Begg Technique ORTHO / orthodontic courses by Indian dental academy

INDIAN DENTAL

ACADEMYLeader in continuing dental educationwww.indiandentalacademy.com

www.indiandentalacademy.comwww.indiandentalacademy.com

CONTENTSCONTENTS IntroductionIntroduction Instruments used in Begg techniqueInstruments used in Begg technique Bracket and Buccal-tube placementBracket and Buccal-tube placement Case - selectionCase - selectionSTAGE I :-STAGE I :- 1. Stage-I arch wire formation1. Stage-I arch wire formation 2. Objectives of stage-I2. Objectives of stage-I 3. Biomechanics of stage-I3. Biomechanics of stage-I Conclusion Conclusion (Picture at the end of stage (Picture at the end of stage

I)I) ReferencesReferences www.indiandentalacademy.comwww.indiandentalacademy.com

INTRODUCTIONINTRODUCTION Begg Begg “ LIGHT WIRE DIFFERENTIAL “ LIGHT WIRE DIFFERENTIAL

FORCE TECHNIQUE ”FORCE TECHNIQUE ”is a unique is a unique technique of moving teeth using technique of moving teeth using simple tipping movements to bring simple tipping movements to bring about correction of malocclusionsabout correction of malocclusions

Based on the theories of -Based on the theories of - 1. Attritional occlusion1. Attritional occlusion 2.The theory of differential pressures2.The theory of differential pressures 3. Light round wire forces3. Light round wire forces


BEGG INSTRUMENTARIUMBEGG INSTRUMENTARIUM THE LIGHT WIRE PLIERTHE LIGHT WIRE PLIER

1.The main plier in Begg 1.The main plier in Begg technique technique

2.Is a refined version of2.Is a refined version of an original plier designed an original plier designed by E.H Angle for S.Sby E.H Angle for S.S White companyWhite company 3.Referred to as 3.Referred to as No. 139No. 139 or or BIRD BIRD BEAK PLIERBEAK PLIER


BIRD BEAK PLIER S.S WHITE No.-130BIRD BEAK PLIER S.S WHITE No.-130 T.P-No.139T.P-No.139


Dr. Begg found it necessary Dr. Begg found it necessary to to reduce the size of the beak in order reduce the size of the beak in order to make delicate bendsto make delicate bends eg. The boot eg. The boot hooks and the vertical loopshooks and the vertical loops

Design –Design – 1.Has one round and one square 1.Has one round and one square

beakbeak 2.The beaks are tapering2.The beaks are tapering 3.A groove at ½ to 1 mm 3.A groove at ½ to 1 mm


Uses –Uses – 1.Arch wire bending (S.S White No.-1.Arch wire bending (S.S White No.- 139)139)

2.Placing lock pins (Longer beak-T.P2.Placing lock pins (Longer beak-T.P No.130)No.130)


ARCH WIRE CONTOURING PLIERARCH WIRE CONTOURING PLIER

1.No. 128 pliers1.No. 128 pliers


2.Used to develop 2.Used to develop “ “cuspid-curves” cuspid-curves”

3.Improperly formed3.Improperly formed arch wire results inarch wire results in NARROWINGNARROWING ofof the cuspids. the cuspids.


ARCH FORMING PLIERS/ARCH FORMING PLIERS/RIBBON ARCH PLIERSRIBBON ARCH PLIERS

Originally designed to bend RIBBON Originally designed to bend RIBBON ARCH and EDGE-WISE arch wiresARCH and EDGE-WISE arch wires


Beaks are ground to be parallel at Beaks are ground to be parallel at appox .020’’appox .020’’


Used to firmly grasp both wires when Used to firmly grasp both wires when wrapping the end of an arch wire wrapping the end of an arch wire when completing the bending of a when completing the bending of a double –back enddouble –back end


PIN AND LIGATURE CUTTING PIN AND LIGATURE CUTTING PLIERSPLIERS

Originally designed by Dr. E.H AngleOriginally designed by Dr. E.H Angle USED TO –USED TO – 1. Cut and remove lock pins1. Cut and remove lock pins 2.To cut ligature wires2.To cut ligature wires


TWEED LOOP FORMING PLIERTWEED LOOP FORMING PLIER Plier No. 442Plier No. 442

Used to make Used to make cuspid circles cuspid circles and verticle and verticle loopsloops

The 2The 2ndnd step of step of the plier is the plier is used (2mm )used (2mm )

2 mm

12step

3

Cuspid circle


BRACKET and MOLAR TUBE BRACKET and MOLAR TUBE PLACEMENTPLACEMENT


BRACKET PLACEMENTBRACKET PLACEMENT Is of utmost importance Is of utmost importance

Brackets can be Brackets can be 1.Weldable1.Weldable 2.Bonded2.Bonded

High flange bracket preferred;possess wider area of welding


Jigs- helps to place brackets in proper Jigs- helps to place brackets in proper positionposition

Bracket positioning jig


Bracket placed at 4mm from the incisal edge

Bracket centered mesio-distally


Brackets are placed on all teeth Brackets are placed on all teeth except the molarsexcept the molars

Are - Are - CENTERED MESIO-DISTALLYCENTERED MESIO-DISTALLY

Base of the bracket slots - 4 mm Base of the bracket slots - 4 mm from the incisal edges or the cusp from the incisal edges or the cusp tips tips


Only exception –Maxillary lateralOnly exception –Maxillary lateral incisor, placed at 3.5 mm (for desired incisor, placed at 3.5 mm (for desired esthetic shortening), but if it’s esthetic shortening), but if it’s lingually placed bracket positioned lingually placed bracket positioned 4mm 4mm

If the tooth is rotated originally the If the tooth is rotated originally the bracket is placed bracket is placed

off-centeroff-center

Off-centered brackets

1

2


BANDING THE 2nd BICUSPIDS ?BANDING THE 2nd BICUSPIDS ? Banding the 2Banding the 2ndnd bicuspids - optional in bicuspids - optional in

first stagefirst stage

DisadvantageDisadvantage – long length of – long length of unsupported archwire , liable to get unsupported archwire , liable to get distorted distorted Unsupported arch wire


Banding the 2Banding the 2ndnd bicuspids , placing bicuspids , placing brackets on them along with bypass brackets on them along with bypass clamps clamps provide protection and provide protection and supportsupport to the arch wire against to the arch wire against buccal rolling and gives buccal rolling and gives firmer bodily firmer bodily control over the anchor molars.control over the anchor molars.

Bypass clamp guides the arch wire


Second bicuspid brackets should not be Second bicuspid brackets should not be placed , if they contact the distal of the placed , if they contact the distal of the buccal cusps of the Mx molar in class II buccal cusps of the Mx molar in class II relation , when class II traction is usedrelation , when class II traction is used

Second bicuspids should be banded before Second bicuspids should be banded before the final act of space closure the final act of space closure in order to -in order to -

1. Avoid the possibility of over closure 1. Avoid the possibility of over closure 2. Possible exclusion of these teeth from2. Possible exclusion of these teeth from the dental arch the dental arch


The lingual buttonThe lingual button – placed directly – placed directly opposite to the areas of arch wire opposite to the areas of arch wire engagement.engagement.


BUCCAL TUBE PLACEMENTBUCCAL TUBE PLACEMENT

Lower molar tube positioned more gingival to avoid occlusal interference

Molar tubeAt center of M-B

cusp


Molar tube to be Molar tube to be parallel to the occlusal surface Molar tube to be

Ball end hook


MOLAR OFF-SETSMOLAR OFF-SETS As suggested by As suggested by

SWAINSWAIN 1.Upper molar 1.Upper molar

tubestubes fixed fixed perpendicular to the perpendicular to the mesial aspect of the mesial aspect of the Mx-molar bands , Mx-molar bands , which results in which results in appox.10 degree appox.10 degree disto-lingual disto-lingual rotational off-setrotational off-set


LOWER MOLAR LOWER MOLAR TUBESTUBES

1.Lesser off-set of 1.Lesser off-set of appox. 5 degrees appox. 5 degrees disto-lingual disto-lingual rotational off-setrotational off-set

2.Off-sets are placed 2.Off-sets are placed to maintain the to maintain the relation of the M-B relation of the M-B and the D-B cuspsand the D-B cusps


POSITION OF THE BRACKETS POSITION OF THE BRACKETS AND THE TUBESAND THE TUBES

4 mm 3.5 mm 4 mm 4 mm 4 mm

4 mm 4 mm 4 mm 4 mm3.5 mm


Molar tube off-set

Brackets centered mesio-distally

Off-centered brackets on rotated teeth

Mx molar offset- 5-10Md molar 5-7

BRACKET AND TUBE ARRANGEMENT


CASE SELECTIONCASE SELECTION Begg appliance offers a comprehensive Begg appliance offers a comprehensive

mechanical system suited for almost all mechanical system suited for almost all forms of mal-occlusionsforms of mal-occlusions

Most effective in extraction cases which Most effective in extraction cases which provide a margin of excess of space provide a margin of excess of space

Can be successfully used in non-Can be successfully used in non-extraction cases as wellextraction cases as well


1.Well suited in cases of Class I with 1.Well suited in cases of Class I with marked bi-dental marked bi-dental

protrusionprotrusion2.Class II div. 1 and 2.Class II div. 1 and div. 2 with deep bite div. 2 with deep bite 3.Cases with severe3.Cases with severe crowding crowding 4.Cases with pronounced 4.Cases with pronounced over-jet and excess over-jet and excess anterior spacing anterior spacing

Bi-max

Marked over-jet and bite


Bi-max protrusionIncompetent lips



WHETHER TO EXTRACT OR WHETHER TO EXTRACT OR NOT?NOT?

Depends on –Depends on –1.Type and severity of mal-occlusion1.Type and severity of mal-occlusion2.Treatment goals2.Treatment goals3.Ability and experience of the operator3.Ability and experience of the operator4.Age of the patient 4.Age of the patient 5.Condition of the teeth5.Condition of the teeth6.Anticipated patient co-operation6.Anticipated patient co-operation7.Skeletal pattern7.Skeletal pattern8.Patient’s preferences8.Patient’s preferenceswww.indiandentalacademy.comwww.indiandentalacademy.com

REQUIREMENTSREQUIREMENTS

Accurate diagnosis and treatment Accurate diagnosis and treatment planplan

Good study modelsGood study models OPG and lateral cephalogramOPG and lateral cephalogram Good set of facial photographsGood set of facial photographs


RELATIONSHIP OF THE LOWER RELATIONSHIP OF THE LOWER INCISORS TO THE A-P LINEINCISORS TO THE A-P LINE (A (A Diagnostic aid) –A.J.O , May 1969Diagnostic aid) –A.J.O , May 1969

Will alignment of the lower teeth relocate the incisal edges of the lower incisors too far ahead of the A-P line?


Will leveling of the curve of spee in the in the lower arch move the incisal edges of the lower incisors too far ahead of the A-P line ?


Will correcting the molarWill correcting the molar relation consume so relation consume so much anchorage that the much anchorage that the incisal edges of the incisal edges of the lower incisors are moved lower incisors are moved too far ahead the A-P too far ahead the A-P line?line?


Will remodeling of the point –A ,change the location of theA-P line ,resulting in the

incisal edges of the lower incisors being too far

ahead of the A-P line ?


Will the growth orWill the growth or repositioning during repositioning during

treatment, change the treatment, change the location of the A-P line , location of the A-P line , and result in the incisal and result in the incisal edges of the lower edges of the lower incisors being too far incisors being too far ahead of the A-P line ?ahead of the A-P line ?


If the answers to all the above is “NO” - non-extraction

If 1 or more answers are “YES” –reduction of tooth mass is must


BEGG TECHNIQUE - STAGE I BEGG TECHNIQUE - STAGE I

OBJECTIVESOBJECTIVES 1.Open the anterior over-bite1.Open the anterior over-bite 2.Over-correct the mesio-distal relation-2.Over-correct the mesio-distal relationship of the buccal segmentsship of the buccal segments 3.Close any anterior spaces3.Close any anterior spaces 4.Eliminate any anterior crowding 4.Eliminate any anterior crowding 5.Over-rotate teeth requiring correction5.Over-rotate teeth requiring correction 6.Correct posterior cross-bite6.Correct posterior cross-bite


APPLIANCE CONSTRUCTIONAPPLIANCE CONSTRUCTION Arch wire with Arch wire with

vertical loopsvertical loops – – 0.016’’0.016’’

1.used to unravel 1.used to unravel crowded teeth and crowded teeth and rotate anterior teethrotate anterior teeth

2.One loop between 2.One loop between two teethtwo teeth

3.Never placed distal 3.Never placed distal to the caninesto the canines

4.Bracket area4.Bracket areawww.indiandentalacademy.comwww.indiandentalacademy.com

CONSTRUCTION CONSTRUCTION

For a lingual positioned tooth

1 mm short

In inter-dental areas


The arch wire is The arch wire is modified in the modified in the BRACKET –AREA to BRACKET –AREA to over-correct the over-correct the anterior teeth anterior teeth


FINISHED STAGE-I ARCH WIRE FINISHED STAGE-I ARCH WIRE WITH VERTICAL LOOPSWITH VERTICAL LOOPS


When anterior teeth areWhen anterior teeth arespaced and irregular -spaced and irregular -VERTICAL CONTRACTIONVERTICAL CONTRACTIONLOOPS ARE USEDLOOPS ARE USED

Difference Difference –arch wire is–arch wire isshifted to the leftshifted to the left

Loops activated (opened)Loops activated (opened)

Intermaxillary circles tied Intermaxillary circles tied distally against the cuspidsdistally against the cuspids

stops

Contraction loop


PLAIN ARCH WIRES TO CLOSE PLAIN ARCH WIRES TO CLOSE ANTERIOR SPACESANTERIOR SPACES

Developed by- Developed by- P.C P.C KESLINGKESLING

1.Using plain arch 1.Using plain arch

wire with elastics ORwire with elastics OR


2.Two small elastic 2.Two small elastic scan be usedscan be used rather than onerather than one large elasticlarge elastic


ROTATING CUSPIDS AND ROTATING CUSPIDS AND BICUSPIDSBICUSPIDS

Rotated using Rotated using elastic thread from elastic thread from the lingual button the lingual button to the arch wireto the arch wire


OrOr using ROTATING using ROTATING SPRINGSSPRINGS


If along with the If along with the premolar the molar premolar the molar also needs rotation, also needs rotation, an elastic – tie can an elastic – tie can be given between be given between the molar and the the molar and the premolarpremolar

ELASTIC - TIE


MOLAR ANCHORAGE BENDSMOLAR ANCHORAGE BENDS Bite-opening bends/Tip-back bends/Anchor-bend Bite-opening bends/Tip-back bends/Anchor-bend

Bend faces vertical occlusally (if not , toe-in or toe-out is Bend faces vertical occlusally (if not , toe-in or toe-out is placed ) placed )

Facing occlusally


LOCATION OF THE ANCHOR LOCATION OF THE ANCHOR BENDSBENDS

3 mm mesial to the 3 mm mesial to the mesial end of the mesial end of the molar tubemolar tube

The wire enters at The wire enters at 6 o’clock and exits 6 o’clock and exits

at 12 o’clock when at 12 o’clock when the anterior segment the anterior segment is pulled incisallyis pulled incisally

ANCHOR BEND

3 mm


DEGREE OF BITE OPENING DEGREE OF BITE OPENING BENDBEND

Amount of bend is 30-50 degreesAmount of bend is 30-50 degrees

Correct amount of bend judged by Correct amount of bend judged by anterior segment deflection of the wire anterior segment deflection of the wire in the vestibulein the vestibule

Upper arch wireUpper arch wire should be- in vestibule should be- in vestibule LowerLower - mid-way between the teeth - mid-way between the teeth

and vestibuleand vestibulewww.indiandentalacademy.comwww.indiandentalacademy.com

30-50 degrees


PRECISELY MEASURING THE PRECISELY MEASURING THE FORCEFORCE

Measured using a Measured using a DIAL-GUAGE ,DIAL-GUAGE , especially when the especially when the intrusive force intrusive force requirement is requirement is criticalcritical


A nearly A nearly 20 mm20 mm displacement of the upper displacement of the upper arch wire will result in arch wire will result in 1.5 1.5 ouncesounces of depressive of depressive force (nearly 42.49grms)force (nearly 42.49grms)

14 mm14 mm of displacement of of displacement of the lower wire produces the lower wire produces 1.2 ounces1.2 ounces of depressive of depressive force force

KESLING 1985KESLING 1985


CHANGING TO AN ARCH WIRE CHANGING TO AN ARCH WIRE WITHOUT VERTICAL LOOPSWITHOUT VERTICAL LOOPS

It’s Desirable to discard the arch wire It’s Desirable to discard the arch wire with vertical loops as soon as with vertical loops as soon as possiblepossible

Reason Reason – Vertical loop increases the – Vertical loop increases the flexibility of the arch wire in the flexibility of the arch wire in the vertical plane and thus interferes vertical plane and thus interferes with the anterior bite–opening with the anterior bite–opening (vertical –control) (vertical –control)


Class II elastics and Dontrix


CLASS III ELASTIC IN PLACECLASS III ELASTIC IN PLACE


Plain arch wire with –Bayonet bends , Plain arch wire with –Bayonet bends , intermaxillary hooks ,anchor bends intermaxillary hooks ,anchor bends and elasticsand elastics

Bayonet bends hold the teeth in Bayonet bends hold the teeth in over-corrected positionsover-corrected positions

Intermaxillary circles hold the inter-Intermaxillary circles hold the inter-cuspid arch lengthcuspid arch length

Elastics to correct mesio-distal Elastics to correct mesio-distal relationrelation www.indiandentalacademy.comwww.indiandentalacademy.com

Right buccal

Frontal

Left buccal

INTRA-ORAL PHOTOGRAPHSEnd of stage I


AT THE END OF AT THE END OF STAGE ISTAGE I

Correction of over-bite to edge-to-Correction of over-bite to edge-to-edge bite edge bite

Correction of over-jet to edge-to-edgeCorrection of over-jet to edge-to-edge Correction of crowdingCorrection of crowding

Over-corrections of rotations of Over-corrections of rotations of anteriorsanteriors


Closure of anterior spacesClosure of anterior spaces

Corrections of cross-bitesCorrections of cross-bites

Beginning of correction of pre-molar Beginning of correction of pre-molar rotationsrotations

Over-corrections of disto-occlusion (mesio-Over-corrections of disto-occlusion (mesio-distal molar relations )distal molar relations )


Partial corrections of mid-line Partial corrections of mid-line discrepanciesdiscrepancies

Correction of axial inclinations of Md Correction of axial inclinations of Md incisors incisors

Beginning correction of open - biteBeginning correction of open - bite


MECHANICS OF TOOTH MOVEMENTMECHANICS OF TOOTH MOVEMENTSTAGE ISTAGE I

1.INTRUSION1.INTRUSION In conventional Begg BITE-OPENING In conventional Begg BITE-OPENING

occurred mainly due to molar extrusion occurred mainly due to molar extrusion (Major weakness of conventional Begg)(Major weakness of conventional Begg)

Little is attributed to lower incisor Little is attributed to lower incisor intrusionintrusion

In Begg treatment all the 6-anteriors In Begg treatment all the 6-anteriors are intruded together (a unique are intruded together (a unique feature)feature)


Bite-opening force is derived from Bite-opening force is derived from the ANCHOR BENDthe ANCHOR BEND

A moment generated by the anchor A moment generated by the anchor bend in the molar tube , is bend in the molar tube , is automatically balanced by the automatically balanced by the generation of an intrusive force on generation of an intrusive force on the anteriors , and an extrusive force the anteriors , and an extrusive force on the molars in order to establish on the molars in order to establish equilibriumequilibrium


Moments and counter-moments

generated


Depending on the direction of Depending on the direction of intrusive force –The tooth under-goes intrusive force –The tooth under-goes varying degree of intrusion as well as varying degree of intrusion as well as labial crown-lingual root tipping labial crown-lingual root tipping (rotation-(rotation-UNDESIRABLE)UNDESIRABLE)

This is resisted in case of Mx-incisors This is resisted in case of Mx-incisors by CLASS II elastics in stage I.by CLASS II elastics in stage I.


Class II elastics, not only have a Class II elastics, not only have a HORIZONTAL FORCE component but also HORIZONTAL FORCE component but also have a VERTICAL FORCE COMPONENT have a VERTICAL FORCE COMPONENT

The vertical force component, reduces The vertical force component, reduces the magnitude of intrusive force of the the magnitude of intrusive force of the archwirearchwire

The horizontal force component , affects The horizontal force component , affects the net resultant direction of force the net resultant direction of force


CONSIDERATION OF MAGNITUDE CONSIDERATION OF MAGNITUDE OF INTRUSIVE FORCEOF INTRUSIVE FORCE

Optimum force required for intrusion of Optimum force required for intrusion of is appox. 15-30 grms/ incisor(slightly is appox. 15-30 grms/ incisor(slightly higher values for canines)higher values for canines)

Anchor bend exert force of appox. ;Anchor bend exert force of appox. ; 1. 1.5 oz in Mx (intrusive) – at mid-line1. 1.5 oz in Mx (intrusive) – at mid-line 2. 1.2 oz in Md (intrusive) – at mid-line2. 1.2 oz in Md (intrusive) – at mid-line

Class II elastics – 1 oz (extrusive)Class II elastics – 1 oz (extrusive)www.indiandentalacademy.comwww.indiandentalacademy.com

Thus , the net intrusive force in the Thus , the net intrusive force in the Mx incisors is – 0.5 oz (at mid-line) or Mx incisors is – 0.5 oz (at mid-line) or appox. 14.16 gms for three teeth i.e appox. 14.16 gms for three teeth i.e nearly 5 grms of force /tooth , which nearly 5 grms of force /tooth , which is far below the optimal force is far below the optimal force suggestedsuggested

For active intrusion the Mx incisors For active intrusion the Mx incisors should receive appox. 60-70 grms of should receive appox. 60-70 grms of net force in the mid-line after net force in the mid-line after negating the extrusive component of negating the extrusive component of the class II elastics the class II elastics


PROBLEMS ENCOUNTERED PROBLEMS ENCOUNTERED DURING STAGE IDURING STAGE I

BITE NOT OPENING BITE NOT OPENING 1.Patient not wearing elastics 1.Patient not wearing elastics a).a).RemedyRemedy-Educate the patient -Educate the patient

and and parentsparents

2.Biting of the bite-opening bends2.Biting of the bite-opening bends a).Remedya).Remedy-Remove arch wires and -Remove arch wires and restore bite-opening bendsrestore bite-opening bends


b). Check positions of the anchor b). Check positions of the anchor bends (if too far mesial ,move them bends (if too far mesial ,move them closer)closer)

c). Check the level of Md molars (lower c). Check the level of Md molars (lower , if necessary), if necessary)

d). Check eating habitsd). Check eating habits


3.Failure to place proper bite –opening 3.Failure to place proper bite –opening bends bends

RemedyRemedy –Place proper amount of bite- –Place proper amount of bite-opening bends in the arch wiresopening bends in the arch wires

4.Anchor molars out of occlusion (most 4.Anchor molars out of occlusion (most common in perm. 1common in perm. 1stst molar extractions) molar extractions)

a).Remedya).Remedy- Placement of vertical elastics - Placement of vertical elastics from molar to molarfrom molar to molar

b).Place a horizontal elasticb).Place a horizontal elastic


EXCEPTION TO THE RULEEXCEPTION TO THE RULE


5.Loose molar bands 5.Loose molar bands RemedyRemedy- re-cement the- re-cement the bandband

6.Improper angulation of the buccal 6.Improper angulation of the buccal tube or the entire molar bandtube or the entire molar band

RemedyRemedy-Tube should be parallel to -Tube should be parallel to the occlusal and the buccal surfacesthe occlusal and the buccal surfaces


MOLAR WIDTH NARROWING MOLAR WIDTH NARROWING (USUALLY MANDIBULAR )(USUALLY MANDIBULAR )

1.Vertical component of class II 1.Vertical component of class II elastic forceelastic force

RemedyRemedy-Form Md arch wider in the -Form Md arch wider in the posterior segmentposterior segment

b).Add wide auxilliary arch wireb).Add wide auxilliary arch wire

2.Prolonged wearing of posterior 2.Prolonged wearing of posterior cross -elastics cross -elastics


3.3.Disto-lingually rotated caninesDisto-lingually rotated canines RemedyRemedy- Donot engage the arch wire - Donot engage the arch wire

in the cuspid brackets until these in the cuspid brackets until these teeth have been ratated by elastic teeth have been ratated by elastic thread or other means thread or other means

4.Bicuspid rotational elastic tie on the 4.Bicuspid rotational elastic tie on the

lingual from the bicuspid to the molarlingual from the bicuspid to the molar RemedyRemedy – Extend the main arch wire – Extend the main arch wire

to the buccal surface of the 2to the buccal surface of the 2ndnd molar molar


b).Place toe-out on the distal-end b).Place toe-out on the distal-end c).Re-tie elastic thread from the bicuspid to c).Re-tie elastic thread from the bicuspid to

the arch wirethe arch wired)Alld)All

5.Rolling of the distal ends of the arch wire , 5.Rolling of the distal ends of the arch wire , causing the anchor bend to turn into a causing the anchor bend to turn into a rotational force on the molarrotational force on the molar

RemedyRemedy- Place toe-in or toe-out at the - Place toe-in or toe-out at the anchor bendanchor bend


ADVERSE TIPPING OF THE ANCHOR ADVERSE TIPPING OF THE ANCHOR MOLARSMOLARS

1.No anchor bends (if tipped mesially) 1.No anchor bends (if tipped mesially) RemedyRemedy- Remove archwire and place - Remove archwire and place proper anchor bendsproper anchor bends

2.Too much anchor bends (if tipped 2.Too much anchor bends (if tipped distally)distally) RemedyRemedy-Remove the-Remove the arch wire and arch wire and reduce the amountreduce the amount of anchor bendsof anchor bends


3.Proper anchor bends , but placed for 3.Proper anchor bends , but placed for a long time (anchor molar tips a long time (anchor molar tips distally)distally)

REMEDYREMEDY-Having recognized the -Having recognized the problem, cont. problem, cont. OROR if severe than if severe than band the 2band the 2ndnd molar and it acts as the molar and it acts as the anchor molar now and place an anchor molar now and place an ordinary bracket on the 1ordinary bracket on the 1stst molar molar


4.Loose molar bands (mesial tip)4.Loose molar bands (mesial tip)

5.Improper placement of the tube 5.Improper placement of the tube or/and the band (may tip mesially or or/and the band (may tip mesially or distally)distally)

6.Excessive elastic force (molar tip 6.Excessive elastic force (molar tip mesially)mesially)


7.Improper placement of elastics .7.Improper placement of elastics . (If not placed in the ball-end hook and (If not placed in the ball-end hook and

placed elsewhere, elastic will not slip placed elsewhere, elastic will not slip as the tooth moves and the force is as the tooth moves and the force is not applied in the centre of not applied in the centre of resistance and hence the tooth would resistance and hence the tooth would tip (mesially)tip (mesially)

REMEDYREMEDY- Instruct the patient in - Instruct the patient in proper placement of elasticsproper placement of elastics


NO APPRECIABLE CHANGESNO APPRECIABLE CHANGES

1.Not wearing elastics1.Not wearing elastics REMEDYREMEDY-Educate the patient-Educate the patient

2.Arch wire(s) bend out of shape2.Arch wire(s) bend out of shape REMEDYREMEDY- Rebend the arch wires- Rebend the arch wires b).Check eating habitsb).Check eating habits


c).Check the level of the Md c).Check the level of the Md molar tube (lower them , if molar tube (lower them , if necessary)necessary)

d).Check the position of the d).Check the position of the

anchor bends (if far mesially , anchor bends (if far mesially , move them closer to the tube)move them closer to the tube)


3.Oral habits present that counteract 3.Oral habits present that counteract the forces of the appliancesthe forces of the appliances

REMEDYREMEDY- Identification of the habit- Identification of the habit

4.Patient seen too soon4.Patient seen too soon REMEDYREMEDY- Dismiss the patient for - Dismiss the patient for

atleast 6-weeks atleast 6-weeks


VERTICAL LOOPS BURIED IN VERTICAL LOOPS BURIED IN THE THE

GINGIVAGINGIVA

1.Original, looped arch wire left in the 1.Original, looped arch wire left in the mouth for too longmouth for too long

REMEDYREMEDY-Remove it and replace with -Remove it and replace with plain arch wire with bayonet bendsplain arch wire with bayonet bends


2.Misjudgement in placement of the 2.Misjudgement in placement of the vertical loops in the proper direction vertical loops in the proper direction

REMEDYREMEDY-If anterior teeth are still -If anterior teeth are still crowded and irregular , remove , crowded and irregular , remove , modify the direction of the loops and modify the direction of the loops and replace replace


ELASTICS WHICH BREAK OR ELASTICS WHICH BREAK OR DONOT STAYDONOT STAY

1.May be an excuse for not wearing elastics1.May be an excuse for not wearing elastics REMEDYREMEDY-Educate the patient -Educate the patient

2.Elastic will not stay on the inter-maxillary 2.Elastic will not stay on the inter-maxillary circlecircle

REMEDYREMEDY-Open the inter-maxillary circle -Open the inter-maxillary circle verticallyvertically

And distally engage into the ball-hookAnd distally engage into the ball-hook


LOCK PINS LOSTLOCK PINS LOST1.Occluso-incisal forces 1.Occluso-incisal forces REMEDYREMEDY-Use steel pins , if brass -Use steel pins , if brass

used earlierused earlier b).Check anchor bends to facilitate b).Check anchor bends to facilitate

opening of the biteopening of the bite

2.If missing at random ,throughout the 2.If missing at random ,throughout the mouth (patient must picking them )mouth (patient must picking them )

REMEDYREMEDY-Educate the patient-Educate the patient b).Use ligature instead of pinsb).Use ligature instead of pins


EXTREMELY MOBILE MOLARSEXTREMELY MOBILE MOLARS1.Clenching of the teeth1.Clenching of the teeth REMEDYREMEDY- Educate the patient or- Educate the patient or suggest to chew sugar free gum to suggest to chew sugar free gum to

break the habitbreak the habit

2.Intermittent wearing of the elastics2.Intermittent wearing of the elastics REMEDYREMEDY-Patient education-Patient education

3.Pathology3.Pathology REMEDYREMEDY-Treatment of the pathology-Treatment of the pathology


4.Excessive force applied to the molars4.Excessive force applied to the molars REMEDYREMEDY- Reduce arch wire size to - Reduce arch wire size to

0.016’’0.016’’ b).Reduce elastic force to 2 1/2 ozb).Reduce elastic force to 2 1/2 oz c).Reduce degree of anchor bendsc).Reduce degree of anchor bends

5.No apparent cause5.No apparent cause REMEDYREMEDY-Remove the arch wires and -Remove the arch wires and

elastics for 8-10 wks and obsreve ; elastics for 8-10 wks and obsreve ; the molars should tighten the molars should tighten


LOWER ANTERIOR TEETH LOWER ANTERIOR TEETH TIPPED LABIALLYTIPPED LABIALLY

1.May be an optical illusion with roots 1.May be an optical illusion with roots actually moving linguallyactually moving lingually

REMEDYREMEDY-Educate the patient -Educate the patient

2.Binding of the arch wire in the 2.Binding of the arch wire in the bicuspid brackets bicuspid brackets

REMEDYREMEDY-Use by-pass clamps-Use by-pass clamps b).Remove bicuspid band temporarilyb).Remove bicuspid band temporarily


3.Binding of the ends of the arch wire 3.Binding of the ends of the arch wire in the distal end of the buccal tube in the distal end of the buccal tube

REMEDYREMEDY-Remove the wires and -Remove the wires and correctcorrect

4.Poor diagnosis4.Poor diagnosis REMEDYREMEDY-Reconsider the necessity -Reconsider the necessity

for extractionfor extraction


ANTERIOR OPEN-BITE NOT ANTERIOR OPEN-BITE NOT CLOSINGCLOSING

1.Patient not wearing anterior vertical 1.Patient not wearing anterior vertical elasticselastics

REMEDYREMEDY- Patient education- Patient education

2.Persistent tongue-thrust or other 2.Persistent tongue-thrust or other adverse habitsadverse habits

REMEDYREMEDY- Educate the patient- Educate the patient b).Habit breaking applianceb).Habit breaking appliance


c).Place lingually directed spurs on c).Place lingually directed spurs on lower anteriorslower anteriors

3.Too much anchor bend 3.Too much anchor bend REMEDYREMEDY-Reduce the degree of -Reduce the degree of

the anchor bendsthe anchor bends


TOOTH NOT ROTATINGTOOTH NOT ROTATING

1.Not enough space1.Not enough space REMEDYREMEDY- Check diagnosis and the - Check diagnosis and the

arch wire designarch wire design

2.Not enough activation in the bracket 2.Not enough activation in the bracket area of the arch wirearea of the arch wire

REMEDYREMEDY- Remove the arch wire and - Remove the arch wire and activate the vertical loops activate the vertical loops


MID-LINE DISCREPANCYMID-LINE DISCREPANCY

1.Asymmetrical tipping of the anterior 1.Asymmetrical tipping of the anterior teethteeth

REMEDYREMEDY- Do nothing , but study the - Do nothing , but study the situation carefully and the ultimate situation carefully and the ultimate uprighting of the teeth in the 3uprighting of the teeth in the 3rdrd stage will correct the mid-linestage will correct the mid-line


CONCLUSIONCONCLUSION

The Begg technique is divided into The Begg technique is divided into various stages with the purpose of various stages with the purpose of anchorage preservation and every anchorage preservation and every stage has some specific objectives to stage has some specific objectives to attain.attain.

And for the success of the technique is And for the success of the technique is mandatory to follow and attain all the mandatory to follow and attain all the objectives in the specified stage , objectives in the specified stage , before entering into the next stage before entering into the next stage


Right buccal

Frontal

Left buccal


REFERENCESREFERENCES

1.Begg and Kesling –Orthodontic 1.Begg and Kesling –Orthodontic theory and technique -2theory and technique -2ndnd edition edition

2.Fletcher2.Fletcher3.Vade maecum of Begg technique-3.Vade maecum of Begg technique-

CadmanCadman4.Molleanheaur’s advanced manual4.Molleanheaur’s advanced manual5.Refined Begg by V.PJayade5.Refined Begg by V.PJayade



www.indiandentalacademy.comLeader in continuing dental education

Documents

Begg Technique ORTHO / orthodontic courses by Indian dental academy