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Mohammed Almuzian
1/1/2013
Contents
Table of Contents
Begg orthodontic mechanics.......................................................................................3
History.........................................................................................................................3
Begg philosophy..........................................................................................................3
Advantages..................................................................................................................4
Disadvantages..............................................................................................................5
Position of brackets.....................................................................................................6
Stages of treatment......................................................................................................6
STAGE I......................................................................................................................7
STAGE I Objectives.....................................................................................................7
Mechanics....................................................................................................................8
Stage II........................................................................................................................9
Stage II objectives.......................................................................................................9
Mohammed Almuzian, University of Glasgow, 2013 Page 1
Stage II mechanics.....................................................................................................10
Light elastics in Stage I but heavy elastics in Stage II. Why this difference?...........11
Stage III.....................................................................................................................11
Mechanics..................................................................................................................12
History
1. Begg was trained in Angle school in USA.
2. Angle philosophy was if you expand the arches, the bone growth + soft tissue
maturation will accommodate that, and you end up with the big broad American
smile.
3. Begg recalled Angles patients and found a high proportion of patients had quite
marked relapse
Begg philosophy
Occlusal/incisal wear
This wears the cuspal interlocks and thus allows the mandible to come forward and
adopt a natural "edge to edge" type of occlusion
Interproximal wear
2. Class II division I with increased overbite, full unit II molars, and crowding needing
4 x 4 extractions, is the most common
4. Compliant patient
Advantages
Begg & Kesling in1977
1. Permits all tooth movements to be carried out rapidly and over great distances
without re-activation
Light force
Disadvantages
1. Extraction bases technique
9. Backward rotation of the mandible resulted from molar extrusion and has a
detrimental effect upon the face, especially in open-bite groups.
2. Bracket has minimal mesio-distal width with single point contact on incisors,
canines, premolars allows tipping + rotation therefore less force required
3. Molar bracket which has a round buccal tube with hook with two point contact on
molars (due to wire in a tube) imparts bodily movement with little Arch wire is a
loose fit
6. Accessory springs and archwire modifications used at later stages for apical +
rotational tooth movements
Position of brackets
1. Canine bracket and incisor bracket: similar to LA point in straight wire pre-
adjusted edgewise system
2. Molar tube: upper molar as usual to SWT but in the lower molar, as far
gingivally as possible because in the early stages of treatment we will be employing
a lot of Class 2 intermaxillary elastics and it is an attempt to try and get a point of
delivery of the elastic as close to the centre of resistance of the molar.
Stages of treatment
The following describe the stages in treatment in the Begg appliance system.
STAGE I Objectives
A. Intra-arch tooth Alignment
1. Reliefe of crowding:
When you have crowding of the incisors, the way that crowding is relieved will be
by all the teeth tending to tip distally from the midline (they move around the arch
to align themselves) and thus providing space for alignment. The effect of the tip
back bends and continuation of class 2 elastics once the labial segment is aligned
will result in spacing appearing between the incisors. Therefore once you've got the
labial segment aligned you must tie the canine bracket to helical loop in the arch
wire hence the canine to canine distance is fixed.
B. Transverse correction
C. Vertical correction
D. AP correction
Mechanics
1. 0.016 heat treated high tensile steel wire: All of Stage I and most of Stage II is
done using this wire. Needed to be resilient because of the use of Class II elastics
The closer to the tube the more effective the leverage ie in Stage I 1mm in front
of tube, in Stage II its 2-3mm to allow molar to travel forward
4. Toe-in bends: Class II elastics will rotate L6 mesio-lingually therefore these bends
resist this action
5. Brass pins with heads hold the wire in place but not too tightly to allow tipping.
6. Class II elastics
Stage II
Stage II objectives
1. Maintain Stage I Objectives
Skeletal asymmetry
Arch wire binding results in asymmetrical loss of anchorage and centre line shift
3. Premolar alignment
4. Close Remaining Extraction Spaces: Close residual spaces may result in crashing
back of incisors into the classical “dished-in” profile, This is the classical stage II
dished–in face which people said “my goodness look at the profile’’. The important
benefit of this “dished-in” profile at the end of Stage 2, is that, it is preparing for the
anchorage loss which will inevitably occur during the Stage 3 of treatment which is
to produce the correct torque to the upper and labial segments.
Stage II mechanics
Use same 0.016 arch wire as in Stage I
Reduce anchor bend to reduce resistance to movement of molar but don`t flatten
AW totally otherwise you get dumping into extraction space
Move anchor bend forward 2-3mm in front of tube to allow molar to come forward
Heavy class 2 elastics the patient will have been wearing to maintain stage I results
Use brakes: During space closure, the labial segments go back and the buccal
segments come forward. With uprighting springs or torquing auxillaries you put a
“brake” or maintain the position of the labial segment and encourage mesial
movement of molars. These springs put a brake on the labial segment going back
and so all the space is closed from behind.
2. Anterior x elastics
3. Unilateral brake.
5. Coil springs
Light elastics in Stage I but heavy elastics in Stage II. Why this difference?
The heavy forces exceed the tipping force and you get occlusion of the blood
vessels leading to undermining resorption hence greater resistance to movement at
the incisors, but this force exceeds the anchorage resistance of the molar hence the
molar move forwards.
The resistance of the molar can also be reduced by reducing the tip-back bend.
Anterior brakes
Mechanics
1. Wire: the uprighting springs & torquing springs create heavy forces which may
distort base arch wire leading to loss of arch asymmetry replace 0.016 with 0.020
SS wire
“wagon wheel” effect ie convergence of root apices hence towards the end of Stage
III you will need uprighting springs in the incisors to throw the apices distally.
3. Arch wire is turned through 900 degrees distal to molar to maintain arch length
otherwise all the root torquing in the labial segments will open the extraction space
up and increase the OJ.