Third stage begg mechanotherapy

Third Stage
Begg Mechanotherapy
www.indiandentalacademy.com

INTRODUCTION
Patients at the beginning of third stage
show variation in occlussion from a
class I to class II relationship through
the buccal segments and an edge to
edge bite on the anteriors.
All the anteriors are tipped
mesially and the molars upright.

Encompasses procedures to restore the
teeth to their correct axial inclination.
Mastery over the intricasies involved in
the third stage can mean all the
difference between delight and defeat in
most cases treated with the Begg
appliance

Stage three Begg is Divided into
a)Base archwires
b)Auxiliaries
Base Archwires are the backbone that
shape the outcome of the effort put in.
Auxiliaries can be either
a) Torquing Auxiliary
b) Paralleling Auxiliary

Function of Base archwire
Is mainly to maintain the arch form and
arch symmetry achieved during the
earlier stages as the auxiliaries used in
this stage tend to distort the results
achieved previously
To provide anchorage for certain
movements carried out by the
auxiliaries

Requirements of Base archwire
They need to be
a)Sufficiently rigid
b)Simple to fabricate
c) Should not have a complex
nature
d)Should not harm the tissues

Consideration during fabrication
of Base archwires
Diameter of the wire
a)Type and extent of root torque
required
b)The diameter of the uprighting
spring used
c)The design of the springs used

FORM OF THE BASE ARCHES
In the Begg technique over retraction of
the anterior teeth place very high torque
demands in most extraction cases
such situations would create
considerable expansile counter
moments hence the base archwires had
to be excessively contracted across the
molars in the upper arch.

Lower arch wire is slightly expanded to
prevent lower molars rolling lingually
from continued class II elastic wear
during stage III
Both the upper and lower .020 third
stage archwires have a slight bite
opening bend distal to the cuspids
Anchor bends in the upper archwire are
very slight more if the molars are tipped
distally whereas lower anchor bends
are bit more pronouncedwww.indiandentalacademy.com

Auxiliaries used in third stage
Begg.
Auxiliaries can either be
a)Torquing Auxiliaries
b) Uprighting /Paralelling
Auxiliaries

Torquing auxiliary used in the Begg technique
is the most important single mechanism in the
system.
Chourie in 1965 in his thesis sugested that
length of the torque spur loop exerts an affect
upon the amount of force delivered to the root
tip.
Newmann in 1963 presented a formula
for calculating the force at the apex of
the incissors
.

F=ØG¶r4
2Ld
Ø is the angle in radians
G is the average modulus of
rigidity of stainless steel
¶ is a constant
L is length of the wire
D is the distance from root apex to
bracket area
r is the radius of the wirewww.indiandentalacademy.com

Barrer in 1963 suggested the acuteness
of the angle between the torquing spur
and the horizontal plane
Brandt in 1962 was aware that the
acuteness of the angle between the
torquing spurs and the horizontal plane
of the arch wire

Factors which alter the force
values of an auxiliary are
Type of wire
Diameter of the wire
Size of the circle
length of the spurs
angle the spur makes with the plane of
the auxiliary
Axial inclination of the teeth
Intercanine distance of the maxillary
denture www.indiandentalacademy.com

THE VARIOUS TORQUING AUXILLARIES
USED ARE
Four spur anterior torquing auxiliaries
Two spur
Reciprocal torquing auxiliary
Short four spur auxiliary
Individual torquing
One to one reciprocal torquing
Lower reverse torquing auxiliary
Mouse trap torque and U-springs-
udder archeswww.indiandentalacademy.com

Other Torquing Auxiliaries are
Art four spur
Modified four spur arch
Kitchton two finger spring
F & J two spur arch
Von Der Heydt two spur arch
Modified reverse torque arch
Sain reverse torque arch

Kitchton Torquing Auxiliary
It is recommended that this auxiliary be
used in conjunction with a heavy
archwire
Modification done on the archwire distal
to the central incissors
To counteract the raising of the arch
distal to the lateral hooks of the auxiliary
contd

Two types of auxiliaries
a)two tooth
b)four tooth
Base of the helix is opened and the
auxiliary stradles the archwire secured
by a ligature
Modification to the Four tooth auxiliary
is done by making the horizontal part
half moon shaped to contact the lateral
incissor area.

Problems encountered during
torquing.
Undesirable changes in the arch form
Mesial migration of posterior teeth

Uprighting or Root paralelling
Auxiliaries
The helical “Uprigting spring”is the most
efficient root tipping auxiliary
Consists of a leg to fit through the
vertical slot in the attachment,a helical
loop and an arm into which a hook is
incorporated running parallel to the
main arch
contdwww.indiandentalacademy.com

The helices and the arms of the spring
has to be in the same plane as to the
long axis of the tooth and the arch.
Constucted of .014/.016 for cuspids
and premolars.
In extraction cases springs should be
used on both teeth adjacent to the
extraction site
More recently springs with smaller
helices and shorter arms have been
utilized

MINISPRINGS
Made from .010’supreme wires
can be usable on any bracket
they can be used in conjunction with
lock pins

Advantages are
a) improved aesthetics
b) improved hygiene
c)these springs were kinder to the
anchorage
Disadvantages
a)they fall out easily

Modern Begg
The principles have not changed but it
looks different.
The use of 2 spur is more as this leads
to less flaring of molars and better
control.
Uprighting springs used are of the short
self locking type.
More attention is paid to the second
molars contd

. The extensive use of reciprocal torque
on central and lateral incissors have
been advocated
Recent trends indicate more of a non
extraction treatment plan
this means more use of auxiliaries like
head gears , lip bumper, sliding jigs etc.
cases with vertical growth pattern use of
class II elastiscs is avoided as much as
possible
Thompson -CAT system tries to
combine the favours of Begg technique
with the finishing of straight wire

A new approach to the finishing stage
was suggested by Dr.Barry Mollenuer in
1988.
He suggested using Alpha-Beta-
Titanium rectangular wires.
These wires are more comfortable to
the patient in comparison with other
wires of similar dimensions
Drawback being these wires become
brittle after six weeks

Sequence of insertion of
Archwires and Auxiliaries
The base arch wires are inserted
unpinned but fitting well upto the Begg
slot
Arch wires are cinched distal to the
molars to prevent the spaces from
opening up
Depending on the need for torquing the
torquing auxiliary is fabricated

In the lower arch only uprighting springs
are inserted unless labial/lingual torque
is needed
direct the lower arms towards the root
movement intended
insert the vertical leg into the pin slot
pull it occlusally so the spring lock
holds the archwire firmly
bend this vertical leg towards the root
movement intended
to activate hook the lever arm to the
main archwire.

After the root tipping movements of the
third stage are completed remove the
torquing and paralleling auxiliaries and
make adjustments in the base archwire
to complete the treatment.
To flatten the occlusial plane make
localized vertical offset bends to level
individual teeth
to obtain bilateral symmetry make
definate localized horizontal offset
bends to expand or contract induividual
teeth and make the arch symmetrical

Overcorrection and overrotation are
maintained
Additional finishing is done with the
tooth positioner
the tooth positioner helps to attain a
precise positioning of individual teeth
than that attainable with the third stage
auxiliaries

Summary and Conclusion
One needs a lot of perseverence to
reach proficiency as shown the various
auxiliaries and modification in the Begg
technique have given the orthodontist
inumerable ways of achieving the
objectives of the procedure. We as
Orthodontists should go ahead and put
them to judicious and profitable use.

Third stage begg mechanotherapy

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Third stage begg mechanotherapy