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History:

Dr. P. Raymond Begg was


graduated in dentistry from the
University of Melbourne, Australia
in 1923.
He became interested in
orthodontics almost immediately
and attended Dr. Edward H.
Angle's courses in Pasadena,
California from March 1924 to
November 1925. Dr. Begg
returned to Adelaide and started a
practice of orthodontics utilizing
the edgewise technique.

Some time after 1927 Dr. Begg


broke away from his Angle
background. He began to extract
teeth as an integral concept of the
treatment of malocclusions and he
discarded the edgewise
mechanism in favor of the light
round archwire technique which

History:
He knew from experience and his appreciation of
the role, attrition is meant to play in the
development of mans dentition that seeks
reduction was often necessary to permit the
proper repositioning of the teeth to enhance
Function, Stability & Esthetics.
Dr.Begg realized that edgewise mechanism was
not designed to rapidly close extraction spaces
and for quickly reducing deep overbites.
.

To facilitate such changes, he began using


0.020inch round platinized gold rather than
rectangular arch wire in 1929.
In 1931-1932 he started using 0.018inch round
stainless steel wire bending the vertical loops,
intermaxillary circles right into the arch wire.
However he soon realizes that if round arch
wires were engaged in edgewise brackets,
indiscriminate and often undesired root moving
forces could be created

Beggs Philosophy:
Dr.Begg described a treatment approach based
on the following hypotheses which were backed
to some extent by his own researches.
They were:
1.Theory of Attritional Occlusion.
2.Theory of Differential Forces.
3.The employment of a modified form of Ribbon
arch bracket and light gauge round archwire.

Theory of Attritional Occlusion:


Dr. Begg founded the concept of correct occlusion
based on his studies on the skulls of australian
aboriginals(Stone Age Man).
He found that the dentitions displayed a
considerable amount of attrition ,both occlusally
and interproximally.
The dento - alveolar height was maintained by
continuous eruption and proximal contact by
mesial tooth migration facilitated by cuspal wear.
The incisor relationship became edge to edge
thereby reducing the chance of lower incisor
imbrications through overbite obstruction

The total reduction in arch length resulting


from attrition amounted approximately to one
bicuspid width either side of both dental
arches by the time the aboriginal was 20
years of age.
These findings accord with the studies of
Miss Corisande Smyth with her study of
Anglo-Saxon skulls.
According to Sir Arthur Keith, in bronze-age
Britain, skulls showed edge-to-edge incisor
relationship was common..

But in the present age, due to the refined and precooked food, less dental attrition was observed. The
absence of attrition along with the presence of mesial
tooth migration does not relieve the dental
overcrowding ,particularly in the lower incisor region
where the modern overbite prevents their escape into
edge-to-edge relationship with the uppers.
Dr.Begg used the findings from his study of australian
aboriginal occlusions as a justification to extraction.
He argues that if in this present era tooth material is
not lost through attrition ,it would be reasonable to
cause a commensurate reduction artificially through
extraction.

However, care should be taken to


restrict the employment of extraction
within logical limits..
Thus the extraction approach in
orthodontic treatment came into
existence .
Surely, there will be exceptions to the
extraction approach just as there were

Normal occlusion in young adult of


present day

Normal occlusion in primitive times.

Theory of Differential Forces


The theory of differential forces in its original form
was described by Dr.Begg in an article AJO-1956 his
observation was based to a large extent on the work
of Storey and Smith.
The range of light pressures which would cause the
teeth to move at an optimum rate with minimal
disturbance of the supporting tissues.
Pressures below this range would produce a slow
rate of response while those above incurred a
reaction within the bone support, referred as
undermining resorption.

Applying these principles to the Begg technique, the

force of the intermaxillary elastics used inn stage I of


treatment ,was kept light so that the upper labial
segment was retracted while the lower anchor molars
has negligible mesial movement. later, if it was required
that the residual extraction spaces should be closed
largely by the mesial movement of the posterior teeth,
the elastic forces are increased so that the anterior
segment with their relatively small root area received an
excess of force sufficient to delay their movement, while
the posteriors moved forward.

Advantages of Beggs appliance:


Efficiency of treatment , because many
corrective tooth movements occur
simultaneously with relative little appliance
adjustment.
Minimal patient discomfort and minimal trauma
to the hard and soft tissues as a result of the use
the light and continuous force.
Rapid esthetic improvement, achieved by early
reduction of overjet and alignment of anterior
teeth.

Early correction and


overcorrection of rotations,
possibly reducing relapse after
treatment.
Short treatment time resulting
from the rapidity of the tooth
movement .

Disadvantages:
Patient cooperation is critical for successful
treatment with Begg technique.
Distortion of the light arch wires by mastication of
tough foods or biting hard objects.
Difficulty may be encountered in accomplishing
detailed finishing procedure.
Auxiliary used in stage III constitute a hazard to
maintenance of oral hygiene.
Lack of understanding of the complex dynamics
of force.

Steepening of an existing high mandibular


plane angle may occur as a result of Class
II intermaxillary traction.
The Begg technique does not lend itself to
the intrusion of maxillary incisors when a
deep overbite is associated with over
eruption of the maxillary incisors.
Unpleasing flattening of the lips may
occur during Stage I and Stage II.
Tissue trauma is thought to occur ot the
alveolar crest as a result of tipping & root
resorption from excessive tipping of the
apices of maxillary incisors.

Difference between Begg and Edge wise


Appliance:
In an Edge wise when the rectangular arch wire is
held to each tooth by being engaged in its bracket
that accurately fits the arch wire, force is immediately
exerted that moves the ROOT of each tooth.
It is impossible to tip crowns when the rectangular
arch wires either Ribbon arch or Edgewise arch,
engage their brackets.
The light wire differential force technique employs
forces which are most physiologically acceptable to
the tissues and move teeth most rapidly.

The excessive force delivered by edgewise


limits tooth moving efficiency.
In edgewise there is simultaneous movement of
the anchor & the teeth to be moved. Periodontal
tissues resist high forces; therefore the distance
a teeth can be torqued is relatively small.
with edgewise mechanism there is considerable
anterior movement of the dental arch as a
whole because of greater mesio distal
dimension of the bracket.
In Begg the small mesio distal dimension of the
bracket freely permits mesial or distal tipping of
tooth crowns with less mesial or distal force on
the roots.

When the arch wire is engaged in an edgewise bracket


with wide mesiodistal slot, force is transmitted to the root
of the tooth

In the Edgewise arch wire appliance the need


for extra oral anchorage is great in order to
counteract the tooth root-moving forces that
cause anterior movement of the dental arches
The light arch wire technique has eliminated
the need for extraoral anchorage

Synergism in Begg appliances:

Case selection criteria for Begg case :


The tooth movements required are such as to
demand the forms of control given by banded
appliances and cannot be achieved an adequate
standard.
The ultimate stability of treated occlusion is in
doubt, unless root movements accompany
repositioning of crowns.
The patients interest in his personal
appearance and health.

Patient interest matches with practical ability


to attend regularly at prescribed intervals over
the treatment period
The parent and patient have been given to
understand precisely the nature and duration
of proposed treatment and what is required if
success is to be achieved

Clinically:
Low mandibular plane angle
Not excessive incisal show
Adequate thickness of labial cortical
bone

Orthodontic apparatus in Stage I


Archwires.
Attachments Bands, brackets, tubes & lingual
cleats.
Ligatures.
Elastics.
Auxiliaries - Rotation springs.

Arch wire material:


A.J.Wilcock after years of experimentation developed
a wire which is most suitable for light arch wire
technique
Round austenitic SS heat treated and cold drawn.
Combination of resiliency and flexibility.
Adequate stiffness for bite opening.
0.016 special AJW principal wire of Stage I.
0.018 special Molar extraction cases
0.014 special rotating springs.

The different grades of Australian wires formerly available


were
Regular
Regular plus
Special
Special plus
Now there are three more grades have been introduced
Premium
Premium plus
Supreme
in an order of increasing yield strength Wire sizes available
are,
0.008, 0.009, 0.010, 0.011, 0.012, 0.014, 0.016, 0.018 and
0.020.

Brackets
Main attachment.
Modified ribbon arch brackets - slots facing

gingivally ( narrow brackets permit free


tipping in all the direction)
It has a slot to carry the arch wire and a

vertical slot to carry the lock pin to hold wire.

Dimensions - (TP 256 )


Depth of slot- 0.020
Height of slot -0.045

.020

s.s sheath thickness


0.015

.045

Pin slot dim. 0.020

.015
.
125

Base dim. -.122x.125

.122

Classification of brackets:
According to constitution

Metallic (stainless steel)


bondable
weld able
Non Metallic (Aesthetic)
plastic
ceramic
According to placement
Labial
Lingual
According to anatomical bases
Flat

Brackets

Metallic Bracket
Bracket

Bondable

Ceramic brackets
Mini Mesh
Mesh

Super Mini

Lock pins
essential to hold the wire in bracket &
allows the force to be transmitted from
arch wire & elastics to teeth.
Made from soft s.s or brass (nylon for
ceramic)
must be soft to permit easy bending
close to bracket vertical wall

Types of lock pins


One point safety lock pin
Second stage Safety lock pins
Hook pins
High hat pins
Super high hat pins
T pins
Lingual pin
Spring pin

LOCKPINS:
1.One-point safety lockpin:
first stage of treatment with .016 inch archwire.
Shoulder on labial surface of the head strikes bracket to prevent
impingement of pin and the archwire.
Beveled undersurface of head leaves adequate space for tipping.
2.Second stage lockpin:
Safety shoulder prevents binding on archwires .
The body of the pin is dimensioned to open 256-500 bracket slot to 0.020
inch to accept larger archwires during stage II.
3.Hook lockpin:
Used on all teeth that do not require mesiodistal up righting during stage III.

Lock pins

One point safety lock pin

Hook pins

Second stage Safety lock pins

High hat pins

Lock pins

Super high hat pins

Lingual pin

T pins

Spring pin

Bands
Although bonding has replaced the banding
there are
number of indications--- Teeth that will receive heavy

intermittent forces against attach. e.g..


Molar.
Teeth req. both labial & lingual attach.
Teeth with short clinical crown.
Tooth surface incompatible to bonding.

Dimensions of bands commonly used--- Molars

0.005 x 0.18 or 0.006 x 0.20


Bicuspids
0.004 x 0.15 or 0.005 x 0.15
Anteriors
0.004 x 0.125 or 0.003 x
0.125
Bands can be custom made or
preformed (with or without
attachments.)

Molar tubes
Designed to permit free m-d sliding of arch wire
free distolingual tipping of anterior teeth

Tubes weldable, solderable or bondable.


with hook or without hook.
with vertical slot (uprighting springs).
2 to 6 degree distolingual offset tubes are
also
available.

Types of molar tubes


Round
Dimension - 0.036 inside diameter x
0.25 long

Flat oval tube


Dimension - 0.027 x 0.050 internal diameter,
0.20 long,
When 1st permanent molar is missing / extracted,
used on 2nd molar.
Also used in mandibular arch on 1st permanent
molar when mandibular 2nd premolar is missing /
extracted.

Interchangeable tube
Permits switching
from a double back
arch wire to a
straight back arch
wire with out loosing
mechanical
advantage and
Combination
change oftube
tube
Consist of gingival round tube
0.036diametre x 6.2mm long &
rectangular (ribbon) occlusal tube
0.025x 0.018 dia x 5.5 mm long.
Used when finishing is done by
rectangular wire.

Additional round tube

Placed on molars for engaging


lip bumpers, head gears etc.
Placed gingival to main tube.

Ball end hook


For the hook less tube, ball end

hook is placed at the mesial end of


molar tube with free end directed
gingivally and distally.
Prevents rotation of molars as
compared to elastic attached to
distal end.
Especially useful in short clinical
crown.
Increased patient cooperation.

Lingual attachments
Lingual button or cleat

Placed on lingual surface of teeth for


attachment of elastics, elastic thread,
wire ligature.

Placed on m-d center unless severe


crowding
is present or tooth is rotated.

Can be bondable or weldable.

Lingual cleats are used instead of


button because they provide greater
versatility for attachment of elastics.

ELASTICS
Internal diameter 3/8 (9.5 mm), 5/16 (7.9 mm),
(6.4 mm), 3/16 (4.8 mm) and 1/8 (3.2 mm)

Intended force values 2 Oz (57 gm), 31/2 Oz. (99 gm),


41/2 Oz.( 128 gm), 6 Oz. (170gm), and 8 Oz (227 gm)
varieties.
The funda was that when stretched 3 times their
diameter, the elastics would give the force that they
were marketed to be giving.

Horizontal or intramaxillary elastics in position

Elastic thread tied in figure of 8


pattern

Placement of Attachment
Brackets placement
Height: 4mm from incisal edge except LI 3.5 mm
M-D centre of tooth (on rotated tooth slight off
centre 1 mm closure to the proximal surface
that is rotated towards lingual)

If distance is less chances of occlusal

interference and / or bracket


displacement.
If distance is more, difficult to maintain

dental arch length and rotations because


arch wire will be below the contact area
between the teeth.

Lingual buttons & cleats

Positioned directly opposite to area of


arch wire engagement. (Bracket).

To permit free m-d tipping & uprighting.

Buccal tubes

Mesial end of tube is in line with centre


of mesiobuccal cusp.

Mandibular tube should be placed as


gingivally as possible to keep arch wire
away from occlusal plane.

Elastic hook
Positioned, so that the elastic will pull from a
point as near to the center of crown as
possible.

Stage I in Begg
Technique

Stage I:

(Usually 4 to 8 months)

Objectives:
Correction of Anterior spaces
Correction of crowding
Overcorrection of rotation of anterior teeth
Overcorrection of Over jet to an edge to edge incisor relation
Overcorrection of Overbite to an edge to edge incisor relation
Correction of Cross bites
Correction of molar relation
Beginning of correction of premolars
Overcorrection of disto occlusion of the buccal segments
Partial correction of midline discrepancies
Correction of Axial inclination of mandibular incisors

STAGE MODELS.
THE IMPORTANCE OF STAGE MODELS AS TOLD BY DR.A ROCKE,:
1.TO CHECK THE ARCH CONTOUR AND WIDTH.
2.TO CHECK THE INCLINATION OF UPPER AND LOWER ANTERIOR
TEETH.
3.SELF-DISCIPLINE TO TO COMPLETE EACH STAGE BEFORE
PROCEEDING TO THE NEXT.
4.TO DETERMINE THE TEETH MOVEMENT.
5.TO GAIN INSIGHT INTO ANCHORAGE MAINTAINED IN THE
TREATMENT.
6.VISUAL AID FOR PATIENTS AND PARENTS.
7.VISUAL AID FOR REFERRING DENTISTS THE POSSIBILITY OF
ANTERIOR TORQUING..

Objectives of Stage I
Correction of crowding and irregularity.
Closure of anterior spaces.
Correction of rotations.
Elimination of deep bites edge to edge bite / openbite
except in class III.
Openbites Overbite relations.
Correction of Mesiodistal relations of buccal segments
Class I and Class II Mild class III.
Class III Class I or Class II.

Objectives of Stage I
Co-ordination of upper and lower arches.
Correction of anterior and posterior cross bites.
Axial relation of anchor molars corrected upright position.
Extraction spaces become smaller.
All tooth movements carried out simultaneously & in
both arches.

Eliminate any anterior crowding.


How achieved:

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.
Closure of anterior spaces.
How achieved:

Plain arch wire with elastic from cuspid pin


tail to cuspid pin tail.

Overrotate all teeth that require rotating.


How achieved:

Overcorrection of bracket areas between


anterior vertical loops.

Use of elastic thread from buttons or brackets


to rotate cuspids and bicuspids.

Use of rotating springs on second bicuspids in


first bicuspid extraction cases; also on cuspids
and first bicuspids in non-extraction cases.
Open the anterior overbite.
How achieved:

Use 0.016inch hard Australian wire.

Proper amount of anchor bends at proper


locations.

Continual wearing of Class II or Class III elastics


as required.

Overcorrect the mesiodistal relationship of the


buccal segments as necessary.
How achieved:

Continual wearing of Class II or Class III


elastics as required.

Proper anchorage or bite-opening bends in


both upper and lower arch wires.

Correct posterior crossbites.


How achieved:

Modify arch width of one or both arch wires.

Wearing of cross elastics usually bilaterally.

Modify arch wire width, and wear cross elastics.


If upper arch requires widening and lower arch
is proper width, both arch wires should be
expanded in their buccal segments. The
maxillary arch wire is expanded to accentuate
the widening force created by the cross elastics
hooked to the lingual surfaces of the maxillary
first molars. The mandibular arch wire is
expanded to counteract the narrowing force
from the cross elastics pulling on the buccal
surfaces of the mandibular first molars.

Rapid maxillary overexpansion, followed by a


period of stabilization prior to the placement of
complete appliances and the beginning of Stage
1.

Objectives Of Second
Stage.
Maintain all corrections achieved

during first stage.


Close any remaining post. spaces.

Maintain all corrections achieved during first stage.


How achieved:

Mesiodistal molar relationship maintained through


the wearing of Class II or Class III elastics as required.

Original spaces between anterior teeth are prevented


from recurring by tying intermaxillary circles to the
cuspid brackets with steel ligature wire.

Overrotations of cuspids are maintained by engaging


the brackets which have been offset on the teeth.

Overrotations of bicuspids are held by replacing


elastic threads with steel ligature ties.

Overrotations of central and lateral incisors are


maintained through the continued use of bayonet
bends in the arch wires.

Opening of a deep anterior overbite is maintained


through the continued use of bite opening bends and
Class II and Class III elastics.

The correction of posterior crossbites is maintained


by modifying the arch wire or by wearing of cross
elastics s necessary.

Close any remaining posterior spaces.


How achieved:
Wearing of horizontal elastics across
spaces until closed.

Objectives of Stage 3

Maintain all corrections achieved


during first and second stages.
Achieve desired axial inclinations of
all teeth.

Maintain all corrections achieved


during first and second stages.
How achieved:
Same s those listed for maintaining
corrections achieved during stage 1.
Posterior spaces kept closed by
bending the distal ends of the arch
wires around the buccal tubes.
Arch form and overbite correction
maintained by using heavier (0.018
to 0.025 inch) main arch wires.

Achieve desired axial inclinations of all


teeth.
How achieved:
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 of torqueing
auxiliaries.

Arch wire:
Different diameter of wire is available but the most commonly used one is
0.016 wire
0.016 special

- Looped arch wire in any case

0.016 special

- Plain arch wire in extraction cases or in which 1st and


2nd premolars are extracted

0.018

- Plain arch wire in molar extraction cases

Initial Arch wire:


The basic shape of the initial archwire depends upon the shape of
malocclusion and although it is similar it isn seldom identical.
The archwire shape is proportional to the width, the form and symmetry
of dental arch.
There may be localized modifications of archwire in the vertical and
horizontal plane and these are called Offset bends.

Offset bends:
In Anterior segment
Vertical offset

- To Intrude or Extrude

Horizontal offset

- to Expand, contract and rotate

In posterior segment
Gingival offset

- to avoid occlusal distortion and


interference with bicuspids

Shape of Anterior segment:


The anterior curve of the initial arch wire is usually a compromise between
the shape of the malocclusion and that of normal occlusion.
E.g.: If anterior segment is narrow and protrusive the arch wire is made
slightly broader in the cuspid region and flatter opposite to central incisors.

Intermaxillary Hooks:
Routinely bent into the arch wire for both the upper and lower arches and are
positioned 1mm mesial to the cuspid brackets.
The coil Pattern is usually a small helical loop 2 to 2.5mm of outside diameter.
The helical Intermaxillary hook two primary and two secondary advantages
Archwire is stiffer and aids in overbite correction
Wire is stiffer in horizontal plane and aids in correction of arch form,
width
and symmetry
Helical hook can be formed quickly
Helical hook is seldom distorted or broken
If Boot shaped loops are used they are angulated buccaly away the vertical in
order to avoid any possibility if wedging of distal arm of loop into slot.

Vertical Loops:
Used to supply local increased arch flexibility or used for space opening or
closing, stops, rotation or root torque.
The most vertical loops to allign six anterior teeth are five, one in each
interproximal area.
Generally loops are made 6 to 8mm long but greater the length of the loop,
the more gentle the force on the tooth .
The Loop between the maxillary central incisors should be avoided, when
indicated the loop is made shorter because
1) Avoid irritation to the labial frenum
2) Loop in midline causes arch wire to assume V shape when contracted
by placement in the molar tube

Horizontal bracket area for severly


lingually placed tooth is bent 1mm further
gingivally than plane of arch wire to
prevent elongation of tooth as it tips
labially

Contraction Loop in midline with


incisor stops to tip crowns of upper
centrals

Vertical loops bent in case of


high frenum attachment

Molar anchorage bends:


Placed immediately posterior to the 2nd premolar bracket
Bent opposite so that when inserted into the buccal tubes the anterior
section of the archwire lies in the buccal sulci
Amount of bend varies from case to case
The leverage force incorporated on the incisors should be around 65mg
Greater force tend to eventually cause lingual rolling and distal tilting of
molars
Increase of excessive leverage the mesial marginal ridge of the molars
are is seen to raise above the occlusal level
the purpose of anchor bend in upper arch is to prevent mesial migration
of the molars; In lower is to supply bodily control of the lower molars as
these are moved forward by action of Class II elastics

Anchorage bend opposite


to molar premolar contact
point
Labial portion lying in
buccal sulci

Bayonet bends:
It is inadvisable to use bayonet bends for active correction, because of the
tendency for round archwire to rotate within bracket slots causing the bayonet
bend to become ineffective or supply movement in wrong plane
Commonly used passively to retain overrotation brought about via
previously looped arch.
They should be small and offset section is 5 degrees to the line of main arch.

Pinning and ligation of arch wires:


The pins used in the opening stages of treatment should be safety lock
design which will automatically obviate friction between pinhead and
archwire.
In the StageI of treatment of ClassII all the teeth are pinned except
The second premolars
Teeth initially so far displaced
Upper laterals which are lingual to centrals
Rotated Buccal teeth.

Placement of Elastics:
It is impossible for the arch wire to function properly without the proper
elastics.
In order to determine the size of the elastics the tension gauge is used.
The Class II elastics are engaged around the distal ends of the molar
tubes or molar hooks and stretched anteriorly to engage the maxillary
Intermaxillary hook mesial to the maxillary cuspid.
In Class III elastics are worn from the maxillary molars to the intermaxillary
hook mesial to the mandibular cuspid bracket.
No horizontal (intramaxillary) elastics are applied during stage I

Class II elastics pulling 2 to 3


ounce at the beginning

Class III elastics

Horizontal (intramaxillay) elastic

Check list for stage I:


Check for desired movements
Overbite and over jet improvement
Anterior alignment progressing
Dental arch width particularly the molar width
Dental arch form being maintained
Antero - posterior relation of cuspids and molars being maintained
Individual molar positions being maintained
Check for undesired movements or manifestations
Failure to wear elastics at all times
Poor hygiene
Vertical loops impinging on tooth or tissues
Arch wire distortion
contraction or expansion of arch width

Problems encountered during the first stage:


1) Bite not opening
Patients not wearing elastics
Patient biting out bite opening bends
Failure to place proper amount of bite opening bends when arches were placed
Anchor molars out of occlusion
Loose molar band
Improper angulations of buccal tube or entire band
2) Molar width narrowing (usually mandibular molars)
Vertical component of Class II elastic force
Prolonged wearing of posterior cross elastics to widen opposing molars
Distolingually rotated cuspids
Bicuspid rotational elastic tie on the lingual from the bicuspid to the molar
Rolling of distal ends of archwire, causing anchor bend to turn into rotational force on
molar
3) Adverse tipping of anchor molars
No anchor bends
Too much anchor bend
Proper amount of anchor bends, but in place for too long time

Loose molar band


Excessive elastic force
Improper placement of elastics on tooth
Oversize arch wire
4) No appreciable changes
Not wearing elastics
Arch wires bent out of shape
Oral habits present that counteract force of appliances
Patient seen too soon
5) Vertical loops buried in gingiva
Original Looped arch wire left in the mouth too long
Maladjustment in the proper direction of vertical loops when the arch wire was placed
6) Elastics which break or do not stay on
May just be an excuse for not wearing elastics
Elastic will not stay in Intermaxillary circle
Distal end archwire too short or imbedded in the gingiva
7) Lock pin lost
occlusal incisal forces
If missing randomly throughout the mouth, probably patient is picking at them

8) Extremely mobile molars


Clenching of teeth
Intermittent wearing of elastics
Pathology
Excessive force applied to molar
No apparent cause
9) Lower anterior teeth tipping labially
May be an optical illusion with the roots actually moving lingually
Binding of the archwire in bicuspid brackets
binding of ends arch wire inside distal ends of buccal tube
10) Anterior Open bite not Closing
Patient not wearing anterior vertical elastics
Persistent Tongue-thrust or adverse habbits
Too much anchor bends
11) Tooth not rotating
Not enough space
Not enough activation in bracket area of arch wire
Elastic threads slipping over the top of the tooth
12) Midline discrepancy
Asymmetrical tipping of anterior teeth

Stage II:

( usually 1 to 4 months)

Completion of extraction space closure


1. By continuing retraction of anterior teeth
2. Correction of premolar rotations
Completion of correction of midline discrepancies
Maintenance of all anterior and posterior overcorrection achieved in stage I
Continued correction of Open Bite

Arch wire:
The Archwire pattern is basically that of Stage I treatment
0.016 gauge of wire is used
0.018 is used when there is frequent arch wire distortions or unilateral
space closure
Anchor bend is made 1mm mesial to the molar, premolar contact point.
The pressure supplied by the anchor bends to the molars and incisors is
slightly reduced from that employed during Stage I
Because Intermaxillary elastics tend to rotate molars slight toe in bends are
made in the molar areas to prevent molar rotation
Intermaxillary hooks are incorporated in both archwire immediately mesial
to the cuspid brackets and in contact or very near contact with them
The hooks in upper arch has to bear two elastics which is somewhat
difficult for
ring pattern. A Z shaped hook makes it easier for the patient
to apply two rubbers
to the hook
The 2nd premolar is bypassed from pinning as in Stage I, The wire is held in position
by bypass clamp or steel ligature

The bypass clamp in position of the bracket


in premolar

Slight horizontal offsets are formed distal to canines to maintain correct buccolingual
position of the premolars and canines

Inter & Intramaxillary elastics:


Lateral Cephalogram is taken and from cephalometric evaluation it is determined
whether the anteriors are to be retracted or posteriors are moved for closure of space.
The Space closing elastic ( esp. the maxillary) stretching from the Intermaxillary hook
to the molar hook against molar lies against the gingiva and irritates the gingiva, to
overcome this elastic is twisted one half turn when it is placed

Wearing of horizontal elastics try to rotate the molars distobuccaly and this should be
counteracted by the toe in bends of the arch wire. If rotation aggravates after giving
toe in bends the elastics can be engaged on the lingual hooks. Care should be taken of
the second premolar so it doesnt tip when elastic crosses it occlusally.

Correction of Midline discrepancy:


Midline must be determined by reference to the center of face, whether the
discrepancy is confined to one arch or in both
If one arch is involved shifts more than 2mm is major; lesst han 2mm is a minor
problem.
The application of intramaxillary elastic will complete closure on the side to which
midline is shifted; The intramaxillary elastic on the side which closes first can be
discontinued
Minor discrepancies are self correcting

Diagonal elastics for correction of midline


in both the arches

Correction by movement of
individual units or small group
after distal tipping of canine

Auxiliaries in stage II:


The auxiliaries used are passive mesio distal root uprighting springs on the
mandibular canines and the lower anterior braking arches.
The function of of these types of auxiliaries is to establish two point contact
between teeth and archwire and prevent free tipping movement of the
anteriors.

Lower braking auxiliary on the four


Anteriors

Check list for stage II:


Check the teeth and appliances berfore treatment progress for
Loosened bands
Loosened brackets
Patient co-operation in elastic wearing
Compare the positions of the teeth on the second stage model with those in
mouth
Check for desired movements
Check for undesired movements or manifestations such as
Failure to wear elastics at all times
Poor oral hygiene
Arch wire projecting out and causing impingement
Contraction or expansion of the arch
Asymmetry of dental arch
Molars rotating mesiolingually due to use of single elastic on the buccal
Anterior class III relation developing
Excessive anterior open bite
Anchorage bend coming into close proximity
Midline is maintained

Problems encountered during stage II:


1) Anterior bite opening
Not enough bite opening bends placed in the arch
Bite opening bends bitten out or arch wires distorted
Patient not wearing Intermaxillary elastics
Anchor molars out of occlusion
2) Anterior teeth assuming Class III relationship
Excessive wearing of class II elastics
Determine if anterior bite is truly open
3) Spaces developing between anterior teeth
Failure to tie with steel ligature from Intermaxillary hook distal to cuspids
Intermaxillary circles formed too apart
4) Anchor molars rotating distobuccaly
Toe out on arch wire
Too much force from horizontal elastic

5) Cuspid roots bulging on labial plate of alveolar bone


Normal distal tipping
Poor arch form
Poor bracket placement
6) Posterior spaces not closed
Patient not wearing elastics
Arch wire not free to slide through the buccal tube
Arch wire pinned or caught in bicuspid bracket slot
Patient placing tongue or pencil in space
Occlusal interference
Anterior teeth not free to tip distally
Anteriors cannot tip distally owing to tongue habits
7) Second premolars tipping mesially in extraction caseof 1st premolar
Slight expected mesial movement of anchor molars
Abnormal loss of anchorage, if second premolars are tipping excessively

8) Mandibular anterior teeth achieving desired lingual inclination before


posterior spaces are closed completely
Inexperienced orthodontic skill
Careful preservation of anchorage
Excess space at beginning of treatment

CONCLUSION:
The development of Beggs different way of orthodontic
therapy was not the result of a single discovery but rather
,the product of a long tedious ,well-organized trial and error
process.
When correctly applied, his light archwire technique can
produce universal tooth movement with light optimum
forces, least discomfort to patients ,minimum loosening of
teeth and least injury to tooth investing tissues.
Dr.Begg theory does not depend upon cephalometrics to
establish angulations nor does it require complicated
engineering formulae for moving teeth.
Because the Begg technique, requires shorter time, it does
not mean that it is a snap method requiring less
orthodontic skill or ingenuity..

References:
The Begg orthodontic theory and technique Kesling 3rd edition
Begg appliance and technique Fletcher
Current orthodontic concepts and technique Graber and Swain
New vistas of orthodontics Lysle E Johnston
AJO 1975 may volume 67 George R Cadman
AJO 1973 Jan volume 63 Doyle W Baldbridge
AJO 1963 oct volume 49 George V Newman

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