Background: to determine the role of treatment timing in the long-term effects produced by rapid maxillary expansion and facemask therapy (RME/FM) in Class III patients. Methods: This study compared two sample groups treated with RME/FM followed by fixed appliances: the early prepubertal group (EPG) (17 patients; mean age before treatment (T0), 5.8 ± 0.7 years; range, 4.3–6.9 years) and the late prepubertal group (LPG) (17 patients; mean age at T0, 10.1 ± 0.8 years; range, 9.0–11.1 years). Lateral cephalograms for the two groups were examined before treatment (T0) and at a long-term observation (T1) (EPG, 19.8 ± 1.0 years; LPG, 21.0 ± 2.1 years). Independent sample t-tests were performed to compare the two groups at T0 and T1. Results: No statistically significant differences were found for any of the cephalometric variables at T0, except for the total mandibular length, overjet, and inclination of the maxillary incisors to the palatal plane, which were greater in the LPG. At T1, no statistically significant differences were detected for any of the cephalometric variables. Conclusions: There were no significant long-term differences when treating Class III patients with RME/FM, either during an early prepubertal phase (≤7 years of age) or during a late prepubertal phase (≥9 years of age).

Background: Bone-Anchored Class III Elastics (BAC3E) with miniplates offer better skeletal outcomes but require invasive surgical placement and removal. This pilot study explores a minimally invasive alternative by assessing the dental, skeletal, and soft tissue effects of miniscrew-assisted maxillary protraction (MAMP) combined with computer-aided design/manufacturing (CAD/CAM) in skeletal Class III patients. Methods: Eleven pre-peak subjects (seven females, four males) with a retrusive maxilla were treated with MAMP and compared with two retrospective control groups (BAC3E and untreated Class III controls). Subjects were matched for age, gender, and vertical skeletal pattern. Pre- and post-treatment lateral cephalograms were taken. The MAMP protocol involved custom CAD/CAM frameworks with four miniscrews, with Class III elastics worn full-time. Paired t-tests and ANOVA were employed for statistical comparisons. Results: The MAMP group showed significant maxillary skeletal improvements (SNA, +2.5°; Co-A, +2.4 mm), reduced SNML angle (−0.6°), maxillary incisors retroclination (U1-PP, −4.7 °), mandibular incisors proclination (L1-ML, +1.6°), and improved overjet (+3.8 mm). Compared to BAC3E, the MAMP group had significantly smaller midfacial advancement but significantly greater maxillomandibular outcomes than untreated controls. No significant differences in mandibular sagittal position were found between the MAMP and BAC3E groups, but the MAMP group exhibited significant Co-Gn changes compared to untreated controls. No significant vertical changes were observed among the three groups. Conclusions: MAMP with CAD/CAM frameworks offers an effective, minimally invasive approach for early Class III intervention, with favourable skeletal improvements and vertical control.