Orthodontic miniplate with tube as an efficient tool for borderline cases.

An orthodontic miniplate tube device, the C-tube, was designed for use in patients for whom a conventional miniscrew is not suitable, such as those with narrow interradicular spaces, extended maxillary sinuses, dilacerated roots, or severe alveolar bone loss. After local anesthesia, 2 parallel horizontal incisions are made in the area of placement, and the periosteum is elevated. The C-tube is slipped under the mucosal flap and fixed with self-drilling miniscrews (diameter, 1.5 mm; length, 4 mm). Because the screws are short, there is adequate retention in the alveolar plate, and the clinician can avoid the increased morbidity of anchoring to the zygomatic buttress. This makes placement possible with superficial anesthesia. A small rolled tube at the head part can act as an orthodontic tube and accommodate archwires or as a hook to attach orthodontic elastics. However, in some patients with pneumatization or systemic diseases, such as diabetes mellitus, or in heavy smokers, cross-type C-tubes with longer miniscrews are recommend for better stability. This new type of orthodontic miniplate can be an effective alternative to conventional 1-component screws or miniplates in complex situations.