Third Stage

Begg Mechanotherapy

A Seminar by
Dr.Girish Gerard
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

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
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.