BEGGS TECHNIQUE – 3rd STAGE
INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com 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. www.indiandentalacademy.com
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
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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
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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 www.indiandentalacademy.com
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 www.indiandentalacademy.com
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
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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. www.indiandentalacademy.com
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 pronounced www.indiandentalacademy.com
Auxiliaries used in third stage Begg.
Auxiliaries can either be a)Torquing Auxiliaries b) Uprighting /Paralelling Auxiliaries www.indiandentalacademy.com
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 . www.indiandentalacademy.com
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 www.indiandentalacademy.com r is the radius of the wire
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 www.indiandentalacademy.com
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 www.indiandentalacademy.com denture
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-springsudder arches www.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 www.indiandentalacademy.com
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 www.indiandentalacademy.com
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. www.indiandentalacademy.com
Problems encountered during torquing. Undesirable changes in the arch form Mesial migration of posterior teeth
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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 www.indiandentalacademy.com
contd
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 www.indiandentalacademy.com
MINISPRINGS Made from .010’supreme wires can be usable on any bracket they can be used in conjunction with lock pins www.indiandentalacademy.com
Advantages are a) improved aesthetics b) improved hygiene c)these springs were kinder to the anchorage Disadvantages a)they fall out easily www.indiandentalacademy.com
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 www.indiandentalacademy.com
. 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 www.indiandentalacademy.com 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-BetaTitanium 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 www.indiandentalacademy.com
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 www.indiandentalacademy.com
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. www.indiandentalacademy.com
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 www.indiandentalacademy.com
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 www.indiandentalacademy.com
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. www.indiandentalacademy.com
www.indiandentalacademy.com Leader in continuing dental education
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