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BEGG‟S PHILOSOPHY AND
TECHNIQUE
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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CONTENTS


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





Evolution of Beggs technique
Beggs philosophy
Beggs technique
Components
Stage I
Stage II
Stage III

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DEVELOPMENT OF
LIGHT WIRE TECHNIQUE

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

Dr P.R Begg was born in
1898 in a small, gold
mining town Coolgardie,
west Australia.



Grew up in south
Australia.As a boy he saw
the sketch of Australia
aborginal and noticed
their teeth were worn flat,
no one thought to tell him
why or how it happened.

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

In his early twenties he worked as a Jackaroo at
Boonoke- a sheep and cattle station in New south
Australia, looking after both cattle and sheep.



He noticed many people with crooked teeth and saw
many feeble attempts at correction of these problems
with many treatment failures and few successes.

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.


As he wanted to help such people he enrolled in the

dental course at the University of Melbourne instead of
taking the medical course, as he originally intended.



At the commencement of third year of training, Dr Begg
decided to practice orthodontics after graduating in
dentistry.

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

Dr Stanley Wilkinson, a former student of E.H Angle was
the lecturer in Orhodontics and used the seventh edition

of “Malocclusion of the teeth” as the text book. Dr Begg
graduated in 1923 with B.D.Sc Degree the L.D.S
Diploma.



His introduction to Dr. Angle‟s work led him to travel to
Pasadena, California in 1924 to study with Dr. Angle.

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-

DR. Begg was with Dr.
Angle from
February,1924 to
November,1925.
- At that time Dr. Angle
was teaching his
followers the Ribbon arch
appliance which he
introduced in 1916.

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-

Coincidentally with Begg‟s arrival in California Dr. Angle
was developing he Edgwise arch mechanisms, Which he
felt was a vast improvement over the Ribbon arch
Appliance

-

Angle instructed Dr. Begg and Fred Ishii of Japan in the
use of the Edgewise mechanism, before it was revealed
to the profession. Since Dr. Angle was ill, it was they
who first treated patients with Edge wise Appliance
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

The relation between Dr,Begg and Dr.Angle was warm
and mutually rewarding. Dr.Begg helped Dr.Angle to cut

Edgewise brackets on a lathe from milled strips of
platinized gold provided by S.S. white dental company.



At that time Dr.Spenser Atkison demonstrated to the
students that it was normal for the upper first permanent
molars to move continuously mesially throughout life. Dr.

angle referred to this as the anterior component of force.
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

During Dr. Begg‟s stay Dr.Angle wrote, and read for the
first time, his paper entitled. “ The latest and Best in
orthodontic Mechanism” ( published in Dent. Cosmos

1928 and 1929 ). It disclosed the use of edge wise
Mechanism.



In November, 1925 Dr. Begg sailed back to Australia. In
December of the same year he began practicing
Orthodonics in Adelaide, south Australia.



Married Nellie Hamilton in 1928.
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

Begg the only orhodontist in Adelaide in 1926 practiced Edgewise
non extraction, technique.



He was appointed Lecturer in Orthodontics at the university of
Adelaide, a position he held until the university‟s retirement age. (
Retirement in 1964).



For two years, Dr. Begg faithfully followed Dr. Angle‟s
teaching of retaining the full compliment of teeth.

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

However in many of his patients he was‟nt satisfied with
post treatment profiles and there was the serious

problem of relapses.



In February of 1928 he began to routinely remove teeth

or reduce tooth widths by mesio - distal stripping in
patients with excess tooth substance.

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.


He learnt from experience and his ever – growing appreciation of the
role of attritional occlusion in the development of man‟s dentition,
that such reduction was often necessary to permit the proper
repositioning of the teeth to enhance function, stability and esthetics.



Initially he faced opposition from dentist of his patients. It was only
after his superior treatment results were seen to stand the test of
time that the criticism relented. He retreated many patients who had
relapse due to retention of excessive tooth material.

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CHANGING THE MECHANICS
-

Dr. Begg began to realize the Edgewise mechanism was not
designed to rapidly close extraction space or quickly reduce deep
overbites.

-

To facilitate such changes he began using 0.20‟‟ round platinized
gold, rather than rectangular, arch wire in 1929. In 1931 he started
using .018‟‟ round stainless steel wire, bending the now popular
vertical loops and intermaxillary hooks right into the arch wires.

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-

He soon realized that if round arch wire were engaged in edgewise
brackets, indiscriminate and often undesired root moving forces could be
created this prolongs the anterior bite opening and taxed intraoral
anchorage.

-

In 1933, about 3 years after switching from rectangular to round arch wire
material, he began treating some cases using S.S. White ribbon arch

brackets, to which he had been exposed during his stay with Dr.Angle.

-

Dr. Begg faced the openings of the brackets slots of the ribbon arch
brackets gingivally, instead of incisally as advocated by Dr. Angle. He

realized that these relatively narrow brackets with vertically facing slots
allowed the teeth to move under much lighter forces.
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

To improve rotation tooth control with the use of smaller round wires
in the Ribbon Arch Brackets, Dr. Begg filed their bases before
soldering them to the bands. This reduced the widths of the arch
wire slots.



In 1935 Dr. Begg was awarded the title of D.D.Sc. For his thesis
entitled, “Some aspects of the etiology of irregularity and

malocclusion of teeth‟‟. This was the illumination of his study of
attritional occlusion that began with the casual observation in the
aborginal prior to World War I, and included studying the skulls of
American Indian at the southern Museum in California.

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A NEW WIRE


In the early 1940‟s Dr. Begg met Arthur J.Wilcock, director of
metallurgical research projects at the University of Melbourne.



After many years of research Wilcock produced a cold drawn heat
treated wire that combined the balance between hardness and
resilience with the unique property of zero stress relaxation that
Dr.Begg was seeking.



This unusual wire permitted to open anterior over bites, while
controlling arch form and providing molar stability.

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

He also produced the modified Ribbon arch brackets,
lock pins and special buccal tubes to meet Dr.Begg‟s
ever-changing requirements in these experimental years



In 1952 Dr Begg began to use 0.16‟‟ round stainless
steel wires instead of 0.18‟‟ permitting to open anterior
overbites quickly.

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

In 1939 DR.Begg wrote his doctoral thesis “ The Evolutionary
Reduction and degenaration of Man‟s Jaws and teeth‟‟ in 1939. It
relates attrition or more often lack of it, to the etiology of
malocclusion and other dental problems in modern man.



In 1954 Dr.Begg published paper entitled, “Stone Age Man‟s
dentition” and as the title suggests, it also dealt with attritional
occlusion, and explained why it is the anatomically correct
occlusion.



At the end of his article he disclosed a new technique which he
referred to as the “round wire technique”, advocating at that time the
use of 0.18” (0.46mm) diameter stainless steel arch wires in

modified Ribbon Arch brackets.

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

The technique describe in this 1954 article was much
different from what it is today, and the treatment results
shown did not include detailed finishing. Even so, it drew
relatively large response including correspondance from
three prominent orthodontist who expressed an interest
in the treatment method disclosed – his found from the
Angle school, Dr. Spencer Atkinson; Dr. Robert strang
and Dr. CharlesTweed.

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

In 1956 (Am Jr) Dr. Begg had another article published entitled,
differential Force in orthodontic Treatment.



While he did not specifically define differential force in so many words,
its operation was explained.

This demonstrated that this techniques and theories of
treatment were able to produce acceptable results in unbelievable
short treatment times for all types of malocclusion- from the simplest
to the most extreme discrepancies of both teeth and jaws.

.
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

As a result of reading this article several orthodontists

visited Dr.Begg in Adelaide, South Australia.



In 1957 Dr.H.D. Kesling and Dr. George Dissham came

from the United states. They spent several weeks in
Dr.Begg‟s office and home, attempting to learn the
technique, which was extremely difficult as there was no

organization to it.
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INTRODUCTION OF BEGG TECHNIQUE IN THE
UNITED STATES


Upon Kesling‟s return from Adelaide,he had plans to implement
his new technique in his practice along with Dr.R. A. Rocke not just
to selected patients, but every patient.



In 1959 the Kesling and Rocke Orthodontic group invited over

150 orthodontist from across the united states, to assess the results
of their results of their 100 consecutively – treated cases by Begg
technique.

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

Dr .H.D. Kesling, first
orthodontist in the United
States to practice the
Begg Technique, and the
one most responsible for
popularizing its use
through showings and
courses

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

While the results were not of the quality of the results achieved
today, they demonstrated the ability of the Begg technique to quickly
open deep anterior open bites. Treatment times were relatively
short, and the number of adjustments few. As a result there arose a
demand for training in this new technique.



First course in Begg Technique had 31 students, was held in the
new orthodontic center in Westville, Indiana on june 1959 (1week
course). The brackets used were the new Double - Tab type.

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 However, the use of the double tab bracket proved difficult, as arch
wires were unnecessarily complicated to permit desired tooth
movement. Also, it lacked the ability to overcorrect the teeth which is

so necessary to reduce the tendency for relapse.



Dr Begg realized that inorder to make his technique acceptable to
leading orthodontist in the united states, most of whom were using
Edgewise mechanism at that time, he had to finish his cases with
more precision.

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

Prior to their visit, Dr. Begg was mainly concerned with repositioning
the teeth instable positions over basal bone. The final settling of
teeth he left to the forces of occlusion, guided when necessary by an
upper retainer with circumferential wire.



Also he realized the growing demand for training in his new
technique required that the treatment be organised in some manner

to facilitate both teaching and learning.

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

The result was that in April of 1960, as Dr. Begg began

unpacking his models (which he had brought as part of
his presentation before the American Association of
Orthodontist), members of the kesling and Rocke group

were stunned by his quality of treatment . Hours after
seeing the quality of results achieved by Dr.Begg with
modified Ribbon Arch brackets, Dr.Kesling made the
decision to scrap his double- tab brackets.

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In the years between Dr.Kesling‟s first visit in 1957 and his trip to the United
states in the spring of 1960, Dr.Begg did the following:

1.Finished his cases with such detail and precision that they could not be

discerned from similar cases treated with Edgewise mechanism.
2. Seperated the technique into three distinct stages and established objectives
for each stage.
3.Developed root torqueing auxiliaries separate from the main arch wire.

4.Introduced mesiodistal uprighting spring.
5. Emphasized the importance of free tipping of tooth crowns in the early
stages of treatment.
6. Suggested taking stage models to discipline the orthodontist.

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BEGG‟S PHILOSOPHY

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

The Begg differential force technique is a unique approach to
orthodontic treatment. The philosophy behind it, including diagnosis,
method and direction of tooth movement , is keyed to attritional
occlusion.



Dr.Begg‟s studies of stone age Man‟s dentition indicate that man‟s
occlusion is not static, but an ever changing one.The teeth
continoully migrate mesially and vertically and compensate for the
attrition of their proximal and occluso – incisal surfaces. The
absence of attrition caused by civilized man‟s soft diet does not
eliminate the migration of teeth.

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DIFFERENTIAL FORCE


In 1956 Dr Begg introduced the concept of

Differential force.



His observations was based on the work of Storey

and Smith and their experiments on tooth
movement response to different pressure
applications.

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

IT IS DEFINED AS A FORCE THAT RESULTS IN A
DIFFERENT RATE OR TOOTH MOVEMENT AT ONE
END THAN THE OTHER.

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

A range of light pressures which would
cause teeth to move at an optimum rate and with

minimal disturbance of the supportive tissues optimum orthodontic force.


Pressures below this produce a slow rate of

response, while above incurred a reaction within
the bone support (undermining resorption), which
also had an effect of retarding tooth movement.

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

When a relatively light force is applied reciprocally
between small – rooted anterior teeth and larger –
rooted posterior teeth, the anterior teeth move
relatively rapidly, whereas the larger – rooted
posterior teeth remain almost stationary.



Conversely, if a relatively heavy force is applied in
the same situation, the posterior teeth tend to
migrate mesially while the anterior teeth resist
movement.
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

Here given elastic force is relatively constant, It is
the rate of movement of the teeth on either end of

the force that varies.

Accordingly, it would perhaps be more appropriate
to refer to “ differential reactions” rather than
differential forces.

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

A. Mechanics at each end of the force permites the force to
differentiate as desired.



B. If the mechanics are the same at both ends of the force,

the initial reaction will be for the molar, which has a smaller
root surface area, to move forward and the anterior teeth
remain stationary.

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

The significance of this concept is enhanced by the
ability to choose mechanics that promote free tipping
where the greatest movement is desired and prevent

free tipping where stability or anchorage is indicated.

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

A goal of Begg‟s treatment is over correction of the teeth to allow for
the natural tendency for relapse that occurs when orthodontic
appliance removed.



The differential force technique is designed to permit teeth to move
towards their anatomically correct positions in the jaw under the

influence of very light forces – as would occur naturally in the
presence of attrition.
.

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

The light intra oral forces of Begg Technique do not
place undue strain on the anchor molars.



The appliance is designed to permit the teeth to move
independently of one another – whether tipping freely in
the early stages or during detailed root positioning in the
final stage.

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

Another feature is that the movement of all the teeth towards and
beyond their desired final positions is initiated at the start of
treatment ie. The movement of the teeth is not segmented into
groups with one group waiting for another.



Both archwires and intermaxillary elastics are applied at the bonding
appointment causing immediate reduction of deep overbite and
overjets. The discomfort caused by the initiation of tooth movement
produces a change in eating and biting habits that lessens the
chance for appliance damage.

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

The movement of all teeth is due to the synergistic effect
of the forces and appliances working together in the
presence of proper diagnosis.



The begg synergistic arch graphically demonstrates and
emphasizes the importance of the combination of
avrious components comprising the Begg theory and
technique.

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SEVEN SYNERGISTIC COMPO NENTS


1. A diagnosis and treatment plan that recognizes the persistence of
hereditary forces of mesial migration and vertical eruption of teeth and has
its objectives the over correction of malrelationships of both teeth and jaws.



2. The simultaneous movement of all teeth. From the beginning of
treatment each tooth is directed towards its final position in the dental arch.



3. The total separation of root moving forces from arch wire forces during
the final third stage of treatment.



4. The application of proper elastic forces to create the desired differential

movement of the teeth.

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

5. The use of light round continuos arch wires bent from the hardest
wire possible – Not only must the wire be of highest quality, but the
aech wire have proper form, including bite opening bends, to control
the vertical dimension.



6. The use of molar attachments that prevent free mesiodistal
tipping and yet permit the arch wire to slide freely mesio distally.

This permits the rapid retraction of the anterior teeth.


7. The use of attachments on all teth, except anchor molars, that
control rotations yet permit free tipping in the desired direction and
free sliding along arch wires.

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ATTRITIONAL OCCLUSION



There is nothing more important for a dental or
orthodontic student to learn than the normal attritional
development of mans dentition. Only then can he or she
understand the true cases of most dental and
orhtodontic problems, and take appropriate remedial
action.

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

Dr. Begg noticed that the teeth of Aborigines had not only extensive
occlusal and interproximal wear, but also exhibited total lack of
caries, periodontal disease and tooth crowding. He recognized
along with several others,that such examples of stone age man‟s
attritional occlusion represented the true occlusion for man – not a
pathological condition. This occlusion was far more efficient and
healthy than “textbook normal occlusion”. Civilized Man‟s unworn
dentition with all its related problems is abnormal.

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

Teeth continually erupt vertically, migrate mesially, and

usually are collectively too large to be accommodated in
the jaws without a reduction of tooth mass. This
reduction, which occurs naturally in primitive man from

attrition, can be replaced in civilized man by planned
mesiodistal stripping and / or tooth extractions.

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Attrition causes continual
changes in the shapes
and sizes of the teeth.
Mesial migration
and vertical eruption in
the presence of attrition
result in their moving
occlusomesially in the
jaws

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

It is only recently that man has developed the ability to adapt the
elements of the environment to fit his demands. One of the first
elements altered was food. Civilized man has refined his food;
eliminated the grit and excess fiber, resulting in foods that are soft,
pasty, ultra – refined and high in carbohydrates – causing caries.



Dr. Begg feels the present concept of textbook-normal occlusion

with its static tooth relationships shapes and sizes, is incorrect. Such
an occlusion, and diet that permits it, are actually the causes of the
majority of dental problems existing today.

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

In civilized man the persistence of an anterior overbite

locks the lower incisors in an anatomically and
functionally incorrect position. This restraint the natural
tendency for the lower incisor to become more
procumbent,also encourages further crowding of these
teeth. Persistence of anterior overbite also locks the
maxillary incisors in an anatomically and functionally
abnormal labial location.

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

Hard, coarse and gritty
food quickly causes
incisal and occlusal wear.
Initially the incisal wear is
oblique, but becomes
horizontal as wear
progress. The lower
incisors tip labially, while
the upper incisors
become more upright
until they assume an
edge to edge relationship.
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Gingival Recession And Vertical Eruption



The physiologic process of continual tooth eruption has
evolved to compensate for occlusal attrition. It persists in
modern man, even in the absence of attrition. As a result

of this, there is often continual increase in the vertical
dimension between maxilla and mandible. Consequently
civilized Man‟s face grows „‟longer‟‟ with age.

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

This eruption is often clinically misinterpreted as gingival
recession, when in fact it is the teeth that are erupting,
and the gingival margin that is remaining relatively

stationary. The rate of eruption and varies among
individuals.


The course and gritty diet that causes attrition also

controls caries and help prevent periodontal problems.Pit
and fissures are quickly reduced by occlusal
wear,thereby eliminating the focus of most caries in

civilized man.
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

In primitive man the
excessive occlusal forces
of mastication retard this
eruption to a rate
harmonious with the
progression of attritional
wear.If an individual lived
long enough, continoual
eruption and attritional
occlusion would result in
the shedding of the apical
portion of the root.

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

The course and gritty diet that causes attrition also

controls caries and help prevent periodontal
problems.Pits and fissures are quickly reduced by
occlusal wear,thereby eliminating the focus of most

caries in civilized man.
The diet itself is of low in carbohydrates and its
coarseness plus high volume prevents the accumulation

of dental plaque, without which there can be no dental
decay.
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

Gingival embrassure
areas (black triangles) in
civilized Man become
larger with age, due to
lack of proximal wear.



In primitive man the
interdental space remains
small,since the teeth
move together as the
proximal surfaces are
worn flat –creating large
broad contact areas.

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ERUPTION OF FIRST PERMANENT MOLARS


The edge to edge anterior tooth
relationship results in the lower
teeth being further forward in
relation to the upper teeth and
therefore, the mandibular second
deciduous molars are mesial to
the maxillary decidous second
molars. The lower first permanent
molar is then able to erupt in a

more mesial position and proper
initial relationship with the
maxillary first permanent molar is
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achieved.
ANATOMY OF TMJ



Attritional occlusion
can also affect anatomy
of the temporomandibular
joint.Primitive man
exhibits a shallow glenoid
fossa and flattened
condylar head, not the
deep fossa and round
head found in modearn
man.
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Eruption of succedaneous teeth.




Attrition brings about
enough reduction in
mesiodistal dimensions of
teeth to allow adequate
space for the erupting
permanent canines.
In the absence of
attrition there is often not
enough space for the
canine

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PROXIMAL WEAR




In attritional occlusion decidous teeth are worn away
quickly, both proximally an occlusally. The proximal wear
can result in increased space for later erupting canine
such as the canines.
In civilized man due to lack of proximal
attrition ,the permanent canines frequently lack adequate
space for eruption.

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ERUPTION OF THIRD MOLARS




In civilized man as no
proximal wear occurs
causes inadequate room
distal to the second
molars for normal
eruption of third molars
which leads to delayed
eruption and complete
impaction.
At the age of
12 to 13 years the third
molar begin to erupt in
attritional occlusion.
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CHANGE IN CURVE OF WILSON


As the permanent molars erupt
the bucco – lingual plane is
oblique. As wear progress, the
plane becomees horizontal, then
begins to slant downwards and
cusp of carabelli serves to
increase overall occlusal surface
area.



In civilized man the buccolingual
plane is oblique throughout life.

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SECONDARY DENTINE AND PULPAL PAIN


Value of pulpal pain is not to
warn of caries, but to warn of
atttrition approaching the pulp
faster than secondary dentin
can be laid down. This causes
automatic shift of bolus of food

and therefore attrition to other
teeth until secondary can
overtake the attrition.

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INCIDENCE OF CROWDING


Since attrition especially interproximallly causes a
continoual reduction in mesiodistal tooth widths, the
incidence of tooth crowding is relatively low in primitive
man.



The persistence of large teeth and the processes of
mesial migration in civilized Man explain the currrent
relatively high incidence of tooth crowding.

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CONCLUSION


As can be seen from the preceding examples, Man‟s

dentition is far healthier and efficient in an attritional
environment. However, this does not mean that
orthodontist or Dentist must prescribe abrasive diets or

begin eliminating cusps from their patients teeth. Rather,
it provides the reason for most of the problems seen in
the mouth of both dental and orthodontic patients.

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BEEG‟S TECHNIQUE

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

An orthodontic technique may defined as a
systematic sequence of definite procedure to achieve the
correction of malocclusion with a specific type of
appliance or with a combination of appliances.



The Begg method is a system that demands
stringent interdependence of technique and appearance;
this technique requires specific bracket design, arch wire
size and configurations, molar tube size and molar tube
placement as well as specific system of procedure.

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

The method consist essentially of tipping movements of
the teeth. Two successive tipping movements are

required to achieve bodily movement. The first to
position the tooth crowns and second to position the
tooth roots. As a result of these tipping movements,

complemented by intrusion, extrusion and rotation of
teeth whenever required, optimal occlusion, axial
positioning and alignment of the teeth are secured.

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COMPONENTS OF BEGG APPLIANCE


ARCH WIRE MATERIAL
Round austenitic stainless
steel wire of 0.016 inch diameter,
which has been heat treated and
cold drawn down to its proper
diameter, in order to give it the

required properties of resiliency,
toughness and tensile strength. –
without which this technique could
not have been devleloped and

cannot be employed.

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PRECAUTION TAKEN WHILE BENDING THE WIRE


When the wire is bent around
the round beak of the pliers,
the stress on the crystalline
structure is confined to a small
area, which may cause the
wire to break.
When bending the wire
around the square beak the
points of stressare offset,
providing more area for
crystalline adjustment and
there fore less chance fracture.

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MODIFIED RIBBON ARCH BRACKET ( TP -256500)
By changing the lock pins,
the size of the arch wire
slot can be changed to
accept properly either a
0.016 inch or a 0.020 inch
arch wire

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Requirements for a light wire brackets








Ease of arch wire engagement
A means to guide both the tail and head of lock pin
during locking
Positive retention of arch wire in all 3 stages
Free tipping and sliding on arch wire
Ability to effect and hold rotation
Ability to prevent accidental tipping in stage III.
These brackets are fabricated from stainless
steel strips, hence it is economical.

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TYPES
A.

B.

c.
d.

1. Full flange
2.Half flange
1. Bondable
2. Weldable
1.Flat
2. Curved
Full flange brackets will have more friction with
arch wire and hence hindrance to smooth tipping
movement of anteriors.
in half flange brackets, contact of the flange
with arch wire is minimal , thus friction is also minimal.
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AUSTRALIAN ARCHWIRES



In 1952 Dr Begg in collaboration with an Australian
Metallurgist Mr. A.J Wilcock, developed a high tensile S.S wire
that is heat treated and cold drawn to yield its now familiar and
excellent clinical properties.



It was made thin enough, to distribute force at an optimal level
for tooth movement over a considerable period of time, over
long distance and with minimal loss of force intensity while
doing so.
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SIX TYPES OF AUSTRALIAN WIRE
1. REGULAR GRADE:
- Lowest grade – easy to bend

- Used for practice bending and forming auxillaries.
2. REGULAR PLUS:
- Easy to form, more resilient than regular grade

- Used for auxiliaries and arch wires when more
pressure and resistance to deformation as desired.
3. SPECIAL GRADE:
- Highly resilient yet can be formed into shape.

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

SPECIAL PLUS GRADE:
- Hardness and resiliency of 0.016” wire, is

excellent for supporting anchorage, and reducing
deep overbites.
- Must be bent with care.


EXTRA SP ECIAL PLUS GRADE :
- Also called premium plus

- This grade is unequalled in resiliency and
hardness.
- More difficult to bend and more subjected to
fracture.

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

SUPREME GRADE:
- It is ultra light tensile fine round stainless steel

wire.
- It was initially introduce in 0.010” diameter and
then further reduced to 0.009 diameter.
-It is primarily used in the early treatment for
rotation. Alignment and leveling.
- Although supreme exceeds the yield strength of
E.S.P, it is intended for use in either short section or
full arches where sharp bends are not required.
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BAND MATERIAL


These bands made of stainless steel strips of different
size and thickness are recommended for different teeth.
These available on 8 feet rolls or cut of 2 inches to 2.5
inches.

1. For incisors - 0.125 x 0.003 inch
2. For canines, premolars – 0.150 x 0.004 inch
3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch

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LOCK PINS


Second stage safety lock pin: Shoulder on head ensures free
mesiodistal tipping. Labiolingual width of tail dimension is reduced to
fit properly into TP – 256 – 500 bracket in conjunction with inch arch
wire.



One point safety lock pin : Used in stage I and II. The pin has a
shoulder that keeps the head of the pin outside the bracket slot and
prevents the impingement of pin on arch wire. The beveled
undersurface of head permits free mesiodistal tipping. Thickness of
pin is 0.019 length 0.200‟‟ x 0.220”

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

Hook lock pins : Used during III
stage. Since there is no safety
shoulder, they hold the arch wire
firmly against the base of the arch
wire slot. Thickness – 0.014” to
0.018” , length – 0.220 to 0.293



High hat safety lock pins:
They have a gingival extension on
head which provides a positive
point for engagement of vertical or
cross elastics.
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BUCCAL TUBES


Round molar tubes with
0.036 internal diameter
and 0.250 length are
routinely used.



Flat oval molar tubes and
doubled back wires are
used when second
permanent molars are the
anchor teeth and also
used in mandibular dental
arch when second
premolar is absent.
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AUXILLARY ATTACHMENTS


In addition to the
foregoing parts, the light
round arch wire technique
requires the following
adjustments .



LINGUAL BUTTONS:
The name clearly
indicates the side of the
teeth where it is to be
welded. Used for
correction of premolar
and molar rotation.
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EYELETS:
Are made from thin
stainless steel stiff wires.
They are very useful in
tying the ligature wire on
anterior teeth for purpose
of rotation.

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CLEAT LUG
-

-

-

Are made from heavier
metal.
Welded in the centre of
lingual surfaces and
gingival 1/3 of the band.
Facilitate proper pushing
of bands to its proper
place on the tooth.

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SEATING LUG - HOOK


Flat or contoured bases
designed for the use on lingual
surface of all teeth.



Uses:
- for placement of
elastics
- easy insertion and
removal of band.

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BALL END HOOKS:
They are attached to
buccal or lingual of molar
bands. Positioned as far
gingivally and near the
mesiodistal centre of the
tooth. Make the placing of
elastic simple for patient.

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Bypass clamp


Pinning of the arch wire in
the premolar brackets
can cause hinderence to
free tipping.
So in stage I and stage
II Bypass clamps are
used on the premolar
brackets.

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Ligature wires
These are very thin (0.007 to 0.009) stainless steel soft

wires.
- They are very useful in tying of the span of looped arch
wire, which are far away from its ideal position, thus

porgressive increase In force and also avoiding plastic
deformation of the arch wire.
- Also used as extra holding devices. When one wants to

feel secure about arch wire not getting disengaged from
the bracket slot by slipping out
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ELASTICS


Elastics are made of synthetic latex and of uniform sizes
and applying uniform forces when stretched to required
length. These elastics come in different sizes of internal
diameter and different thickness of their wall. Thinner
walled elastics are called “light elastics” and thick
walled elastics are called “Heavy elastics”



These elastics will exert a force equal to between 60 and
70 gms when they are new and first placed.

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Strength of the elastics varied according to the
clinical requirement.

- LIGHT( yellow) class I or class II used for
anterior retraction.
-STRONGER ( green) class I are used for
posterior protraction.
- BLUE OR RED used only when green elastics are
ineffective.
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USES OF ELASTICS












Anterior retraction
Posterior protraction
Correction of deep bite
Correction of class II or class III occlusion
Closure of extraction spaces
Correction of cross bite
Correction of rotation
Anterior open bite (box elastics )
Correction of midline.
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CLASS I ELASTICS

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Class 2 Elastics

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EFFECTS OF CLASS II ELASTIC


In lower molar region one
vector

taking

posteriors

mesially and other vector
extruding force on molar.


On

upper

anteriors

horizontal vector will tipp
and retract anteriors distally
and

vertical

counteract

vector
the

will

intrusive

effect of upper arch wire on
anteriors.
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CLASS III ELASTICS

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SEPARATING SPRING

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BRACKET PLACEMENT

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BUCCAL TUBE PLACEMENT

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STAGES OF THE BEGG TECHNIQUE


STAGE I – OBJECTIVES
1. Open the anterior overbite
2. Overcorrect the mesiodistal relationship of the
buccal segment as necessary.
3. Close any anterior space.
4. Eliminate any anterior crowding.
5. Overrotate all teeth that require rotating.
6.Correct posterior crossbites.

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HOW TO ACHIEVE THE OBJECTIVES




1.Open the anterior over bite
- use 0.016 inch hard Australian wire.
- Proper amount of anchor bends at proper
locations.
-Continual wearing of class II or Class III elastics.
2. Overcorrect the mesiodistal relationship of the buccal segments as
necessary.
- Continoual wearing of class II or class III elastics
as required.
- Proper anchorage or bite – opening bends in both upper and
lower arch wires.

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3. Close any anterior space:
Plain arch wire with elastic from cuspid pin tail to
cuspid pin tail.
4.Eliminate any anterior crowding:
- Vertical loops between crowded anterior teeth, with
bracket areas modified for desired overcorrections.
- Arch length designed so that intermaxillary circles
rest against mesial surfaces of cuspid brackets.
5.Overrotate all teeth that require rotating
- Overcorrection of bracket areas between anterior
vertical loops.

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- Use of elastic thread from buttons or brackets to
rotate cuspids and bicuspids.
- Use of rotating springs
6. Correct posterior crossbites:
- Modify arch width of one or both arch wires
-wearing cross elastics
- Rapid maxillary overexpansion, folloed by aperiod
of stabilization prior to the placement of complete
appliances and the beginning of stage I.

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PRIORITIES IN THE STAGE I


1. It is generally agree that reduction of overbite must
precede reduction of overjet.



2. While treating cases with anterior crowding,
alignment of teeth becomes an important consideration.



3. when the upper incisors are very much proclined they
should be subjected to a light intrusive force and a
normal retractive class II elastic force till their
proclination reduces.
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

Stage I arch wire :
- Made from 0.016
heat treated high tensile
stainless steel wire.
- incorporate

anchor bends, intermaxillary
hooks,toe- in, toe – out bends,
vertical loop.

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VERTICAL LOOP

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ANCHOR BENDS

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INTER MAXILLARY HOOK




It helps in placement of
elastics
It prevent slippage of plain
arch wires

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CANINE CONDOUR

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TOE - IN BENDS:
Incorporated in the arch wire as anti – rotational
bends. The toe in bends should never exceed more than
5 degree.
TOE – OUT BENDS
To correct the disto – buccal molar rotation.

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ELASTICS







To open the bite
To correct the mesiodistal relationship of buccal
segments
To close the anterior spacing
Corection of rotation
Posterior crossbite corection

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PROBLEMS ARISING IN STAGE I


BITE NOT OPENING:
A. Patient not wearing elastics:
- educate the patient
-do not give enough elastics
- make it impossible to hook elastics and
see if problem is reported
B. Patient biting out bite opening bends.
- Remove the arch wire : restore bite
opening bends

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- Check the level of mandibular molar tubes, lower thm, if
necessary.
-

Check position of anchor bends, if too far mesially, move
them closer to molar tube.

-

Failure to place proper amount of bite opening bends
when arches were placed.

-

Loose molar band

-

Improper angulations of buccal tube or entire molar
bend.

MOLAR WIDTH NARROWING:
A. Verticl component of classs II elastic force
- Form mandibular arch wire wider in posterior
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segment
B. Prolonged wearing of posterior cross elastics to widen
opposing molars
- discontinue cross elastics and correct cross bite by
others means.
C. Disto – lingually rotated cuspids
1. Do not engage the arch wire in the cuspid brackets
until these teeth have been rotated by elastic thread or
other means.
3. ADVERSE TIPPING OF ANCHOR MOLARS
- If tipped mesially : there is no anchor bends. If tipped
distaly too much anchor bends.
- Improper placement of molar band or tube
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- Excessive elastic force
- Improper placement of elastics
- Oversize arch wire – molar tipped distally.
4. NO APPRECIABLE CHANGE
- Patient not wearing elastics
- Arch wire bend out of shape
- patient seen too soon
5. VERTICALLOOPS BURIED IN THE GINGIVA
a. Original, looped arch wire left in the mouth too
long
- replace it with plain arch wire with bayonet bends
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b. Misjudgment in the proper direction of vertical loops
when the arch wire was plced
- remove and modify the direction of the loops and
replace.
6. ELASTICS WHICH BREAK OR DO NOT STAY ON:
a. may just be an excuse for not wearing elastics
b. elastic will not stay on the intermaxillary circle.
7.LOCK PINS LOST;
a. occluso incisal force
-use steel pin
- Chek anchor bends to facilitate opening the bite

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8. EXTREMELY MOBILE MOLARS:
A. clenching of the teeth
b. intermittent wearing of elastics
c. pathology
d. excessive force applied to molar
- Reduce arch wire size to 0.016 inch
- Reduce elastic force to 2 ½ ounces
- Reduce degree of anchor bends
9. LOWER ANTERIOR TEETH TIPPING LABIALLY:
A. May be an optical illusion with roots actually moving
lingually.
b. Binding of the arch wire in bicuspid brackets
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

Binding of ends of the arch wire inside distal ends of
buccal tube.

10. ANTERIOR OPEN BITE NOT CLOSING:
A. patient not wearing anterior vertical elastics
B. Persistent tongue thrust or other adverse habits
c. Too much anchor bend.

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STAGE II


OBJECTIVES:
1. Maintain all corrections achieved during
first stage.
2. Close any remaining posterior space.

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

Mesiodistal molar relationship maintained
through the wearing of clasII or ClassIII elastics

as required.


Spaces between the anterior teeth are prevented
by tying intermaxillary circles to the cuspid

brackets.


Overrotations of central and lateral incisors are
maintained through the continued use of
bayonet bends in the arch wires.
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

Mesiodistal molar relationship maintained
through the wearing of clasII or ClassIII elastics

as required.


Spaces between the anterior teeth are prevented
by tying intermaxillary circles to the cuspid

brackets.


Overrotations of central and lateral incisors are
maintained through the continued use of
bayonet bends in the arch wires.
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

Overrotations of bicuspids are held by
replacing elastic threads with steel ligature

tie.


Opening of deep anterior overbite is
maintained through the continued use of

bite opening bends and class II or class III
elastics.


Closing of extraction space by wearing of
horizontal elastics.
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ARCH WIRE ( 0.020 SS)

- To maintain the corrections already
achieved.
- To stabilize the teeth against any adverse
reciprocal forces may occur as a result of the application of
elastics or auxiliaries.
ANCHOR BEND:
- Less compared to stage I
PREMOLAR OFFSET BEND
LOCK PIN:
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- “Stage 2” safety lock pins.
ELASTIC


Horizontal intra-maxillary space closing elastics
with class 2 elastics to maintain to maintain the
edge to edge.



creates rotational tendency on molar

(distobuccal).

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

1.

Horizontal

elastic

is

engaged on the lingual of
the molar instead on the
buccal.



2. Elastic thread tie on the
lingual, from the canine to

molar.

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AUXILIARIES USED IN STAGE II


Passive uprighting springs on mandibular
canine.



It establish two point contact between the
teeth and arch wire to prevent further free
tipping.



The strength of horizontal elastics
increased from 21/2 ounces to 8 ounces.

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is
CORRECTION OF MIDLINE


Class II intermaxillary elastics on one side and class three on
other side.



Elastic from intermaxillary hook mesial to upper canine to
intermaxillary hook mesial of the lower canine on opposite
side

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

Ligature wire or by – pass clamps are used on

second premolars in order to avoid overclosure of
extraction space and pushing of II premolar
lingually.

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END OF STAGE II

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PROBLEM ENCOUNTERED DURING
SECOND STAGE


Anterior bite closing:
a. Not enough anchor bend
b. Bite – opening bends bitten out
- Educate patient , correct the archwire
c. Patient not wearing the classII elastics
d. Anchor molars out of occlusion
- Discontinue class II or class III elastics.
Use horizontal elastics to get molars in occlusion.

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

Anterior teeth assuming class III relation
a. Excessive wearing of class II elastics



Spaces Developing Between The Anterior
teeth:
a. Failure to give cuspid tie
b. Intermaxillary circles formed too far apart.



Anchor molar rotating distobucally
a. Toe – out on arch wire

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Anchor molars rotating distobuccally
a. Too much force from horizontal elastics
- Use lighter horizontal elastics
- Elastic thread from cuspid lingual
buttons to the lingual hooks on the molars.





Posterior spaces not closing:
a. Patient not wearing elastics.
b.Arch wire not free to slide distally through
buccal tube.
c. Arch wire pinned or caught in bicuspid
bracket slot.
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d. Anterior teeth or tooth not free to tip distally:
- Use proper brackets that allow free
mesiodistal tipping.
- use safety lock pins


Second bicuspids tipping mesially in first
bicuspid:

-

Slight, expected mesial movement of anchor molar

-

Abnormal loss of anchorage, if second bicuspids
are tipping excessively.

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STAGE III


OBJECTIVES:
1. Maintain all corrections achieved
during first and second stages.
2. Achieve desired axial inclinations of
all teeth.

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- Posterior spaces kept closed by bending the distal ends of
the arch wires around the buccal tubes.
-

Arch form and overbite corrections maintained by using

heavier (0.018 to 0.025) main arch wires.
- Changes in the mesiodistal inclinations of teeth are

accomplished by the use of individual root – tipping springs.
- Lingual or labial root torque is applied to anterior teeth

through the application www.indiandentalacademy.comauxiliaries.
of torqueing
STAGE THREE UPPER ARCH WIRE


Made by 0.20 s.s



Constricted in distal ends.



Gingival bend distal to cuspid
bracket.

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STAGE III LOWER ARCH WIRE


Made by 0.20 round s.s.



Expansion in distal ends.



Molar offset bend



Mild anchor bend distal to
canine.



Slight vertical step in the
anchor bend area.

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AUXILIARIES USED IN STAGE III
UPRIGHTING SPRING:




Used to correct the axial angulation of
teeth in mesio – distal direction.
Made by 0.014” round S.S
for canine and premolars,
0.012 for laterals.
Helix of spring face towards tooth
surface and lie on the gingival aspect of
arch wire.

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

The degree of activation of spring depends on
1. The size of wire from which spring is made
2. The diameter of the helix
3. The number of turns in helix
4. The length of the arms of spring
5. The size of the root of the tooth being
uprighted

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

Arch wire ligation prior to
placement of uprighting
spring

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TYPES OF UPRIGHTING SPRING


A combination safety lock
pin and uprighting spring
that eliminates the need
for ligating the arch wire
to the bracket. Locked in
place by bending the tail
of the spring around the
body of bracket.



Available as two coil and
three coil from .014

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PLAIN UPRIGHTING SPRING


Made of 0.014 for uprighting
canine and premolars, 0.012 for
incisors.



The angulation of the active arm
and retentive arm is 135 degree.



The helix with retentive arm
should face the tooth surface.



The base arch wire is ligated,
otherwise the action of uprighting
spring will extrude the tooth .

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-The

length of hook is made greater than the diameter

of the helix to keep the arm of the spring parallel to the

arch wire in the vertical plane.

--

To avoid a rotating force on the tooth, the arm of the

spring is offset buccally to make it parallel to the arch
wire in the horizontal plane.

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The degree of activation of the uprighting springs depends
on:
1. The size of wire
2. Diameter of helix
3. Number of turns in the helix
4. Length of the arm of the spring
5. The size of the root being uprighted.

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MINISPRING


Made of thinner diameter
(0.009) high resilient supreme
grade wire.



The coil of springs is only twice
the size of the wire.



The activation is 100%, the
stem and active arm are in one
line.

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

The hooks of short –
arm uprighting springs
will slide along the arch
wire and approach each
other as teeth upright.



If long arm uprighting
springs are used, the
arms of premolar and
canine cross each
other.

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

The rotational
component of the
tooth displacement,
caused by a single
force application, is
generally unfavorable.
Hence it is resisted by
applying a counter
moment as by
uprighting sping

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TORQUING AUXILLARY

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TYPES OF TORQUEING AUXILIARY
1.

2.
3.
4.
5.
6.
7.
8.
9.
10.

TWO SPUR TORQUEING
AUXILIARY
FOUR SPUR
SIX SPUR
RECIPROCAL
SHORT FOUR SPUR
INDIVIDUAL
ONE TO ONE
RECIPROCAL
LOWER REVERSE
RAT - TRAP
ASYMMETRICAL

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FOUR SPUR TORQUEING AUXILLARY



Used for torqueing the upper
anterior teeth palataly



Preformed from .016” wire

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TWO SPUR TORQUEING AUXILLARY


Used when lateral incisors do
not require palatal root torque ,
as in extraction cases when
upper laterals were displaced
slightly palataly.

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FABRICATION OF TORQUEING AUXILIARY

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RECIPROCAL TORQUEING AUXILIARY

-

Indicated when the upper
lateral incisors were blocked
out palatally before treatment.
Their root apices must be
torqued labially to reduce the

tendency for the crowns to
relapse lingually.

-

Lever arms on laterals pass
incisaly for labial root torque.
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SHORT FOUR – SPUR TORQUEING AUXILIARY


Indicated for torqueing of
upper anterios.



Does not engage cuspid
bracket



Easy to fabricate.

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INDIVIDUAL TORQUEING AUXILIARY


Used for selected upper or
lower teeth



Auxiliary should extend at least
one tooth pass tooth being
torqued, and around curve of
arch, for maximum activation.



If placed gingivally, torque the
root of the lateral lingually.

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REVERSE TORQUEING AUXILIARY


Indicated if lower anterior
teeth are becoming too
proclined.



Acts as a source of intra
oral mandibular
anchorage to inhibit
forward movement of
mandibular dental arch.

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ONE TO ONE TORQUEING AUXILIARY


Indicated when two
adjacent teeth require
root torque in opposite
directions.



Tends to deliver
excessive force therefore
degree of activation
between lever arms
should be low

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RAT - TRAP TORQUEING AUXILIARY






Main arch wire is formed
from 0.020 inch round
wire.
The auxiliary is wound
from either 0.014 or
0.016 inch highly resilient
round wire.
The torqueing “bars” do
not extend to the gingiva.

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ASYMMETRICAL TORQUING
AUXILIARY
Auxiliary used to produce palatal root torque of
the maxillary right central and lateral incisors.


The ends of the auxiliary are terminated distal to
the canine brackets.


As the central incisor loop is formed mesial to the
bracket and the lateral incisor loop is formed distal
to the bracket mesodistal movement of the auxiliary
is prevented.


www.indiandentalacademy.com
1.
2.
3.
4.
5.
6.
7.
8.

9.

10.

Two spur arch
Four spur arch
Modified four spur
Art four – spur
Modified Kitchon 2 – spurs
Kitchon two finger spur
F and J two spur arch
Von der heydt two – spur
arch
Modified reverse torque
arch
Sain reverse torque arch

www.indiandentalacademy.com
The lingual torquing effect is on account of two
factors:
1. Vertical plane changes to horizontal.
2. Smaller circle opens to large.
Both these effects force the tips of the
spurs to press in a lingual direction against the
gingival portion of the crown. Reciprocally, the

inter – spur spans of the auxiliary tend to lift away
in a labial direction. Thus a force couple is
created. The labial forces are resisted by the

bracket slots and the base archwire to which
auxiliary is tied this accentuates the action of root
www.indiandentalacademy.com

lingual moving force.
PROBLEMS ENCOUNTERED DURING
STAGE III


Maxillary Molars Widening:
A. Anchor bends present in maxillary arch wire.
b.Too much bite – opening bend between cuspid
and bicuspid
c. maxillary arch wire too small in diameter.
d. Maxillary arch wire too wide.
e. Torqueing auxillary not constricted adequately.

www.indiandentalacademy.com


Mandibular molars narrowing
a. Lower arch wire not wide enough
b. class II elastics exerting too much force
c presence of steel ligature tie from the lingual of
the mandibular cuspid to the lingual of the
mandibular molar



Anterior bite deepening:
a. Too much power in the torqueing auxillary
b. Maxillary arch wire too thin.
c. Patient not wearing class II elastic
www.indiandentalacademy.com


Teeth not uprighting mesiodistally:
A. springs not active
B. Arch wire caught on the edge of the bracket
- Tighten spring – pin to draw arch wire in
bracket
- Draw arch wire into bracket with a steel
ligature tie
C. Occlusal interference caused by an elevated
tooth.
D. Springs placed in backwards

www.indiandentalacademy.com


Teeth not uprighting mesiodistally:
A. springs not active
B. Arch wire caught on the edge of the bracket
- Tighten spring – pin to draw arch wire in
bracket
- Draw arch wire into bracket with a steel
ligature tie
C. Occlusal interference caused by an elevated
tooth.
D. Springs placed in backwards

www.indiandentalacademy.com

1.
2.

Maxillary anterior teeth not torqueing palatally
Not enough force from maxillary torqueing auxiliary
Maxillary incisal edges caught lingual to lower
anterior teeth



Lower anterior teeth labially inclined
Normal mesial migration of teeth during third
stage



Rotation of teeth other than molars
Lack of complete bracket engagement
Arch wire slot too large.

1.

2.

www.indiandentalacademy.com
It was partly through studying Stone age man’s attrition that
light tooth moving forces were found to make higher standards of
orthodontic treatment possible.
Furthermore, the light wire technique is unique in that the tooth
moving forces it exerts are so appropriate that extra – oral forces are
never required neither to enhance nor to combat the force values exerted
by it.
The advent of this technique provides common ground for
agreement between the school of thought advocating movement of tooth
roots to their correct relations and the school advocating light forces.
www.indiandentalacademy.com
www.indiandentalacademy.com

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S begg’s

  • 1. BEGG‟S PHILOSOPHY AND TECHNIQUE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. CONTENTS        Evolution of Beggs technique Beggs philosophy Beggs technique Components Stage I Stage II Stage III www.indiandentalacademy.com
  • 3. DEVELOPMENT OF LIGHT WIRE TECHNIQUE www.indiandentalacademy.com
  • 4.  Dr P.R Begg was born in 1898 in a small, gold mining town Coolgardie, west Australia.  Grew up in south Australia.As a boy he saw the sketch of Australia aborginal and noticed their teeth were worn flat, no one thought to tell him why or how it happened. www.indiandentalacademy.com
  • 5.  In his early twenties he worked as a Jackaroo at Boonoke- a sheep and cattle station in New south Australia, looking after both cattle and sheep.  He noticed many people with crooked teeth and saw many feeble attempts at correction of these problems with many treatment failures and few successes. www.indiandentalacademy.com
  • 6. .  As he wanted to help such people he enrolled in the dental course at the University of Melbourne instead of taking the medical course, as he originally intended.  At the commencement of third year of training, Dr Begg decided to practice orthodontics after graduating in dentistry. www.indiandentalacademy.com
  • 7.  Dr Stanley Wilkinson, a former student of E.H Angle was the lecturer in Orhodontics and used the seventh edition of “Malocclusion of the teeth” as the text book. Dr Begg graduated in 1923 with B.D.Sc Degree the L.D.S Diploma.  His introduction to Dr. Angle‟s work led him to travel to Pasadena, California in 1924 to study with Dr. Angle. www.indiandentalacademy.com
  • 8. - DR. Begg was with Dr. Angle from February,1924 to November,1925. - At that time Dr. Angle was teaching his followers the Ribbon arch appliance which he introduced in 1916. www.indiandentalacademy.com
  • 9. - Coincidentally with Begg‟s arrival in California Dr. Angle was developing he Edgwise arch mechanisms, Which he felt was a vast improvement over the Ribbon arch Appliance - Angle instructed Dr. Begg and Fred Ishii of Japan in the use of the Edgewise mechanism, before it was revealed to the profession. Since Dr. Angle was ill, it was they who first treated patients with Edge wise Appliance www.indiandentalacademy.com
  • 11.  The relation between Dr,Begg and Dr.Angle was warm and mutually rewarding. Dr.Begg helped Dr.Angle to cut Edgewise brackets on a lathe from milled strips of platinized gold provided by S.S. white dental company.  At that time Dr.Spenser Atkison demonstrated to the students that it was normal for the upper first permanent molars to move continuously mesially throughout life. Dr. angle referred to this as the anterior component of force. www.indiandentalacademy.com
  • 12.  During Dr. Begg‟s stay Dr.Angle wrote, and read for the first time, his paper entitled. “ The latest and Best in orthodontic Mechanism” ( published in Dent. Cosmos 1928 and 1929 ). It disclosed the use of edge wise Mechanism.  In November, 1925 Dr. Begg sailed back to Australia. In December of the same year he began practicing Orthodonics in Adelaide, south Australia.  Married Nellie Hamilton in 1928. www.indiandentalacademy.com
  • 13.  Begg the only orhodontist in Adelaide in 1926 practiced Edgewise non extraction, technique.  He was appointed Lecturer in Orthodontics at the university of Adelaide, a position he held until the university‟s retirement age. ( Retirement in 1964).  For two years, Dr. Begg faithfully followed Dr. Angle‟s teaching of retaining the full compliment of teeth. www.indiandentalacademy.com
  • 14.  However in many of his patients he was‟nt satisfied with post treatment profiles and there was the serious problem of relapses.  In February of 1928 he began to routinely remove teeth or reduce tooth widths by mesio - distal stripping in patients with excess tooth substance. www.indiandentalacademy.com
  • 15. .  He learnt from experience and his ever – growing appreciation of the role of attritional occlusion in the development of man‟s dentition, that such reduction was often necessary to permit the proper repositioning of the teeth to enhance function, stability and esthetics.  Initially he faced opposition from dentist of his patients. It was only after his superior treatment results were seen to stand the test of time that the criticism relented. He retreated many patients who had relapse due to retention of excessive tooth material. www.indiandentalacademy.com
  • 16. CHANGING THE MECHANICS - Dr. Begg began to realize the Edgewise mechanism was not designed to rapidly close extraction space or quickly reduce deep overbites. - To facilitate such changes he began using 0.20‟‟ round platinized gold, rather than rectangular, arch wire in 1929. In 1931 he started using .018‟‟ round stainless steel wire, bending the now popular vertical loops and intermaxillary hooks right into the arch wires. www.indiandentalacademy.com
  • 17. - He soon realized that if round arch wire were engaged in edgewise brackets, indiscriminate and often undesired root moving forces could be created this prolongs the anterior bite opening and taxed intraoral anchorage. - In 1933, about 3 years after switching from rectangular to round arch wire material, he began treating some cases using S.S. White ribbon arch brackets, to which he had been exposed during his stay with Dr.Angle. - Dr. Begg faced the openings of the brackets slots of the ribbon arch brackets gingivally, instead of incisally as advocated by Dr. Angle. He realized that these relatively narrow brackets with vertically facing slots allowed the teeth to move under much lighter forces. www.indiandentalacademy.com
  • 18.  To improve rotation tooth control with the use of smaller round wires in the Ribbon Arch Brackets, Dr. Begg filed their bases before soldering them to the bands. This reduced the widths of the arch wire slots.  In 1935 Dr. Begg was awarded the title of D.D.Sc. For his thesis entitled, “Some aspects of the etiology of irregularity and malocclusion of teeth‟‟. This was the illumination of his study of attritional occlusion that began with the casual observation in the aborginal prior to World War I, and included studying the skulls of American Indian at the southern Museum in California. www.indiandentalacademy.com
  • 19. A NEW WIRE  In the early 1940‟s Dr. Begg met Arthur J.Wilcock, director of metallurgical research projects at the University of Melbourne.  After many years of research Wilcock produced a cold drawn heat treated wire that combined the balance between hardness and resilience with the unique property of zero stress relaxation that Dr.Begg was seeking.  This unusual wire permitted to open anterior over bites, while controlling arch form and providing molar stability. www.indiandentalacademy.com
  • 21.  He also produced the modified Ribbon arch brackets, lock pins and special buccal tubes to meet Dr.Begg‟s ever-changing requirements in these experimental years  In 1952 Dr Begg began to use 0.16‟‟ round stainless steel wires instead of 0.18‟‟ permitting to open anterior overbites quickly. www.indiandentalacademy.com
  • 22.  In 1939 DR.Begg wrote his doctoral thesis “ The Evolutionary Reduction and degenaration of Man‟s Jaws and teeth‟‟ in 1939. It relates attrition or more often lack of it, to the etiology of malocclusion and other dental problems in modern man.  In 1954 Dr.Begg published paper entitled, “Stone Age Man‟s dentition” and as the title suggests, it also dealt with attritional occlusion, and explained why it is the anatomically correct occlusion.  At the end of his article he disclosed a new technique which he referred to as the “round wire technique”, advocating at that time the use of 0.18” (0.46mm) diameter stainless steel arch wires in modified Ribbon Arch brackets. www.indiandentalacademy.com
  • 23.  The technique describe in this 1954 article was much different from what it is today, and the treatment results shown did not include detailed finishing. Even so, it drew relatively large response including correspondance from three prominent orthodontist who expressed an interest in the treatment method disclosed – his found from the Angle school, Dr. Spencer Atkinson; Dr. Robert strang and Dr. CharlesTweed. www.indiandentalacademy.com
  • 24.  In 1956 (Am Jr) Dr. Begg had another article published entitled, differential Force in orthodontic Treatment.  While he did not specifically define differential force in so many words, its operation was explained. This demonstrated that this techniques and theories of treatment were able to produce acceptable results in unbelievable short treatment times for all types of malocclusion- from the simplest to the most extreme discrepancies of both teeth and jaws. . www.indiandentalacademy.com
  • 25.  As a result of reading this article several orthodontists visited Dr.Begg in Adelaide, South Australia.  In 1957 Dr.H.D. Kesling and Dr. George Dissham came from the United states. They spent several weeks in Dr.Begg‟s office and home, attempting to learn the technique, which was extremely difficult as there was no organization to it. www.indiandentalacademy.com
  • 26. INTRODUCTION OF BEGG TECHNIQUE IN THE UNITED STATES  Upon Kesling‟s return from Adelaide,he had plans to implement his new technique in his practice along with Dr.R. A. Rocke not just to selected patients, but every patient.  In 1959 the Kesling and Rocke Orthodontic group invited over 150 orthodontist from across the united states, to assess the results of their results of their 100 consecutively – treated cases by Begg technique. www.indiandentalacademy.com
  • 27.  Dr .H.D. Kesling, first orthodontist in the United States to practice the Begg Technique, and the one most responsible for popularizing its use through showings and courses www.indiandentalacademy.com
  • 28.  While the results were not of the quality of the results achieved today, they demonstrated the ability of the Begg technique to quickly open deep anterior open bites. Treatment times were relatively short, and the number of adjustments few. As a result there arose a demand for training in this new technique.  First course in Begg Technique had 31 students, was held in the new orthodontic center in Westville, Indiana on june 1959 (1week course). The brackets used were the new Double - Tab type. www.indiandentalacademy.com
  • 29.  However, the use of the double tab bracket proved difficult, as arch wires were unnecessarily complicated to permit desired tooth movement. Also, it lacked the ability to overcorrect the teeth which is so necessary to reduce the tendency for relapse.  Dr Begg realized that inorder to make his technique acceptable to leading orthodontist in the united states, most of whom were using Edgewise mechanism at that time, he had to finish his cases with more precision. www.indiandentalacademy.com
  • 30.  Prior to their visit, Dr. Begg was mainly concerned with repositioning the teeth instable positions over basal bone. The final settling of teeth he left to the forces of occlusion, guided when necessary by an upper retainer with circumferential wire.  Also he realized the growing demand for training in his new technique required that the treatment be organised in some manner to facilitate both teaching and learning. www.indiandentalacademy.com
  • 31.  The result was that in April of 1960, as Dr. Begg began unpacking his models (which he had brought as part of his presentation before the American Association of Orthodontist), members of the kesling and Rocke group were stunned by his quality of treatment . Hours after seeing the quality of results achieved by Dr.Begg with modified Ribbon Arch brackets, Dr.Kesling made the decision to scrap his double- tab brackets. www.indiandentalacademy.com
  • 32. In the years between Dr.Kesling‟s first visit in 1957 and his trip to the United states in the spring of 1960, Dr.Begg did the following: 1.Finished his cases with such detail and precision that they could not be discerned from similar cases treated with Edgewise mechanism. 2. Seperated the technique into three distinct stages and established objectives for each stage. 3.Developed root torqueing auxiliaries separate from the main arch wire. 4.Introduced mesiodistal uprighting spring. 5. Emphasized the importance of free tipping of tooth crowns in the early stages of treatment. 6. Suggested taking stage models to discipline the orthodontist. www.indiandentalacademy.com
  • 34.  The Begg differential force technique is a unique approach to orthodontic treatment. The philosophy behind it, including diagnosis, method and direction of tooth movement , is keyed to attritional occlusion.  Dr.Begg‟s studies of stone age Man‟s dentition indicate that man‟s occlusion is not static, but an ever changing one.The teeth continoully migrate mesially and vertically and compensate for the attrition of their proximal and occluso – incisal surfaces. The absence of attrition caused by civilized man‟s soft diet does not eliminate the migration of teeth. www.indiandentalacademy.com
  • 35. DIFFERENTIAL FORCE  In 1956 Dr Begg introduced the concept of Differential force.  His observations was based on the work of Storey and Smith and their experiments on tooth movement response to different pressure applications. www.indiandentalacademy.com
  • 36.  IT IS DEFINED AS A FORCE THAT RESULTS IN A DIFFERENT RATE OR TOOTH MOVEMENT AT ONE END THAN THE OTHER. www.indiandentalacademy.com
  • 37.  A range of light pressures which would cause teeth to move at an optimum rate and with minimal disturbance of the supportive tissues optimum orthodontic force.  Pressures below this produce a slow rate of response, while above incurred a reaction within the bone support (undermining resorption), which also had an effect of retarding tooth movement. www.indiandentalacademy.com
  • 38.  When a relatively light force is applied reciprocally between small – rooted anterior teeth and larger – rooted posterior teeth, the anterior teeth move relatively rapidly, whereas the larger – rooted posterior teeth remain almost stationary.  Conversely, if a relatively heavy force is applied in the same situation, the posterior teeth tend to migrate mesially while the anterior teeth resist movement. www.indiandentalacademy.com
  • 39.  Here given elastic force is relatively constant, It is the rate of movement of the teeth on either end of the force that varies. Accordingly, it would perhaps be more appropriate to refer to “ differential reactions” rather than differential forces. www.indiandentalacademy.com
  • 40.  A. Mechanics at each end of the force permites the force to differentiate as desired.  B. If the mechanics are the same at both ends of the force, the initial reaction will be for the molar, which has a smaller root surface area, to move forward and the anterior teeth remain stationary. www.indiandentalacademy.com
  • 41.  The significance of this concept is enhanced by the ability to choose mechanics that promote free tipping where the greatest movement is desired and prevent free tipping where stability or anchorage is indicated. www.indiandentalacademy.com
  • 42.  A goal of Begg‟s treatment is over correction of the teeth to allow for the natural tendency for relapse that occurs when orthodontic appliance removed.  The differential force technique is designed to permit teeth to move towards their anatomically correct positions in the jaw under the influence of very light forces – as would occur naturally in the presence of attrition. . www.indiandentalacademy.com
  • 43.  The light intra oral forces of Begg Technique do not place undue strain on the anchor molars.  The appliance is designed to permit the teeth to move independently of one another – whether tipping freely in the early stages or during detailed root positioning in the final stage. www.indiandentalacademy.com
  • 44.  Another feature is that the movement of all the teeth towards and beyond their desired final positions is initiated at the start of treatment ie. The movement of the teeth is not segmented into groups with one group waiting for another.  Both archwires and intermaxillary elastics are applied at the bonding appointment causing immediate reduction of deep overbite and overjets. The discomfort caused by the initiation of tooth movement produces a change in eating and biting habits that lessens the chance for appliance damage. www.indiandentalacademy.com
  • 45.  The movement of all teeth is due to the synergistic effect of the forces and appliances working together in the presence of proper diagnosis.  The begg synergistic arch graphically demonstrates and emphasizes the importance of the combination of avrious components comprising the Begg theory and technique. www.indiandentalacademy.com
  • 46. SEVEN SYNERGISTIC COMPO NENTS  1. A diagnosis and treatment plan that recognizes the persistence of hereditary forces of mesial migration and vertical eruption of teeth and has its objectives the over correction of malrelationships of both teeth and jaws.  2. The simultaneous movement of all teeth. From the beginning of treatment each tooth is directed towards its final position in the dental arch.  3. The total separation of root moving forces from arch wire forces during the final third stage of treatment.  4. The application of proper elastic forces to create the desired differential movement of the teeth. www.indiandentalacademy.com
  • 47.  5. The use of light round continuos arch wires bent from the hardest wire possible – Not only must the wire be of highest quality, but the aech wire have proper form, including bite opening bends, to control the vertical dimension.  6. The use of molar attachments that prevent free mesiodistal tipping and yet permit the arch wire to slide freely mesio distally. This permits the rapid retraction of the anterior teeth.  7. The use of attachments on all teth, except anchor molars, that control rotations yet permit free tipping in the desired direction and free sliding along arch wires. www.indiandentalacademy.com
  • 49. ATTRITIONAL OCCLUSION  There is nothing more important for a dental or orthodontic student to learn than the normal attritional development of mans dentition. Only then can he or she understand the true cases of most dental and orhtodontic problems, and take appropriate remedial action. www.indiandentalacademy.com
  • 50.  Dr. Begg noticed that the teeth of Aborigines had not only extensive occlusal and interproximal wear, but also exhibited total lack of caries, periodontal disease and tooth crowding. He recognized along with several others,that such examples of stone age man‟s attritional occlusion represented the true occlusion for man – not a pathological condition. This occlusion was far more efficient and healthy than “textbook normal occlusion”. Civilized Man‟s unworn dentition with all its related problems is abnormal. www.indiandentalacademy.com
  • 52.  Teeth continually erupt vertically, migrate mesially, and usually are collectively too large to be accommodated in the jaws without a reduction of tooth mass. This reduction, which occurs naturally in primitive man from attrition, can be replaced in civilized man by planned mesiodistal stripping and / or tooth extractions. www.indiandentalacademy.com
  • 53. Attrition causes continual changes in the shapes and sizes of the teeth. Mesial migration and vertical eruption in the presence of attrition result in their moving occlusomesially in the jaws www.indiandentalacademy.com
  • 54.  It is only recently that man has developed the ability to adapt the elements of the environment to fit his demands. One of the first elements altered was food. Civilized man has refined his food; eliminated the grit and excess fiber, resulting in foods that are soft, pasty, ultra – refined and high in carbohydrates – causing caries.  Dr. Begg feels the present concept of textbook-normal occlusion with its static tooth relationships shapes and sizes, is incorrect. Such an occlusion, and diet that permits it, are actually the causes of the majority of dental problems existing today. www.indiandentalacademy.com
  • 55.  In civilized man the persistence of an anterior overbite locks the lower incisors in an anatomically and functionally incorrect position. This restraint the natural tendency for the lower incisor to become more procumbent,also encourages further crowding of these teeth. Persistence of anterior overbite also locks the maxillary incisors in an anatomically and functionally abnormal labial location. www.indiandentalacademy.com
  • 56.  Hard, coarse and gritty food quickly causes incisal and occlusal wear. Initially the incisal wear is oblique, but becomes horizontal as wear progress. The lower incisors tip labially, while the upper incisors become more upright until they assume an edge to edge relationship. www.indiandentalacademy.com
  • 57. Gingival Recession And Vertical Eruption  The physiologic process of continual tooth eruption has evolved to compensate for occlusal attrition. It persists in modern man, even in the absence of attrition. As a result of this, there is often continual increase in the vertical dimension between maxilla and mandible. Consequently civilized Man‟s face grows „‟longer‟‟ with age. www.indiandentalacademy.com
  • 58.  This eruption is often clinically misinterpreted as gingival recession, when in fact it is the teeth that are erupting, and the gingival margin that is remaining relatively stationary. The rate of eruption and varies among individuals.  The course and gritty diet that causes attrition also controls caries and help prevent periodontal problems.Pit and fissures are quickly reduced by occlusal wear,thereby eliminating the focus of most caries in civilized man. www.indiandentalacademy.com
  • 59.  In primitive man the excessive occlusal forces of mastication retard this eruption to a rate harmonious with the progression of attritional wear.If an individual lived long enough, continoual eruption and attritional occlusion would result in the shedding of the apical portion of the root. www.indiandentalacademy.com
  • 60.  The course and gritty diet that causes attrition also controls caries and help prevent periodontal problems.Pits and fissures are quickly reduced by occlusal wear,thereby eliminating the focus of most caries in civilized man. The diet itself is of low in carbohydrates and its coarseness plus high volume prevents the accumulation of dental plaque, without which there can be no dental decay. www.indiandentalacademy.com
  • 61.  Gingival embrassure areas (black triangles) in civilized Man become larger with age, due to lack of proximal wear.  In primitive man the interdental space remains small,since the teeth move together as the proximal surfaces are worn flat –creating large broad contact areas. www.indiandentalacademy.com
  • 62. ERUPTION OF FIRST PERMANENT MOLARS  The edge to edge anterior tooth relationship results in the lower teeth being further forward in relation to the upper teeth and therefore, the mandibular second deciduous molars are mesial to the maxillary decidous second molars. The lower first permanent molar is then able to erupt in a more mesial position and proper initial relationship with the maxillary first permanent molar is www.indiandentalacademy.com achieved.
  • 63. ANATOMY OF TMJ  Attritional occlusion can also affect anatomy of the temporomandibular joint.Primitive man exhibits a shallow glenoid fossa and flattened condylar head, not the deep fossa and round head found in modearn man. www.indiandentalacademy.com
  • 64. Eruption of succedaneous teeth.   Attrition brings about enough reduction in mesiodistal dimensions of teeth to allow adequate space for the erupting permanent canines. In the absence of attrition there is often not enough space for the canine www.indiandentalacademy.com
  • 65. PROXIMAL WEAR   In attritional occlusion decidous teeth are worn away quickly, both proximally an occlusally. The proximal wear can result in increased space for later erupting canine such as the canines. In civilized man due to lack of proximal attrition ,the permanent canines frequently lack adequate space for eruption. www.indiandentalacademy.com
  • 66. ERUPTION OF THIRD MOLARS   In civilized man as no proximal wear occurs causes inadequate room distal to the second molars for normal eruption of third molars which leads to delayed eruption and complete impaction. At the age of 12 to 13 years the third molar begin to erupt in attritional occlusion. www.indiandentalacademy.com
  • 67. CHANGE IN CURVE OF WILSON  As the permanent molars erupt the bucco – lingual plane is oblique. As wear progress, the plane becomees horizontal, then begins to slant downwards and cusp of carabelli serves to increase overall occlusal surface area.  In civilized man the buccolingual plane is oblique throughout life. www.indiandentalacademy.com
  • 68. SECONDARY DENTINE AND PULPAL PAIN  Value of pulpal pain is not to warn of caries, but to warn of atttrition approaching the pulp faster than secondary dentin can be laid down. This causes automatic shift of bolus of food and therefore attrition to other teeth until secondary can overtake the attrition. www.indiandentalacademy.com
  • 69. INCIDENCE OF CROWDING  Since attrition especially interproximallly causes a continoual reduction in mesiodistal tooth widths, the incidence of tooth crowding is relatively low in primitive man.  The persistence of large teeth and the processes of mesial migration in civilized Man explain the currrent relatively high incidence of tooth crowding. www.indiandentalacademy.com
  • 70. CONCLUSION  As can be seen from the preceding examples, Man‟s dentition is far healthier and efficient in an attritional environment. However, this does not mean that orthodontist or Dentist must prescribe abrasive diets or begin eliminating cusps from their patients teeth. Rather, it provides the reason for most of the problems seen in the mouth of both dental and orthodontic patients. www.indiandentalacademy.com
  • 72.  An orthodontic technique may defined as a systematic sequence of definite procedure to achieve the correction of malocclusion with a specific type of appliance or with a combination of appliances.  The Begg method is a system that demands stringent interdependence of technique and appearance; this technique requires specific bracket design, arch wire size and configurations, molar tube size and molar tube placement as well as specific system of procedure. www.indiandentalacademy.com
  • 73.  The method consist essentially of tipping movements of the teeth. Two successive tipping movements are required to achieve bodily movement. The first to position the tooth crowns and second to position the tooth roots. As a result of these tipping movements, complemented by intrusion, extrusion and rotation of teeth whenever required, optimal occlusion, axial positioning and alignment of the teeth are secured. www.indiandentalacademy.com
  • 74. COMPONENTS OF BEGG APPLIANCE  ARCH WIRE MATERIAL Round austenitic stainless steel wire of 0.016 inch diameter, which has been heat treated and cold drawn down to its proper diameter, in order to give it the required properties of resiliency, toughness and tensile strength. – without which this technique could not have been devleloped and cannot be employed. www.indiandentalacademy.com
  • 75. PRECAUTION TAKEN WHILE BENDING THE WIRE  When the wire is bent around the round beak of the pliers, the stress on the crystalline structure is confined to a small area, which may cause the wire to break. When bending the wire around the square beak the points of stressare offset, providing more area for crystalline adjustment and there fore less chance fracture. www.indiandentalacademy.com
  • 76. MODIFIED RIBBON ARCH BRACKET ( TP -256500) By changing the lock pins, the size of the arch wire slot can be changed to accept properly either a 0.016 inch or a 0.020 inch arch wire www.indiandentalacademy.com
  • 77. Requirements for a light wire brackets       Ease of arch wire engagement A means to guide both the tail and head of lock pin during locking Positive retention of arch wire in all 3 stages Free tipping and sliding on arch wire Ability to effect and hold rotation Ability to prevent accidental tipping in stage III. These brackets are fabricated from stainless steel strips, hence it is economical. www.indiandentalacademy.com
  • 78. TYPES A. B. c. d. 1. Full flange 2.Half flange 1. Bondable 2. Weldable 1.Flat 2. Curved Full flange brackets will have more friction with arch wire and hence hindrance to smooth tipping movement of anteriors. in half flange brackets, contact of the flange with arch wire is minimal , thus friction is also minimal. www.indiandentalacademy.com
  • 79. AUSTRALIAN ARCHWIRES  In 1952 Dr Begg in collaboration with an Australian Metallurgist Mr. A.J Wilcock, developed a high tensile S.S wire that is heat treated and cold drawn to yield its now familiar and excellent clinical properties.  It was made thin enough, to distribute force at an optimal level for tooth movement over a considerable period of time, over long distance and with minimal loss of force intensity while doing so. www.indiandentalacademy.com
  • 80. SIX TYPES OF AUSTRALIAN WIRE 1. REGULAR GRADE: - Lowest grade – easy to bend - Used for practice bending and forming auxillaries. 2. REGULAR PLUS: - Easy to form, more resilient than regular grade - Used for auxiliaries and arch wires when more pressure and resistance to deformation as desired. 3. SPECIAL GRADE: - Highly resilient yet can be formed into shape. www.indiandentalacademy.com
  • 81.  SPECIAL PLUS GRADE: - Hardness and resiliency of 0.016” wire, is excellent for supporting anchorage, and reducing deep overbites. - Must be bent with care.  EXTRA SP ECIAL PLUS GRADE : - Also called premium plus - This grade is unequalled in resiliency and hardness. - More difficult to bend and more subjected to fracture. www.indiandentalacademy.com
  • 82.  SUPREME GRADE: - It is ultra light tensile fine round stainless steel wire. - It was initially introduce in 0.010” diameter and then further reduced to 0.009 diameter. -It is primarily used in the early treatment for rotation. Alignment and leveling. - Although supreme exceeds the yield strength of E.S.P, it is intended for use in either short section or full arches where sharp bends are not required. www.indiandentalacademy.com
  • 83. BAND MATERIAL  These bands made of stainless steel strips of different size and thickness are recommended for different teeth. These available on 8 feet rolls or cut of 2 inches to 2.5 inches. 1. For incisors - 0.125 x 0.003 inch 2. For canines, premolars – 0.150 x 0.004 inch 3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch www.indiandentalacademy.com
  • 84. LOCK PINS  Second stage safety lock pin: Shoulder on head ensures free mesiodistal tipping. Labiolingual width of tail dimension is reduced to fit properly into TP – 256 – 500 bracket in conjunction with inch arch wire.  One point safety lock pin : Used in stage I and II. The pin has a shoulder that keeps the head of the pin outside the bracket slot and prevents the impingement of pin on arch wire. The beveled undersurface of head permits free mesiodistal tipping. Thickness of pin is 0.019 length 0.200‟‟ x 0.220” www.indiandentalacademy.com
  • 85.  Hook lock pins : Used during III stage. Since there is no safety shoulder, they hold the arch wire firmly against the base of the arch wire slot. Thickness – 0.014” to 0.018” , length – 0.220 to 0.293  High hat safety lock pins: They have a gingival extension on head which provides a positive point for engagement of vertical or cross elastics. www.indiandentalacademy.com
  • 86. BUCCAL TUBES  Round molar tubes with 0.036 internal diameter and 0.250 length are routinely used.  Flat oval molar tubes and doubled back wires are used when second permanent molars are the anchor teeth and also used in mandibular dental arch when second premolar is absent. www.indiandentalacademy.com
  • 87. AUXILLARY ATTACHMENTS  In addition to the foregoing parts, the light round arch wire technique requires the following adjustments .  LINGUAL BUTTONS: The name clearly indicates the side of the teeth where it is to be welded. Used for correction of premolar and molar rotation. www.indiandentalacademy.com
  • 89. EYELETS: Are made from thin stainless steel stiff wires. They are very useful in tying the ligature wire on anterior teeth for purpose of rotation. www.indiandentalacademy.com
  • 90. CLEAT LUG - - - Are made from heavier metal. Welded in the centre of lingual surfaces and gingival 1/3 of the band. Facilitate proper pushing of bands to its proper place on the tooth. www.indiandentalacademy.com
  • 91. SEATING LUG - HOOK  Flat or contoured bases designed for the use on lingual surface of all teeth.  Uses: - for placement of elastics - easy insertion and removal of band. www.indiandentalacademy.com
  • 92. BALL END HOOKS: They are attached to buccal or lingual of molar bands. Positioned as far gingivally and near the mesiodistal centre of the tooth. Make the placing of elastic simple for patient. www.indiandentalacademy.com
  • 93. Bypass clamp  Pinning of the arch wire in the premolar brackets can cause hinderence to free tipping. So in stage I and stage II Bypass clamps are used on the premolar brackets. www.indiandentalacademy.com
  • 94. Ligature wires These are very thin (0.007 to 0.009) stainless steel soft wires. - They are very useful in tying of the span of looped arch wire, which are far away from its ideal position, thus porgressive increase In force and also avoiding plastic deformation of the arch wire. - Also used as extra holding devices. When one wants to feel secure about arch wire not getting disengaged from the bracket slot by slipping out www.indiandentalacademy.com
  • 95. ELASTICS  Elastics are made of synthetic latex and of uniform sizes and applying uniform forces when stretched to required length. These elastics come in different sizes of internal diameter and different thickness of their wall. Thinner walled elastics are called “light elastics” and thick walled elastics are called “Heavy elastics”  These elastics will exert a force equal to between 60 and 70 gms when they are new and first placed. www.indiandentalacademy.com
  • 96. Strength of the elastics varied according to the clinical requirement. - LIGHT( yellow) class I or class II used for anterior retraction. -STRONGER ( green) class I are used for posterior protraction. - BLUE OR RED used only when green elastics are ineffective. www.indiandentalacademy.com
  • 97. USES OF ELASTICS          Anterior retraction Posterior protraction Correction of deep bite Correction of class II or class III occlusion Closure of extraction spaces Correction of cross bite Correction of rotation Anterior open bite (box elastics ) Correction of midline. www.indiandentalacademy.com
  • 100. EFFECTS OF CLASS II ELASTIC  In lower molar region one vector taking posteriors mesially and other vector extruding force on molar.  On upper anteriors horizontal vector will tipp and retract anteriors distally and vertical counteract vector the will intrusive effect of upper arch wire on anteriors. www.indiandentalacademy.com
  • 105. STAGES OF THE BEGG TECHNIQUE  STAGE I – OBJECTIVES 1. Open the anterior overbite 2. Overcorrect the mesiodistal relationship of the buccal segment as necessary. 3. Close any anterior space. 4. Eliminate any anterior crowding. 5. Overrotate all teeth that require rotating. 6.Correct posterior crossbites. www.indiandentalacademy.com
  • 106. HOW TO ACHIEVE THE OBJECTIVES   1.Open the anterior over bite - use 0.016 inch hard Australian wire. - Proper amount of anchor bends at proper locations. -Continual wearing of class II or Class III elastics. 2. Overcorrect the mesiodistal relationship of the buccal segments as necessary. - Continoual wearing of class II or class III elastics as required. - Proper anchorage or bite – opening bends in both upper and lower arch wires. www.indiandentalacademy.com
  • 107. 3. Close any anterior space: Plain arch wire with elastic from cuspid pin tail to cuspid pin tail. 4.Eliminate any anterior crowding: - Vertical loops between crowded anterior teeth, with bracket areas modified for desired overcorrections. - Arch length designed so that intermaxillary circles rest against mesial surfaces of cuspid brackets. 5.Overrotate all teeth that require rotating - Overcorrection of bracket areas between anterior vertical loops. www.indiandentalacademy.com
  • 108. - Use of elastic thread from buttons or brackets to rotate cuspids and bicuspids. - Use of rotating springs 6. Correct posterior crossbites: - Modify arch width of one or both arch wires -wearing cross elastics - Rapid maxillary overexpansion, folloed by aperiod of stabilization prior to the placement of complete appliances and the beginning of stage I. www.indiandentalacademy.com
  • 109. PRIORITIES IN THE STAGE I  1. It is generally agree that reduction of overbite must precede reduction of overjet.  2. While treating cases with anterior crowding, alignment of teeth becomes an important consideration.  3. when the upper incisors are very much proclined they should be subjected to a light intrusive force and a normal retractive class II elastic force till their proclination reduces. www.indiandentalacademy.com
  • 110.  Stage I arch wire : - Made from 0.016 heat treated high tensile stainless steel wire. - incorporate anchor bends, intermaxillary hooks,toe- in, toe – out bends, vertical loop. www.indiandentalacademy.com
  • 113. INTER MAXILLARY HOOK   It helps in placement of elastics It prevent slippage of plain arch wires www.indiandentalacademy.com
  • 116. TOE - IN BENDS: Incorporated in the arch wire as anti – rotational bends. The toe in bends should never exceed more than 5 degree. TOE – OUT BENDS To correct the disto – buccal molar rotation. www.indiandentalacademy.com
  • 117. ELASTICS      To open the bite To correct the mesiodistal relationship of buccal segments To close the anterior spacing Corection of rotation Posterior crossbite corection www.indiandentalacademy.com
  • 120. PROBLEMS ARISING IN STAGE I  BITE NOT OPENING: A. Patient not wearing elastics: - educate the patient -do not give enough elastics - make it impossible to hook elastics and see if problem is reported B. Patient biting out bite opening bends. - Remove the arch wire : restore bite opening bends www.indiandentalacademy.com
  • 121. - Check the level of mandibular molar tubes, lower thm, if necessary. - Check position of anchor bends, if too far mesially, move them closer to molar tube. - Failure to place proper amount of bite opening bends when arches were placed. - Loose molar band - Improper angulations of buccal tube or entire molar bend. MOLAR WIDTH NARROWING: A. Verticl component of classs II elastic force - Form mandibular arch wire wider in posterior www.indiandentalacademy.com segment
  • 122. B. Prolonged wearing of posterior cross elastics to widen opposing molars - discontinue cross elastics and correct cross bite by others means. C. Disto – lingually rotated cuspids 1. Do not engage the arch wire in the cuspid brackets until these teeth have been rotated by elastic thread or other means. 3. ADVERSE TIPPING OF ANCHOR MOLARS - If tipped mesially : there is no anchor bends. If tipped distaly too much anchor bends. - Improper placement of molar band or tube www.indiandentalacademy.com
  • 123. - Excessive elastic force - Improper placement of elastics - Oversize arch wire – molar tipped distally. 4. NO APPRECIABLE CHANGE - Patient not wearing elastics - Arch wire bend out of shape - patient seen too soon 5. VERTICALLOOPS BURIED IN THE GINGIVA a. Original, looped arch wire left in the mouth too long - replace it with plain arch wire with bayonet bends www.indiandentalacademy.com
  • 124. b. Misjudgment in the proper direction of vertical loops when the arch wire was plced - remove and modify the direction of the loops and replace. 6. ELASTICS WHICH BREAK OR DO NOT STAY ON: a. may just be an excuse for not wearing elastics b. elastic will not stay on the intermaxillary circle. 7.LOCK PINS LOST; a. occluso incisal force -use steel pin - Chek anchor bends to facilitate opening the bite www.indiandentalacademy.com
  • 125. 8. EXTREMELY MOBILE MOLARS: A. clenching of the teeth b. intermittent wearing of elastics c. pathology d. excessive force applied to molar - Reduce arch wire size to 0.016 inch - Reduce elastic force to 2 ½ ounces - Reduce degree of anchor bends 9. LOWER ANTERIOR TEETH TIPPING LABIALLY: A. May be an optical illusion with roots actually moving lingually. b. Binding of the arch wire in bicuspid brackets www.indiandentalacademy.com
  • 126.  Binding of ends of the arch wire inside distal ends of buccal tube. 10. ANTERIOR OPEN BITE NOT CLOSING: A. patient not wearing anterior vertical elastics B. Persistent tongue thrust or other adverse habits c. Too much anchor bend. www.indiandentalacademy.com
  • 127. STAGE II  OBJECTIVES: 1. Maintain all corrections achieved during first stage. 2. Close any remaining posterior space. www.indiandentalacademy.com
  • 128.  Mesiodistal molar relationship maintained through the wearing of clasII or ClassIII elastics as required.  Spaces between the anterior teeth are prevented by tying intermaxillary circles to the cuspid brackets.  Overrotations of central and lateral incisors are maintained through the continued use of bayonet bends in the arch wires. www.indiandentalacademy.com
  • 129.  Mesiodistal molar relationship maintained through the wearing of clasII or ClassIII elastics as required.  Spaces between the anterior teeth are prevented by tying intermaxillary circles to the cuspid brackets.  Overrotations of central and lateral incisors are maintained through the continued use of bayonet bends in the arch wires. www.indiandentalacademy.com
  • 130.  Overrotations of bicuspids are held by replacing elastic threads with steel ligature tie.  Opening of deep anterior overbite is maintained through the continued use of bite opening bends and class II or class III elastics.  Closing of extraction space by wearing of horizontal elastics. www.indiandentalacademy.com
  • 131. ARCH WIRE ( 0.020 SS) - To maintain the corrections already achieved. - To stabilize the teeth against any adverse reciprocal forces may occur as a result of the application of elastics or auxiliaries. ANCHOR BEND: - Less compared to stage I PREMOLAR OFFSET BEND LOCK PIN: www.indiandentalacademy.com - “Stage 2” safety lock pins.
  • 132. ELASTIC  Horizontal intra-maxillary space closing elastics with class 2 elastics to maintain to maintain the edge to edge.  creates rotational tendency on molar (distobuccal). www.indiandentalacademy.com
  • 133.  1. Horizontal elastic is engaged on the lingual of the molar instead on the buccal.  2. Elastic thread tie on the lingual, from the canine to molar. www.indiandentalacademy.com
  • 134. AUXILIARIES USED IN STAGE II  Passive uprighting springs on mandibular canine.  It establish two point contact between the teeth and arch wire to prevent further free tipping.  The strength of horizontal elastics increased from 21/2 ounces to 8 ounces. www.indiandentalacademy.com is
  • 135. CORRECTION OF MIDLINE  Class II intermaxillary elastics on one side and class three on other side.  Elastic from intermaxillary hook mesial to upper canine to intermaxillary hook mesial of the lower canine on opposite side www.indiandentalacademy.com
  • 136.  Ligature wire or by – pass clamps are used on second premolars in order to avoid overclosure of extraction space and pushing of II premolar lingually. www.indiandentalacademy.com
  • 137. END OF STAGE II www.indiandentalacademy.com
  • 138. PROBLEM ENCOUNTERED DURING SECOND STAGE  Anterior bite closing: a. Not enough anchor bend b. Bite – opening bends bitten out - Educate patient , correct the archwire c. Patient not wearing the classII elastics d. Anchor molars out of occlusion - Discontinue class II or class III elastics. Use horizontal elastics to get molars in occlusion. www.indiandentalacademy.com
  • 139.  Anterior teeth assuming class III relation a. Excessive wearing of class II elastics  Spaces Developing Between The Anterior teeth: a. Failure to give cuspid tie b. Intermaxillary circles formed too far apart.  Anchor molar rotating distobucally a. Toe – out on arch wire www.indiandentalacademy.com
  • 140. Anchor molars rotating distobuccally a. Too much force from horizontal elastics - Use lighter horizontal elastics - Elastic thread from cuspid lingual buttons to the lingual hooks on the molars.   Posterior spaces not closing: a. Patient not wearing elastics. b.Arch wire not free to slide distally through buccal tube. c. Arch wire pinned or caught in bicuspid bracket slot. www.indiandentalacademy.com
  • 141. d. Anterior teeth or tooth not free to tip distally: - Use proper brackets that allow free mesiodistal tipping. - use safety lock pins  Second bicuspids tipping mesially in first bicuspid: - Slight, expected mesial movement of anchor molar - Abnormal loss of anchorage, if second bicuspids are tipping excessively. www.indiandentalacademy.com
  • 142. STAGE III  OBJECTIVES: 1. Maintain all corrections achieved during first and second stages. 2. Achieve desired axial inclinations of all teeth. www.indiandentalacademy.com
  • 143. - Posterior spaces kept closed by bending the distal ends of the arch wires around the buccal tubes. - Arch form and overbite corrections maintained by using heavier (0.018 to 0.025) main arch wires. - Changes in the mesiodistal inclinations of teeth are accomplished by the use of individual root – tipping springs. - Lingual or labial root torque is applied to anterior teeth through the application www.indiandentalacademy.comauxiliaries. of torqueing
  • 144. STAGE THREE UPPER ARCH WIRE  Made by 0.20 s.s  Constricted in distal ends.  Gingival bend distal to cuspid bracket. www.indiandentalacademy.com
  • 145. STAGE III LOWER ARCH WIRE  Made by 0.20 round s.s.  Expansion in distal ends.  Molar offset bend  Mild anchor bend distal to canine.  Slight vertical step in the anchor bend area. www.indiandentalacademy.com
  • 146. AUXILIARIES USED IN STAGE III UPRIGHTING SPRING:   Used to correct the axial angulation of teeth in mesio – distal direction. Made by 0.014” round S.S for canine and premolars, 0.012 for laterals. Helix of spring face towards tooth surface and lie on the gingival aspect of arch wire. www.indiandentalacademy.com
  • 147.  The degree of activation of spring depends on 1. The size of wire from which spring is made 2. The diameter of the helix 3. The number of turns in helix 4. The length of the arms of spring 5. The size of the root of the tooth being uprighted www.indiandentalacademy.com
  • 148.  Arch wire ligation prior to placement of uprighting spring www.indiandentalacademy.com
  • 149. TYPES OF UPRIGHTING SPRING  A combination safety lock pin and uprighting spring that eliminates the need for ligating the arch wire to the bracket. Locked in place by bending the tail of the spring around the body of bracket.  Available as two coil and three coil from .014 www.indiandentalacademy.com
  • 150. PLAIN UPRIGHTING SPRING  Made of 0.014 for uprighting canine and premolars, 0.012 for incisors.  The angulation of the active arm and retentive arm is 135 degree.  The helix with retentive arm should face the tooth surface.  The base arch wire is ligated, otherwise the action of uprighting spring will extrude the tooth . www.indiandentalacademy.com
  • 151. -The length of hook is made greater than the diameter of the helix to keep the arm of the spring parallel to the arch wire in the vertical plane. -- To avoid a rotating force on the tooth, the arm of the spring is offset buccally to make it parallel to the arch wire in the horizontal plane. www.indiandentalacademy.com
  • 152. The degree of activation of the uprighting springs depends on: 1. The size of wire 2. Diameter of helix 3. Number of turns in the helix 4. Length of the arm of the spring 5. The size of the root being uprighted. www.indiandentalacademy.com
  • 153. MINISPRING  Made of thinner diameter (0.009) high resilient supreme grade wire.  The coil of springs is only twice the size of the wire.  The activation is 100%, the stem and active arm are in one line. www.indiandentalacademy.com
  • 154.  The hooks of short – arm uprighting springs will slide along the arch wire and approach each other as teeth upright.  If long arm uprighting springs are used, the arms of premolar and canine cross each other. www.indiandentalacademy.com
  • 155.  The rotational component of the tooth displacement, caused by a single force application, is generally unfavorable. Hence it is resisted by applying a counter moment as by uprighting sping www.indiandentalacademy.com
  • 157. TYPES OF TORQUEING AUXILIARY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. TWO SPUR TORQUEING AUXILIARY FOUR SPUR SIX SPUR RECIPROCAL SHORT FOUR SPUR INDIVIDUAL ONE TO ONE RECIPROCAL LOWER REVERSE RAT - TRAP ASYMMETRICAL www.indiandentalacademy.com
  • 158. FOUR SPUR TORQUEING AUXILLARY  Used for torqueing the upper anterior teeth palataly  Preformed from .016” wire www.indiandentalacademy.com
  • 159. TWO SPUR TORQUEING AUXILLARY  Used when lateral incisors do not require palatal root torque , as in extraction cases when upper laterals were displaced slightly palataly. www.indiandentalacademy.com
  • 160. FABRICATION OF TORQUEING AUXILIARY www.indiandentalacademy.com
  • 161. RECIPROCAL TORQUEING AUXILIARY - Indicated when the upper lateral incisors were blocked out palatally before treatment. Their root apices must be torqued labially to reduce the tendency for the crowns to relapse lingually. - Lever arms on laterals pass incisaly for labial root torque. www.indiandentalacademy.com
  • 162. SHORT FOUR – SPUR TORQUEING AUXILIARY  Indicated for torqueing of upper anterios.  Does not engage cuspid bracket  Easy to fabricate. www.indiandentalacademy.com
  • 163. INDIVIDUAL TORQUEING AUXILIARY  Used for selected upper or lower teeth  Auxiliary should extend at least one tooth pass tooth being torqued, and around curve of arch, for maximum activation.  If placed gingivally, torque the root of the lateral lingually. www.indiandentalacademy.com
  • 164. REVERSE TORQUEING AUXILIARY  Indicated if lower anterior teeth are becoming too proclined.  Acts as a source of intra oral mandibular anchorage to inhibit forward movement of mandibular dental arch. www.indiandentalacademy.com
  • 165. ONE TO ONE TORQUEING AUXILIARY  Indicated when two adjacent teeth require root torque in opposite directions.  Tends to deliver excessive force therefore degree of activation between lever arms should be low www.indiandentalacademy.com
  • 166. RAT - TRAP TORQUEING AUXILIARY    Main arch wire is formed from 0.020 inch round wire. The auxiliary is wound from either 0.014 or 0.016 inch highly resilient round wire. The torqueing “bars” do not extend to the gingiva. www.indiandentalacademy.com
  • 167. ASYMMETRICAL TORQUING AUXILIARY Auxiliary used to produce palatal root torque of the maxillary right central and lateral incisors.  The ends of the auxiliary are terminated distal to the canine brackets.  As the central incisor loop is formed mesial to the bracket and the lateral incisor loop is formed distal to the bracket mesodistal movement of the auxiliary is prevented.  www.indiandentalacademy.com
  • 168. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Two spur arch Four spur arch Modified four spur Art four – spur Modified Kitchon 2 – spurs Kitchon two finger spur F and J two spur arch Von der heydt two – spur arch Modified reverse torque arch Sain reverse torque arch www.indiandentalacademy.com
  • 169. The lingual torquing effect is on account of two factors: 1. Vertical plane changes to horizontal. 2. Smaller circle opens to large. Both these effects force the tips of the spurs to press in a lingual direction against the gingival portion of the crown. Reciprocally, the inter – spur spans of the auxiliary tend to lift away in a labial direction. Thus a force couple is created. The labial forces are resisted by the bracket slots and the base archwire to which auxiliary is tied this accentuates the action of root www.indiandentalacademy.com lingual moving force.
  • 170. PROBLEMS ENCOUNTERED DURING STAGE III  Maxillary Molars Widening: A. Anchor bends present in maxillary arch wire. b.Too much bite – opening bend between cuspid and bicuspid c. maxillary arch wire too small in diameter. d. Maxillary arch wire too wide. e. Torqueing auxillary not constricted adequately. www.indiandentalacademy.com
  • 171.  Mandibular molars narrowing a. Lower arch wire not wide enough b. class II elastics exerting too much force c presence of steel ligature tie from the lingual of the mandibular cuspid to the lingual of the mandibular molar  Anterior bite deepening: a. Too much power in the torqueing auxillary b. Maxillary arch wire too thin. c. Patient not wearing class II elastic www.indiandentalacademy.com
  • 172.  Teeth not uprighting mesiodistally: A. springs not active B. Arch wire caught on the edge of the bracket - Tighten spring – pin to draw arch wire in bracket - Draw arch wire into bracket with a steel ligature tie C. Occlusal interference caused by an elevated tooth. D. Springs placed in backwards www.indiandentalacademy.com
  • 173.  Teeth not uprighting mesiodistally: A. springs not active B. Arch wire caught on the edge of the bracket - Tighten spring – pin to draw arch wire in bracket - Draw arch wire into bracket with a steel ligature tie C. Occlusal interference caused by an elevated tooth. D. Springs placed in backwards www.indiandentalacademy.com
  • 174.  1. 2. Maxillary anterior teeth not torqueing palatally Not enough force from maxillary torqueing auxiliary Maxillary incisal edges caught lingual to lower anterior teeth  Lower anterior teeth labially inclined Normal mesial migration of teeth during third stage  Rotation of teeth other than molars Lack of complete bracket engagement Arch wire slot too large. 1. 2. www.indiandentalacademy.com
  • 175. It was partly through studying Stone age man’s attrition that light tooth moving forces were found to make higher standards of orthodontic treatment possible. Furthermore, the light wire technique is unique in that the tooth moving forces it exerts are so appropriate that extra – oral forces are never required neither to enhance nor to combat the force values exerted by it. The advent of this technique provides common ground for agreement between the school of thought advocating movement of tooth roots to their correct relations and the school advocating light forces. www.indiandentalacademy.com