Modification protocol for an early class III treatment using 3 miniplates for bone-anchored maxillary orthopedic traction.

Abstract

INTRODUCTION: This article introduces the modification of 4-miniplate-assisted

orthopedic protocol for class III correction. Instead of bilateral mandibular

miniplates between lateral incisors and canine, the single modified Y-type C-tube

with extension arms can replace 2 miniplates for temporary skeletal anchorage

with advantages. METHODS: Y-type C-tube was modified to have 2 extension arms for

the application of class III elastics to replace 2 separate miniplates on either

side of the mandible. A patient who declined a facemask therapy was selected to

receive the modified protocol using only 3 C-tubes for bone-anchored maxillary

orthopedic traction. The modified Y-type C-tube was inserted at the mandibular

symphysis, and the bifurcation of the extension arms exited the tissue near the

mucogingival junction. RESULTS: The modified Y-type C-tube was placed on the

mandibular symphysis, and this provided 3 advantages compared with conventional

miniplates: (1) 1 C-tube placement warrants less surgical sites than 2-miniplate

installation, (2) placing the C-tube in between mandibular incisors prevents

damage to developing or erupting permanent canines and allows early treatment

start, and (3) the characteristic bendability of extension arms permits easy

alteration on position and results in the vertical and sagittal vector controls

of class III elastics. When the treatment is finished, it can be also simply

removed like any other C-tubes with simple detachment of extension arms.

CONCLUSIONS: The modification of 4-miniplate-assisted orthopedic protocol for

class III correction provides easier surgical placement of miniplates by

minimizing complications, early initiation of treatment, and more vector control

with bendable extension arms of the modified Y-type C-tube.