Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol.

The combination of the Hybrid Hyrax, facemask, and Alt-RAMEC protocol offers the following advantages in early treatment of severe Class III cases: • Because the sagittal forces are transferred to the maxillary bone, there are no dental side effects in terms of mesial migration. • The transverse forces are applied anteriorly to mini-implants, with no risk of periodontal damage to the premolars or deciduous molars. • Due to the opening of the midpalatal sutures, Alt-RAMEC provides a longer-lasting "RPE effect" for increased maxillary protraction. • The treatment is minimally invasive. • The upper and lower arches remain fully accessible for orthodontic corrections.