effectiveness of protraction face mask therapy: a meta-analysis","volume":"115","author":"Kim \n JH,","year":"1999","unstructured":"Kim \n JH, \n \n \n Viana \n MA, \n \n \n Graber \n TM, \n \n \n Omerza \n FF, \n \n \n BeGole \n EA. \n \n \n The effectiveness of protraction face mask therapy: a meta-analysis. Am J Orthod Dentofacial Orthop. 1999;115:675\u2013685."},{"key":"i0003-3219-87-4-519-b10","series-title":"Angle Orthod","first-page":"209","article-title":"Maxillary protraction appliance effect on the size of the upper airway passage","volume":"78","author":"Oktay \n H,","year":"2008","unstructured":"Oktay \n H, \n \n \n Ulukaya \n E. \n \n \n Maxillary protraction appliance effect on the size of the upper airway passage. Angle Orthod. 2008;78:209\u2013214."},{"key":"i0003-3219-87-4-519-b11","series-title":"Angle Orthod","first-page":"660","article-title":"Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway","volume":"79","author":"Kaygisiz \n E,","year":"2009","unstructured":"Kaygisiz \n E, \n \n \n Tuncer \n BB, \n \n \n Yuksel \n S, \n \n \n Tuncer \n C, \n \n \n Yildiz \n C. \n \n \n Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway. Angle Orthod. 2009;79:660\u2013667."},{"key":"i0003-3219-87-4-519-b12","series-title":"Eur J Orthod","first-page":"61","article-title":"Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in class III malocclusion subjects","volume":"30","author":"Kilinc \n AS,","year":"2008","unstructured":"Kilinc \n AS, \n \n \n Arslan \n SG, \n \n \n Kama \n JD, \n \n \n Ozer \n T, \n \n \n Dari \n O. \n \n \n Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in class III malocclusion subjects. 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