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PG STUDENT
DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL
ORTHOPAEDICS
CONTENTS
EVOLUTION OF BEGG TECHNIQUE
EVOLUTION OF REFINED BEGG
APPLIANCE DESIGN
STAGE -I
STAGE -II AND PRE STAGE III
STAGE III
VARIOUS AUXILLARIES
FINISHING AND DETAILING
CONCLUSION
HISTORICAL PERSPECTIVE
Dr. Beggs experience with the
CONCEPTS
His studies on Attritional occlusion
MATERIAL ADVANCEMENTS
He kept close tabs with
CLASSICAL BEGG
ADVANTAGES
Light forces
Anchorage control
Quick correction
Efficient uprighting
Less demands on
patient cooperation
Low cost
DISADVANTAGES
No precise control
Posterior root torque is
difficult
True intrusion is less likely
Poor rotational control
Over use of class II
elastics
Uncontrolled tipping and
root resorption
Heavy torque requirement
Over emphasis on
extractions
No fail safe mechanism
EVOLUTION
MODIFIED BEGG
Change in the
shape of the
bracket
Ex: Tip edge
BEDDTIOT
C.A.T and other
Combination
brackets
REFINED BEGG
Use the same
Begg bracket
Use of newer high
tensile wires and
auxillaries to
overcome the
drawbacks of the
classic technique
REFINED BEGG
Refinements can be broadly classified
under the following headings:
CONCEPTUAL CHANGES
HARDWARE ADVANCEMENTS
MODIFICATION OF MECHANICS
1. Conceptual changes
Attritional occlusion and Differential
2. Treatment objectives
Treatment objectives now include
3. Diagnosis
Diagnosis is now broad based,
4. Treatment planning
Treatment planning varies according
or vice versa,
asymmetric extractions,
5. Biomechanics
The conventional method tipped the
6. Arch-forms
Proper arch form and co-ordination of
1.
2.
3.
4.
Attachments
Arch Wires
Elastics
Other Components
1. Attachments
Brackets: Basic design remains the
same
Built in torque (Kameda)
Anti rotation (Mollenhauer)
Tubes:
Round / Oval / Rectangular
Built in distal offset
Oval / Rectangular tubes are used to get
Other attachments
Palatal brackets
Hooks
Lingual buttons, cleats or eyelets
Additional round tubes
Lingual and palatal sheaths
2. Arch-wires
Newer high grade Australian stainless
steel
Premium
Premium plus
Supreme
3. Elastics
Ultra light
Roadrunner of Ormco
Light
Yellow elastics of T.P. Orthodontics
4. Other Components
By pass hooks and power pins
(Kameda)
Trans palatal arches
Jasper jumper
Stage I
Multi looped arch wires are avoided
Stage II
MAA is continued for controlled
tipping of anteriors.
Base wire may be changed to 0.020
size.
Excessive tipping of incisors is
avoided by applying efficient brakes.
Kameda recommends to start
torquing incisors from this stage
itself.
Stage III
Base wire is 0.020 premium for
Finishing
Rectangular wires along with staples
Retention
Conventional Begg did not emphasize
Bracket
design
0.020
0.045
0.015
Built in Torque
adjustment
Molar Tubes
6 mm
5 mm
0.036
0.072
0.024
Combination Tubes
6.2 mm
0.036
0.025
5.5 mm
0.018
Placement of the
attachments
Height
Mesio-distal location
Brackets
Molar tubes
Bracket Heights
Maxillary
teeth
Height (mm) 3
3.5 4
Height (mm) 3
Mandibular
teeth
Maxillary Anteriors
Height (mm)
Height (mm)
Mandibular Anteriors
3
3.5
3.5
3
2
3
3.5
2
1
4
4
1
Mesio-distal location
Brackets
Ideally placed along the long axis
Offseted in case of rotations
Molar tubes
Mesial of the tube in line with mesio-
Arch wires
(in the order of increasing yield
strength)
Australian wires formerly available
Regular
Regular plus
Special
Special plus
Availability of newer
wires
WIRE
SIZE
(INCH)
.008
.009
.010
.011
.012
.014
.016
.018
.020
PREMIUM
PREMIUM
PLUS
SUPREME
Mechanical properties of
the newer grade wires
Working range(maximum flexibility)
Resiliency
Zero stress relaxation
Formability
General considerations
in bending the archwires
Cuspid circles
Size
Location
Molar stops
Accesories
Power pins
(Kameda)
Trans palatal arches
Pins
Stage I pins
Stage III pins
High hat pins
Hook pins
T pins
STAGE I
Objectives of conventional Begg
Alignment of teeth
Elimination of cross bites
Over bite correction
Over jet correction
Correction of arch form
Matching the midlines
Attaining class I molar and canine
relation
Alignment of teeth
Labio-ligual movements
Correction of rotations
Correction of anterior cross bite
normal.
Molar rotations and posterior cross bites to be
corrected with TPA.
Premolar rotations to be corrected using only
palatal or lingual attachments.
Upper arch form in the canine area is broadened,
if narrow to facilitate mandibular advancement
for class II correction.
during retraction.
Prevent uncontrolled tipping of lower incisors
during bite opening.
Apply root control for correction of extreme labiolingual movements such as blocked in lateral
incisors.
Control the mandibular plane angle.
Match skeletal and dental midlines.
Correct inter arch relationship to Class I.
Premolar displacements and rotations are
corrected if they are bonded.
Spaces to be
opened or
closed
Alignment of
teeth
Arch wire
selection in
stage 1
Anterior
overbite and
effect of
elastics
incisors
Resists lingual rolling of lower molars
3.Amount of wire
deflection
Considerations for
choice of wire
Same diameter coax wire exerts less force
4.Amount of rotational
control required
The arch wire should fill the slot as
7.Over correction of
rotations
As one proceeds to stiffer wires
III.Improving the
inclination of upper
incisors
IV.Molar position
correction
Rotated molars are corrected with
V. Premolar derotations
Can be achieved by tying only the
SUB STAGE I B
It forms the major part of the first stage
Arch wires used are 0.018 P/P+
The elastics employed are mostly class II
Bite opening
Elimination of overjet with controlled tipping
Controlling the mandibular plane angle
Correcting midline discrepancy
Correcting the inter-arch relation to class I
I. Bite opening
True intrusion of incisors and
proclined
Intrusive force=45gms
Class II force=60gms
As inclination improves
Intrusive force=60gms
Class II force=30gms
Modifications for
uniform intrusion
molar bands
Four additional brackets to be bonded on
the palatal aspect of incisors with their
slots facing incisally
Sectional 0.016 wire to be engaged
High hat pins to be used for elastic
engagement
vector
Lateral cephalograph taken with barium
II Elimination of
overjet
Attaining an edge to edge incisor
b)Preventing uncontrolled
tipping of lower incisors
Lower incisor brackets are bonded
more gingivally
Less anchor bend in the lower arch
wire
MAA with labial root torque
Arch wire ends are cinched tight
V.Correcting inter-arch
relation to Class I
In a growing child the class II correction
Pins in stage I B
Mollenhauer observed that excess
Check list
of stage I
at the end
lingual displacements
Maintain good control over root positions
and the mandibular plane angle
Objectives
Arch wires in stage II
Controlled tipping of incisors
Braking mechanics for protracting
posteriors
Elastics used in stage II
Pins used in stage II
Duration of stage II
Rotations of premolars
Check list at the end of stage II
Pre stage III
Objectives
To maintain all corrections
achieved in stage I
To close all extraction spaces
In addition
Controlled tipping during retraction
are used
The heavy 0.020 arch wires are good
for maintaining rotation correction, deep
bite correction and the arch form
Braking mechanics
Passive uprighting springs made in
Elastics
Various configurations are used as per
Stage III
Objectives
To maintain corrections achieved in the
Additional objectives
To carefully monitor anchorage
Problems encountered in
Stage III
Sagittal
Mesial movement of entire dentition or
individual crowns
Class II / Bimax / Rotations / Crowding
reverts back
Spaces opening at extraction site
Vertical
Anterior deep bite reverts partially or
fully
Posterior open bite may develop in
second premolar or first molar
extraction cases
Transverse
Buccal flaring of posteriors leading to
functional disturbances
Root resorption
Methods to overcome
problems
1.Minimise need for root movements in
this stage
Proper diagnosis and careful extraction plan
Use of efficient braking mechanism
Controlled tipping of teeth in the first two
stages
2.Use of heavy base wires
3.Using lighter auxillaries and uprighting
springs
4.Use of light class II elastics
5.Reinforcement of anchorage
6.Over correction of all movements at end of
stage II
Various torquing
auxillaries
Uprighting springs
Mini 0.5 mm diameter
Midi 0.9 mm diameter
Maxi 1.5 mm diameter
Finishing
Objectives
Intra arch
Proper facio lingual positioning
Good inter dental contacts
Well aligned marginal ridges
Flat curve of spee
Proper tip and torque of all teeth
Proper arch form
Maintainence of lower inter canine
width
Inter arch
Normal overjet and overbite
Class I canine, premolar and molar
relations
Tight inter digitation of posterior
occlusion
Functional
No cuspal interferences
Canine and incisor guidance
Healthy and well functioning TMJ
Control of etiologic factors
CONCLUSION
In this ever changing world, when things are
REFERENCES
Refined Beggs of modern times Dr. Vijay jayde
Sidney Brandt Experience with Begg technique
THANK YOU