begg stage -3 ortho / orthodontic courses by indian dental academy

www.indiandentalacademy.com

INDIAN DENTAL ACADEMYLeader in continuing dental education


BEGGS TECHNIQUE – 3rd STAGE

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 pronounced


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 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


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


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 arches----


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.



www.indiandentalacademy.comLeader in continuing dental education

begg stage -3 ortho / orthodontic courses by indian dental academy

Documents