The Begg light-wire appliance remains unique in the history of orthodontic innovation. Whereas many current self-ligating bracket appliances purport to be low friction or friction free, it is the Begg appliance that best exemplifies low friction, free sliding mechanics.
By creating only a single point of contact between the bracket and the arch-wire Dr Begg was able to greatly decrease resistance to sliding, both by reducing friction between the bracket and the arch-wire and virtually eliminating the binding of the arch-wire in the bracket slot, as is seen in all horizontal slot brackets.
Begg’s bracket design allowed teeth to freely tip mesially and distally as well as lingually and labially. This often gave teeth the appearance of being over tipped during treatment and required considerable diligence by Begg practitioners to keep tooth movement under control.
This freedom of tooth movement allowed unprecedented correction of large overbites and overjets to an edge-to-edge position and rapid closure of extraction spaces by initially tipping the adjacent teeth into the extraction site and uprighting the teeth afterwards.
Individual tooth root correction was managed by the use of fine springs that were designed, and often individually crafted to upright, torque and rotate teeth into their correct positions once the position of tooth crowns had been established.
One key advantage of the appliance set up was the use of light elastic forces for the correction of anterior overbites and overjets. All anchorage could be established intra-orally without headgear, without the need for ancillary appliances such as trans-palatal arches, or needing to set up molar anchorage prior to treatment, as Dr Tweed advocated.
7. • Total reduction in arch length resulting from attrition amounted
approximately to one bicuspid width either side of both dental
arches.
• He argues that if in this present era tooth material is not lost through
attrition, it would be reasonable to cause a commensurate reduction
artificially through extraction.
7
8. THEORY OF DIFFERENTIAL FORCES
• The range of light pressures which would cause the teeth to move
at an optimum rate with minimal disturbance of the supporting
tissues.
• Pressures below this range produce a slow rate of response
• above reaction within the bone support, referred as
“undermining resorption”.
8
10. SOME CHARACTERISTICS OF THE
TECHNIQUE
• All tooth movements: bodily, torquing, tipping, and rotating
• All forms of malocclusion are treated with this technique.
• High resiliency arch wires Active treatment time and chair side
time - greatly reduced.
• tooth moving forces are so light that there is less discomfort to
patients and there is less tooth loosening than when heavier arch
wire technique are used
10
11. ATTACHMENTS USED IN BEGG’S
TECHNIQUE
• Brackets & lock pins
• Bands
• Molar tubes
• Ball end hooks
• Lingual attachments
11
12. DESIGN OF BRACKET & TUBES
• design of attachments permit free crown tipping by arch wire and
elastics during first two stages
• permit root tipping by auxiliaries used with arch wire and elastics
during third stage
12
13. BRACKETS
• Main attachment
• slot facing gingivally (narrow brackets - permit free tipping in all the
directions)
• It has a slot to carry the arch wire and a vertical slot to carry the lock
pin to hold the wire
13
14. DIMENSIONS
• Depth - 0.020”
• Height - 0.045”
• Base dimension - 0.122 x 0.125”
14
16. MESH
Mini mesh
• Smallest base available
• Same size of bracket
• More esthetic
Super mini mesh
• Larger than mini mesh
• Extends slightly beyond the bracket base
• More bonding surface
16
17. ESTHETIC BRACKETS
PLASTIC
• Made of polycarbonates
• Tooth color or crystal
clear plastic
• Flat - centrals
• Curved - posteriors
CERAMIC
• Ceramaflex II begg (TP
labs) having all unique
feature of metal brackets
• Base is polycarbonate for
easy debonding
17
18. LOCK PINS
• Essential to hold the wire in bracket & allow the force to be transmitted from arch
wire and elastics to teeth
• Made from soft SS or brass; nylon for ceramic
• Must be soft for easy bending close to bracket vertical wall
18
20. Round:
• It is 0.036” I.D. 6 mm in length.
Oval:
It is 0.024” X 0.072” in internal diameter and 5 mm long. Used when
second bicuspids are extracted.
20
21. LINGUAL ATTACHMENTS
• Placed on lingual surface of teeth for attachment of
elastics, elastic thread, ligature.
• Placed on m-d center unless severe crowding is present
or tooth is rotated.
• Can be bondable or weldable.
21
22. ELASTICS
• These are made of synthetic latex and are of uniform
sizes and also applying uniform forces when
stretched to required length.
• These elastics are available at different sizes,
mainly dependent on internal diameter and thickness
of their walls.
22
23. • Usual sizes used in light arch wire technique with internal diameter of
5/16 and 3/8 inches.
• These elastics must exert optimum of 2.5 to 3 Oz pressure when
stretched and placed between required 2 points.
• Heavier are useful in extraoral technique.
• Lighter maintaining the molar position by reinforcing the
anchorage, preventing the mesial drift.
23
25. ARCHWIRES
• Light round wire
A. Regular grade:
B. Regular plus grade
C. Special grade
D. Special plus grade
E. Premium grade:
F. Premium plus grade
G. Supreme
25
27. • All the brackets are placed 4mm from the Incisal
edges except for the lateral incisor which is placed
3.5mm
• The brackets are placed at the centre of the crown’s
mesiodistal width except in rotated teeth where they
are off centered.
27
28. STAGES IN BEGG TECHNIQUE
Begg technique is divided into three stages:
• Stages I and II – Crown tipping phase.
• Stage III – Root tipping phase.
Overlapping of the stages must be avoided.
Objectives of each stage met before proceeding.
28
29. OBJECTIVES OF STAGE I
Correction of crowding and irregularity.
Closure of anterior spaces.
Correction of rotations.
Elimination of deep bites, edge to edge bite / openbite except in class II
Correction of Mesiodistal relations of buccal segments
Class I and Class II Mild class III.
Class III Class I or Class II.
29
30. OBJECTIVES OF STAGE I
Co-ordination of upper and lower arches.
Correction of anterior and posterior cross bites.
Axial relation of anchor molars corrected – upright position.
NOTE: All tooth movements carried out simultaneously & in both arches.
30
31. ARCHWIRES
• Round austenitic SS - Heat treated and cold drawn.
0.016” special plus Looped arch wire in any case
0.016” special plus Plain arch wire in extraction cases or in which
1st and 2nd premolars are extracted
0.018” Plain arch wire in molar extraction cases
31
32. • The basic shape of the initial arch shape of malocclusion
• The arch wire shape - proportional to the width, the form and
symmetry of dental arch.
32
34. Location of IMH:
• Well aligned anterior teeth 1-2 mm mesial to the cuspid bracket.
• Spaced anteriors Further mesially.
• Mildly crowded anteriors impinging on the bracket.
• Severely crowded multi loop wires.
34
35. OFFSET BENDS
In Anterior segment
Vertical offset - To Intrude or Extrude
Horizontal offset - To Expand, contract and rotate
In posterior segment
Gingival offset - To avoid occlusal distortion and interference with bicuspids
35
37. STAGE I
• The arch form - generally expanded over it’s entire width
Ans. counteract the lingual movement of the anchor molars
• In this technique, no teeth should be held firm
Ans. so that they can respond to gentle tooth moving forces.
37
39. BAYONET BENDS
• It is inadvisable to use bayonet bends for active correction, because of the
tendency for round arch wire to rotate within bracket slots causing the
bayonet bend to become ineffective or supply movement in wrong plane
• Commonly used passively to retain over rotation brought about via
previously looped arch.
• They should be small and offset section is 5 degrees to the line of main arch.
39
41. PLACEMENT OF ELASTICS
• It is impossible for the arch wire to function properly without the proper
elastics.
• No horizontal (intramaxillary) elastics are applied during stage I
41
42. Class II elastics pulling 2
to 3 ounce at the
beginning
Class III elastics
Horizontal
(intramaxillay)
elastic
42
43. STAGE II
OBJECTIVES OF THE SECOND STAGE:
• 1.Maintain all corrections achieved during first stage.
• 2.close any remaining posterior spaces.
• All tooth movements that should be performed in the second
stage of treatment are carried out simultaneously and must be
completed in both dental arches before proceeding to stage III.
43
44. STAGE II
ARCH WIRE:
• The function of arch wires in stage II is
maintain the corrections already achieved
stabilize the teeth against any adverse reciprocal forces.
• To achieve this heavier {0.020 inch} upper and lower arch wires are
used..
• The anchor bends placed in the heavier arch wire must be less than
that of the lighter wires.
44
45. WEARING OF ELASTICS DURING
STAGE II
• The wearing of horizontal elastics creates a rotational force on the
molars.
• To prevent this, the distal ends of the archwires can be given a slight
amount of toe-in.
45
46. ARCHWIRE
• The Arch wire pattern is basically that of Stage I treatment
• 0.016” gauge of wire is used
• 0.018” is used when there is frequent arch wire distortions or
unilateral space closure
• Anchor bend is made 1mm mesial to the molar, premolar contact
point.
46
47. • Intermaxillary hooks are incorporated in both archwire
immediately mesial to the cuspid brackets and in contact or
very near contact with them
• The hooks in upper arch has to bear two elastics which is
somewhat difficult for ring pattern. A ‘Z’ shaped hook makes it
easier for the patient to apply two rubbers to the hook
47
48. TOE IN AND TOE OUT BENDS
• They are horizontal offset bends that are often combined with the anchor
bends
Functions:
• Corrective: for rotation of molars when required.
• After insertion, the toe-in or toe-out bend exerts light force so that the molar
tends to rotate and the wire and the tube gradually become parallel
• Preventive: preventing the rotation of molars due to elastic force
48
49. Passive- to prevent the rotation of anchor molars already in
normal alignment
49
50. ELASTICS IN STAGE II
• Lateral Cephalogram is taken
• cephalometric evaluation whether the anteriors are to be retracted
or posteriors are moved for closure of space.
50
51. Correction of Midline discrepancy:
If one arch is involved shifts more than 2mm is major problem.
The application of intramaxillary elastic will complete closure on the side
to which midline is shifted
The intramaxillary elastic on the side which closes first can be
discontinued
Minor discrepancies are self correcting
51
53. • The auxiliaries used are passive mesio distal root uprighting springs on
the mandibular canines and the lower anterior braking arches.
• The function of of these types of auxiliaries is to establish two point
contact between teeth and archwire and prevent free tipping movement
of the anteriors.
53
54. Changes observed in stage II
• All extraction spaces are closed
• The crowns of the upper and lower anterirs are tipped back
further than the first stage
• The anteroposterior occlusal relations attained in the first stage are
maintained
• The overcorrections of rotations done in the first stage are maintained
54
55. STAGE III
TOOTH RELATIONSHIPS AT THE START OF STAGE III –
1.Edge-edge incisors –all upper and lower anteriors retroclined.
2.Canines distally tipped and second premolar mesially tipped.
3.Molars upright.
55
56. • all spaces closed ,rotations and midline deviations overcorrected. all
the teeth should be well-aligned and occluding in slight mesio-
occlusion.
56
57. OBJECTIVES OF STAGE III
1.MAINTAIN ALL CORRECTIONS ACHIEVED FIRST AND
SECOND STAGES
• Posterior spaces kept closed by bending the distal ends of the
archwires around the buccal tubes.
• Archform and overbite correction maintained by using heavier
{0.018 to 0.020 inch} main arch wires.
57
58. 2. ACHIEVE DESIRED AXIAL INCLINATIONS OF ALL TEETH
• Changes in the mesiodistal inclination of teeth by the use of
individual root-tipping springs.
• Lingual or labial root torque is applied to the anterior teeth through
the application of torqueing auxillaries.
58
61. ADVANTAGES OF BEGG’S APPLIANCE
• Efficiency of treatment- many corrective tooth movements with
relative little appliance adjustment
• Minimal patient discomfort and minimal trauma to the hard and
soft tissues
• Rapid esthetic improvement
• Early correction and overcorrection of rotations
• Short treatment time
61
62. DISADVANTAGES OF BEGG’S APPLIANCE
• Patient cooperation is critical
• Distortion of the light arch wires by mastication of tough foods or biting
hard objects
• Difficulty - accomplishing detailed finishing procedure
• Auxiliary used in stage III constitute a hazard to maintenance of oral
hygiene
62
63. • Tissue trauma at the alveolar crest
• Root resorption
• The Begg technique does not lend itself to the intrusion of maxillary incisors
when a deep overbite is associated with over eruption of the maxillary incisors
• Unpleasing flattening of the lips may occur during Stage I and Stage II
63
64. CONCLUSION
64
The Begg appliance is both comprehensive and versatile,
but it is only an instrument which, like a musical one, can be played to good
effect only by those with the talent, training and perseverence to do so.
Discord and disharmony will haunt those who do not possess these
characteristics.
It is the operator, not the appliance, who produces the results, acceptable or
otherwise, directly in accordance with his ability.
65. REFERENCES
• Begg orthodontic theory and technique : Begg and Kesling.
• Begg:appliance and technique - fletcher.
• Light wire technique ,American journal of orthodontics Jan vol 47 ,no
1, 1961
• Begg, P. R.: Stone age man's dentition, AM. J. Orthodontics 40
• Begg, p. R.: Differential force in orthodontic treatment, AM. J.
Orthodontics
• Begg, P. R. : Light arch wire technique, AM. J. Orthodontics
65