BEGG’S PHILOSOPHY

AND TECHNIQUE
 CONTENTS

• EVOLUTION OF BEGGS TECHNIQUE

• BEGGS PHILOSOPHY
• BEGGS TECHNIQUE
• COMPONENTS
• STAGE I
• STAGE II
• STAGE III
• CONCLUSION
• REFERENCES
DEVELOPMENT OF LIGHT
WIRE TECHNIQUE
• Dr. Percival Raymond Begg was born in 1898
in a small, gold mining town Coolgardie, west
Australia.
• Grew up in south Australia.
• In his early twenties he worked in a sheep and
cattle station in New south Australia, looking
after both cattle and sheep.
• As a boy he saw the sketch of Australia Aboriginal and noticed their
teeth were worn flat, no one thought to tell him why or how it
happened.
• He noticed many people with crooked teeth and saw many feeble
attempts at correction of these problems with many treatment
failures and few successes.
• As he wanted to help such people he enrolled in the dental course
at the University of Melbourne instead of taking the medical
course, as he originally intended.
• At the commencement of third year of training, Dr Begg decided to
practice orthodontics after graduating in dentistry.
• Dr Begg graduated in 1923 with B.D.Sc Degree.
• His introduction to Dr. Angle’s work led him to travel to Pasadena,
California in 1924 to study with Dr. Angle.
• Coincidentally with Begg’s arrival in California Dr. Angle was
developing the Edgewise arch mechanisms, which he felt was a vast
improvement over the Ribbon arch Appliance
• Angle instructed Dr. Begg and Fred Ishii of Japan in the use of the
Edgewise mechanism, before it was revealed to the profession.
Since Dr. Angle was ill, it was they who first treated patients with
Edge wise Appliance
• During Dr. Begg’s stay, Dr. Angle wrote and read for the first time,
his paper entitled. “ The latest and Best in orthodontic
Mechanism” ( published in Dent. Cosmos 1928 and 1929 ). It
disclosed the use of edge wise Mechanism.
• In November, 1925 Dr. Begg sailed back to Australia. In
December of the same year he began practicing Orthodonics in
Adelaide, south Australia.
• Begg was the only orthodontist in Adelaide in 1926 practiced
Edgewise non extraction, technique.
• He was appointed Lecturer in Orthodontics at the university of
Adelaide, a position he held until the university’s retirement age.
(Retirement in 1964).
• For two years, Dr. Begg faithfully followed Dr. Angle’s teaching of
retaining the full compliment of teeth.
• However in many of his patients he wasn’t satisfied with post
treatment profiles and there was the serious problem of relapses.
• In February of 1928 he began to routinely remove teeth or reduce
tooth widths by mesio - distal stripping in patients with excess
tooth substance.
• He learnt from experience and his ever – growing appreciation of
the role of attritional occlusion in the development of man’s
dentition..
• Initially he faced opposition from other dentists.
• He retreated many patients who had relapse due to retention of
excessive tooth material.
 C H A N G I N G THE
MECHANICS
• Dr. Begg began to realize the Edgewise mechanism was not
designed to rapidly close extraction space or quickly reduce
deep overbites.
• To facilitate such changes he began using 0.20’’ round platinized
gold, rather than rectangular, arch wire in 1929. In 1931 he started
using .018’’ round stainless steel wire, bending the now
popular vertical loops and intermaxillary hooks right into the
arch wires.
• He soon realized that round arch wire were engaged in
edgewise brackets.
• In 1933, about 3 years after switching from rectangular to
round arch wire material, he began treating some cases using
S.S. White ribbon arch brackets, to which he had been exposed
during his stay with Dr. Angle.
• He realized that these relatively narrow brackets with vertically
facing slots allowed the teeth to move under much lighter
forces.
• To improve rotation tooth control with the use of smaller round
wires in the Ribbon Arch Brackets, Dr. Begg filed their bases
before soldering them to the bands. This reduced the widths of
the arch wire slots.
 A NEW WIRE

• In the early 1940’s Dr. Begg met Arthur J.

Wilcock, director of metallurgical research
projects at the University of Melbourne.
• After many years of research Wilcock
produced a cold drawn heat treated wire
that combined the balance between
hardness and resilience with the unique
property of zero stress relaxation that Dr.
Begg was seeking.
• This unusual wire permitted to open
anterior over bites, while controlling arch
form and providing molar stability.
• He also produced the modified Ribbon arch brackets, lock pins
and special buccal tubes to meet Dr. Begg's ever-changing
requirements in these experimental years
• In 1952 Dr Begg began to use 0.016’’ round S.S wires instead of
0.018’’ permitting to open anterior overbites quickly.
• In 1954 he published paper entitled, “Stone Age Man’s dentition”
• At the end of his article he disclosed a new technique which he
referred to as the “round wire technique”, advocating at that time
the use of 0.018” diameter stainless steel arch wires in modified
Ribbon Arch brackets.
• The technique describe in this 1954 article was much different
from what it is today.
• Even so, it drew relatively large response including correspondence
from three prominent orthodontist who expressed an interest in
the treatment method disclosed his found from the Angle school,
Dr. Spencer Atkinson; Dr. Robert Strang and Dr. Charles Tweed.
• In 1956 Dr. Begg had another article published entitled, Differential
Force in orthodontic Treatment.
 INTRODUCTION OF BEGG TECHNIQUE IN
THE UNITED STATES
• In 1957 Dr. H.D. Kesling and Dr. George Dissham
came from the United states.
• Upon Kesling’s return from Adelaide, he had
plans to implement his new technique in his
practice along with Dr. R. A. Rocke not just to
selected patients, but every patient.
• In 1959 the Kesling and Rocke Orthodontic
group invited over 150 orthodontist from
across the united states, to assess the results
of their 100 consecutively – treated cases by
Begg technique.
• Dr. H.D. Kesling, first orthodontist in the United
States to practice the Begg Technique, and the
one most responsible for popularizing its use
through showings and courses
• While the results were not of the quality of the results achieved
today, they demonstrated the ability of the Begg technique to
quickly open deep anterior bites. Treatment time was relatively
short, and the number of adjustments were few. As a result there
arose a demand for training in this new technique.
• First course in Begg Technique had 31 students, was held in the
new orthodontic center in Westville, Indiana in June 1959 (1week
course). The brackets used were the new Double-Tab type.
• However, the use of the double tab bracket proved difficult, as arch
wires were unnecessarily complicated to permit desired tooth
movement.
• Also, it lacked the ability to overcorrect the teeth which is so
necessary to reduce the tendency for relapse.
• Dr Begg realized that, he had to finish his cases with more
precision.
• Dr. Begg was mainly concerned with repositioning the teeth in
stable positions over basal bone. The final settling of teeth he left
to the forces of occlusion, guided when necessary by an upper
retainer with circumferential wire.
• Also he realized the growing demand for training in his new
technique required that the treatment be organized in some
manner to facilitate both teaching and learning.
• The result was that in April of 1960, as Dr. Begg began unpacking
his models (which he had brought as part of his presentation
before the American Association of Orthodontist), members of the
Kesling and Rocke group were stunned by his quality of treatment .
Hours after seeing the quality of results achieved by Dr. Begg with
modified Ribbon Arch brackets, Dr. Kesling made the decision to
scrap his double- tab brackets.
In the years between Dr. Kesling’s first visit in 1957 and his trip to the
United states in the spring of 1960, Dr. Begg did the following:

1.Finished his cases with such detail and precision that they could
not be discerned from similar cases treated with Edgewise
mechanism.
2. Separated the technique into three distinct stages and
established objectives for each stage.
3.Developed root torquing auxiliaries separate from the main arch
wire.
4.Introduced mesiodistal uprighting spring.
5. Emphasized the importance of free tipping of tooth crowns in
the early stages of treatment.
6. Suggested taking stage models to discipline the orthodontist.
BEGG’S PHILOSOPHY
 Attritional Occlusion
• In 1939 Dr. Begg wrote his doctoral thesis “ The Evolutionary
Reduction and degenaration of Man’s Jaws and teeth’’.
• In 1954 Dr. Begg published paper entitled, “Stone Age Man’s
dentition”
• Dr. Begg noticed that the teeth of Aborigines. They had:

1. Not only had extensive occlusal and interproximal wear

2. Total lack of :
I. Caries
II. periodontal disease
III. tooth crowding.
• Hard, coarse and gritty food quickly
causes incisal and occlusal wear.
• Initially the incisal wear is oblique.
• The lower incisors tip labially, while the
upper incisors become more upright
until they assume an edge to edge
relationship.
• This restraint the natural tendency for the lower incisor to
become more procumbent, also encourages further crowding of
these teeth.
• Persistence of anterior overbite also locks the maxillary incisors in
an anatomically and functionally abnormal labial location.
• Attrition causes continual changes in the shapes and sizes of the
teeth.
• Mesial migration and vertical eruption in the presence of attrition
result in their moving occlusomesially in the jaws
• This eruption is often clinically misinterpreted as gingival recession,
when in fact it is the teeth that are erupting, and the gingival
margin that is remaining relatively stationary.
 GINGIVAL RECESSION AND VERTICAL
ERUPTION
• The physiologic process of continual tooth eruption has
evolved to compensate for occlusal attrition. It persists in
modern man, even in the absence of attrition.
• As a result of this, there is often continual increase in the vertical
dimension between maxilla and mandible. Consequently
civilized man’s face grows ‘longer’ with age.
• In primitive man the excessive occlusal forces of mastication
retard this eruption to a rate harmonious with the progression of
attritional wear.
 Lack Of Caries
• Pits and fissures are quickly reduced by occlusal wear, thereby
eliminating the focus of most caries.
• The diet itself is of low in carbohydrates and its coarseness plus
high volume prevents the accumulation of dental plaque, without
which there can be no dental decay.
Proximal Wear
• Gingival embrassure areas (black triangles) in civilized man
become larger with age, due to lack of proximal wear.
 Incidence Of Crowding
Eruption of first permanent molars

The edge to edge anterior tooth

relationship

Lower teeth being further forward in relation to the upper teeth

The mandibular second deciduous molars are mesial to the

maxillary deciduous second molars.

The lower first permanent molar is then able to erupt in a more

mesial position and proper initial relationship with the maxillary
first permanent molar is achieved.
 Eruption of succedaneous teeth

• Attrition brings about enough reduction in mesiodistal

dimensions of teeth to allow adequate space for the erupting
permanent canines.
• In the absence of attrition there is often not enough space for the
canine
 Eruption of third molars

• In civilized man as no proximal wear occurs causes inadequate

room distal to the second molars for normal eruption of third
molars which leads to delayed eruption and complete
impaction.

• Since attrition especially interproximallly causes a continoual

reduction in mesiodistal tooth widths, the incidence of tooth
crowding is relatively low in primitive man.
 Change in curve of Wilson

• As the permanent molars erupt the

bucco– lingual plane is oblique. As
wear progress, the plane becomes
horizontal, then begins to slant
downwards and cusp of carabelli
serves to increase overall occlusal
surface area.
• In civilized man the buccolingual plane
is oblique throughout life.
 Secondary dentine and pulpal pain
• Value of pulpal pain is not to warn of caries, but to warn of atttrition
approaching the pulp faster than secondary dentin can be laid
down.

• Teeth continually erupt vertically, migrate mesially, and usually are

collectively too large to be accommodated in the jaws without a
reduction of tooth mass.
• This reduction, which occurs naturally in primitive man from
attrition, can be replaced in civilized man by planned mesiodistal
stripping and / or tooth extractions.
 Differential Force
• In 1956 Dr. Begg introduced the concept of differential force
• His observations was based on the work of storey and smith and
their experiments on tooth movement response to different
pressure applications.
• It is d efi n e d as a fo rc e that results i n a diff erent rate o r
tooth m o v e m e n t at o n e e n d than the other.
• A range of light pressures which would cause teeth to move at an
optimum rate and with minimal disturbance of the supportive
tissues.

Optimum Orthodontic Force.

• Pressures below slow rate of response
• Pressure above undermining resorption

retarding tooth movement.

 WHEN LIGHT FORCES ARE USED

ANTERIORS TIP

ANCHOR UNIT STABLE

 WHEN HEAVY FORCES ARE USED

ANTERIORS STABLE

ANCHOR UNIT MOVE

• The significance of this concept is enhanced by the ability to
choose mechanics that promote free tipping where the greatest
movement is desired and prevent free tipping where stability or
anchorage is indicated.
• A goal of Begg’s treatment is over correction of the teeth to allow for
the natural tendency for relapse that occurs when orthodontic
appliance removed.
• The differential force technique is designed to permit teeth to move
towards their anatomically correct positions in the jaw under the
influence of very light forces – as would occur naturally in the
presence of attrition.
• The light intra oral forces of Begg Technique do not place undue
strain on the anchor molars.
• The appliance is designed to permit the teeth to move
independently of one another – whether tipping freely in the
early stages or during detailed root positioning in the final stage.
• The movement of all teeth is due to the synergistic effect of the
forces and appliances working together in the presence of proper
diagnosis.
• The Begg synergistic arch graphically demonstrates and
emphasizes the importance of the combination of various
components comprising the Begg theory and technique.
 Seven synergistic components

1. A diagnosis and treatment plan that recognizes the persistence of

hereditary forces of mesial migration and vertical eruption of teeth
and has its objectives the over correction of malrelationships of
both teeth and jaws.
2. The simultaneous movement of all teeth. From the beginning of
treatment each tooth is directed towards its final position in the
dental arch.
3. The total separation of root moving forces from arch wire forces
during the final third stage of treatment.
4. The application of proper elastic forces to create the desired
differential movement of the teeth.
5. The use of light round continuous arch wires bent from the
hardest wire possible – Not only must the wire be of highest
quality, but the arch wire have proper form, including bite
opening bends, to control the vertical dimension.
6. The use of molar attachments that prevent free mesiodistal
tipping and yet permit the arch wire to slide freely mesio
distally. This permits the rapid retraction of the anterior teeth.
7. The use of attachments on all teeth, except anchor molars, that
control rotations yet permit free tipping in the desired direction
and free sliding along arch wires.
 A diagnosis and treatment plan that recognizes the
persistence of hereditary forces of mesial migration and
vertical eruption of teeth and has its objectives of over
correction of malrelationships of both teeth and jaws

The simultaneous movement of all teeth. From The total separation of root moving forces
the beginning of treatment each tooth is directed from arch wire forces during the final third
towards its final position in the dental arch. stage of treatment.

The use of light

The application of proper round continuous
elastic forces to create the arch wires bent from
desired differential the hardest wire
movement of the teeth. possible – Not only
must the wire be of
highest quality, but the
arch wire have
proper form,
including bite
opening bends, to
control the vertical
dimension.

The use of molar attachments that

prevent free mesiodistal tipping
“ SYNERGISTIC ARCH ”
and yet permit the arch wire to slide
41653
2 T he use of attachments on all
teeth, except anchor molars, that
control rotations yet permit free
freely mesio distally. This permits the tipping in the desired direction and
rapid retraction of the anterior teeth. free sliding along arch wires.

61734752
BEGG’S TECHNIQUE
• An orthodontic technique may be defined as a systematic
sequence of definite procedures to achieve the correction of
malocclusion with a specific type of appliance or with a
combination of appliances.
• The method consist essentially of tipping movements of the
teeth. Two successive tipping movements are required to achieve
bodily movement. The first to position the tooth crowns and
second to position the tooth roots. As a result of these tipping
movements, complemented by intrusion, extrusion and rotation of
teeth whenever required, optimal occlusion, axial positioning and
alignment of the teeth are secured.
 COMPONENTS OF BEGG APPLIANCE

 ARCH WIRE MATERIAL

 Round austenitic stainless steel

wire of 0.016 inch diameter
 heat treated and cold drawn down
to its proper diameter, in order to
give it the required properties of
resiliency, toughness and tensile
strength.
 produce force for a longer
duration without frequent
reactivation, over long distance.
 Six Types Of Australian Wire
1. Regular grade:
• Lowest grade – easy to bend
• Used for practice bending and forming auxiliaries.
2. Regular plus:
• Easy to form, more resilient than regular grade
• Used for auxiliaries and arch wires when more pressure and
resistance to deformation as desired.
3. Special grade:
• Highly resilient yet can be formed into shape.
4. Special plus grade:
• Hardness and resiliency of 0.016” wire, is excellent for
supporting anchorage, and reducing deep overbites.
• Must be bent with care.
5. Extra special plus grade :
• Also called premium plus
• This grade is unequalled in resiliency and hardness.
• More difficult to bend and more subjected to Fracture.
6. SUPREMEGRADE
• It is ultra light tensile fine round stainless steel wire.
• It was initially introduce in 0.010” diameter and then further
reduced to 0.009 diameter.
• It is primarily used in the early treatment for rotation.
Alignment and leveling.
• It is intended for use in either short section or full arches
where sharp bends are not required.

PRECAUTION TAKEN WHILE BENDING THE WIRE

• When the wire is bent around the round beak of the pliers, the
stress on the crystalline structure is confined to a small area, which
may cause the wire to break
• When bending the wire around the square beak the points of
stress are offset, providing more area for crystalline adjustment and
there fore less chance fracture.
 Requirements For A Light Wire Brackets

• Ease of arch wire engagement

• A means to guide both the tail and head of lock pin during
locking
• Positive retention of arch wire in all 3 stages
• Free tipping and sliding on arch wire
• Ability to effect and hold rotation
• Ability to prevent accidental tipping in stage III.
 Types Of Brackets
1. Bondable
2. Weldable

3. Full flange
4. Half flange
• Full flange brackets will have more friction with arch wire and
hence hindrance to smooth tipping movement of anteriors.
• In half flange brackets, contact of the flange with arch wire is
minimal , thus friction is also minimal.
• The high flange brackets are preferred over the taper flange
 Band Material
• These bands made of stainless steel strips of different size and
thickness are recommended for different teeth. These available on
8 feet rolls or cut of 2 inches to 2.5 inches.

1. For incisors - 0.125 x 0.003 inch

2. For canines/premolars – 0.150 x 0.004 inch
3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch
 Lock Pins
• Second stage safety lock pin: Shoulder on head
ensures free mesiodistal tipping. Labiolingual width of
tail dimension is reduced to fit properly into bracket in
conjunction with inch arch wire.
• One point safety lock pin : Used in stage I and II. The
pin has a shoulder that keeps the head of the pin
outside the bracket slot and prevents the impingement
of pin on arch wire. The beveled undersurface of head
permits free mesiodistal tipping.
• Hook lock pins : Used during III stage. Since there is
no safety shoulder, they hold the arch wire firmly
against the base of the arch wire slot. Thickness –
0.014” to 0.018” , length – 0.220 to 0.293
• High hat safety lock pins: They have a gingival
extension on head which provides a positive point for
engagement of vertical or cross elastics.
 Buccal Tubes
• Round molar tubes with 0.036 internal
diameter and 0.250 length are routinely used.
• Flat oval molar tubes and doubled back
wires are used when second permanent
molars are the anchor teeth and also used in
mandibular dental arch when second
premolar is absent.
Auxiliary Attachments
• In addition to the foregoing parts, the light
round arch wire technique requires the
following adjustments:
LINGUAL BUTTONS AND CLEAT
 Eyelets :
• Are made from thin stainless steel stiff wires. They are very useful
in tying the ligature wire on anterior teeth for purpose of rotation.

Ball End Hooks:

• They are attached to buccal or lingual of molar bands. Positioned
as far gingivally and near the mesiodistal centre of the tooth.
Make the placing of elastic simple for patient.
 Bypass Clamp
• Pinning of the arch wire in the
premolar brackets can cause
hinderence to free tipping.
• So in stage I and stage II Bypass
clamps are used on the premolar
brackets.

Ligature Wires
• These are very thin (0.007 to 0.009) stainless steel soft wires.
• They are very useful in tying of the span of looped arch wire,
which are far away from its ideal position, thus progressive
increase In force and also avoiding plastic deformation of the arch
wire.
• Also used as extra holding devices - secure about arch wire not
getting disengaged from the bracket slot by slipping out
 Elastics
• Elastics are made of synthetic latex and of uniform sizes and
applying uniform forces when stretched to required length.
• Thinner walled elastics are called “light elastics” and thick walled
elastics are called “Heavy elastics”
• These elastics will exert a force equal to between 60 and 70 gms
when they are new and first placed.

Uses Of Elastics
• To open the bite CLASS I ELASTICS

• To correct the mesiodistal relationship

of buccal segments
• To close the anterior spacing ELASTICS

• Corection of rotation
• Posterior crossbite corection
E L ACSLTAI CSSS III
Separating Spring
 Bracket Placement:
Brackets are centered mesio distally on the labial or buccal surface
with the base of the arch wire slot 4mm from the incisal edge or cusp
tips. Only exception is maxillary lateral incisor where 3.5mm from the
incisal edge is placed.

Placement In Rotated Tooth

 Buccal Tube
Molar tubes should be parallel to the occlusal surface when viewed
from buccal and parallel with a line bisecting the occlusal surface
mesiodistally.
 Three Stages Of Treatment
• Begg’s technique is divided into 3 separate and distinct stages
that must not be allowed to overlap.
• It is chiefly with the objective of preventing anchorage failure that
the technique is divided into 3 distinct stages of tooth movement:

1. STAGE I
2. STAGE II
3. STAGE III
STAGE
I
 STAGE I – OBJECTIVES

• Correction of Deep Anterior Over Bite

• Correction of Anterio-posterior Occlusal Relationship of the Buccal
Segments
• Correction of anterior spacing
• Correction Of Crowding
• Correction Of Rotations.
• Correction of posterior cross bite
 Archwire
• 0.016 special AJW – principal wire of Stage I
• Combination of resiliency and flexibility.
• Adequate stiffness for bite opening

The First Stage Archwire Incorporates:

• Intermaxillary hooks
• Molar anchorage bends
• Toe-in or toe-out bends
• Vertical loops
• Bayonet bends
 Intermaxillary Hooks – ( IMH )
•Small loops for engaging elastics
and cuspid ties.
• 2 types –
• Z shaped
• Circle/ oval

• Adv of Circle hook.

• 2 – 2.5 outside diameter.
• Mesial & Distal rolling possible
• Less space requirement.
• Less distortion
• Greater stiffness in horizontal
and vertical plane.
 Location
• Well aligned ant. – 1-2 mm mesial to the cuspid bracket.
• Spaced ant. – Further mesially.
• Mildly crowded ant. – impinging on the bracket.

• Z shaped: are angulated buccaly away from the vertical, in order

to avoid any possibility if wedging of distal arm of loop.
• Cuspid Offset bend

• Horizontal offset bend mesial to the IMH.

• Proper positioning of the cuspid and the lateral incisor.

• Cuspid Curve:

• Labial curvature in cuspid area – incorporated to avoid

lingual tipping of canines.
• In narrow arches requiring expansion, cuspid offset given.
 Anchorage bends / Tip back bends.

• Placed immediately posterior to the 2nd premolar bracket

• Bent so that when inserted into the buccal tubes the
anterior section of the archwire lies in the buccal sulci

• Amount of bend varies from case to case

• The average force incorporated on the incisors should be
around 65mg
• The purpose of anchor bend in upper arch is to prevent mesial
migration of the molars.
• In lower is to supply bodily control of the lower molars as these
are moved forward by action of Class II elastics
• Angulation depends on
• Stage of treatment - decreases as stage progresses.
• Depth of overbite- decreases with bite opening.
• Rate of progress of case.
 Vertical Loops
• Used to supply local increased arch flexibility or used for space
opening or closing, stops, rotation.
• The most vertical loops to align six anterior teeth are five, one in
each interproximal area.
Lingually locked out teeth and vertically displaced teeth

• It may be difficult to engage the wire in the brackets at times if the

space between proximating teeth is less than the length of the
bracket area for a blocked out tooth.
• Ligate the arch wire to the bracket of blocked out tooth
Contraction Loop in midline
with incisor stops to tip
crowns of upper centrals

Vertical loops bent in

case of high frenum
att achment
 Toe in and toe out bends
• Horizontal offset bends combined with anchor bends
• To provide anti-rotational control
• Anchorage bend bent lingually – toe in.
• Anchorage bend bent buccally – toe out.
 Pinning and ligation of arch wires
• In the Stage I of treatment of ClassII all the teeth are pinned
except:
1. The second premolars
2. Teeth initially so far displaced
3. Upper laterals which are lingual to centrals
4. Rotated Buccal teeth.

• Free ends of the lock pins are turned mesially around the brackets
• The wire should extend 2-3mm past the buccal tubes to prevent
 Tying intermaxillary hook to cuspid bracket

No ties between intermaxillary hooks and cuspid brackets

cuspid tip distally the arch wire

Spacing

• Ligation done in figure of eight and always pass ligature through

circle
 How To Achieve The Objectives?
1. Open the anterior over bite
• Proper amount of anchor bends at proper locations.
• Continual wearing of class II or Class III elastics.
2. Correction of the mesiodistal relationship of the buccal
segments.
• Continual wearing of class II or class III elastics as
required.
• Proper anchorage bends in both upper and lower arch
wires.
3. Close any anterior space:
• Loops
• Plain arch wire with elastic from cuspid pin tail to cuspid pin tail.
4. Eliminate any anterior crowding:
• Vertical loops between crowded anterior teeth, with bracket
modified for desired overcorrections.
• Arch length designed so that intermaxillary circles rest against
mesial surfaces of cuspid brackets.

5. Over rotate all teeth that require rotating

• using elastic ligature or thread
• using spring auxiliary areas

• Rotations of cuspid and bicuspid

 Correction may be achieved by using either :-
1. elastic threads
2. rotating springs
Elastic threads
 Rotation springs

• Most efficient & versatile mean

• 0.014” & 0.016”

• Vertical leg inserted in bracket slot from gingival side, holding

activating arm perpendicular to labial surface.
• Rotation of molars
• Incorporation of toe-in or toe-out bends
• Elastic ligature ties
• Recurved arch wire for molar tilt
6. Correct posterior crossbites:
• Modify arch width of one or both arch wires
• wearing cross elastics
• Rapid maxillary overexpansion, followed by a period of stabilization
prior to the placement of complete appliances and the beginning
of stage I.
 Priorities In The Stage I
1. It is generally agree that reduction of overbite must precede
reduction of overjet.
2. While treating cases with anterior crowding, alignment of teeth
becomes an important consideration.
3. when the upper incisors are very much proclined they should
be subjected to a light intrusive force and a normal retractive
class II elastic force till their proclination reduces.

Problems Arising In Stage I

• Failure to correct the deep-bite
• Insufficient retraction of the anteriors
• Mandibular molars tipping lingually
• Rotation of the lower molars
• Anterior spaces opening
• Rotation/tipping of upper molar
• Extremely mobile molars
 Problems Arising In Stage I
1. Bite not opening:
a) Patient not wearing elastics:
• educate the patient
• do not give enough elastics
• make it impossible to hook elastics and see if problem is
reported
b) Patient biting out bite opening bends.
• Remove the arch wire : restore bite opening bends
c) Check the level of mandibular molar tubes, lower them, if
necessary.
d) Check position of anchor bends, if too far mesially, move them
closer to molar tube.
e) Loose molar band
f) Improper angulations of buccal tube or entire molar bend.
2. Molar width narrowing
a) Vertical component of class II elastic force
• Form mandibular arch wire wider in posterior segment
b) Prolonged wearing of posterior cross elastics to widen opposing
molars
• Discontinue cross elastics and correct cross bite by others
means.
c) Disto – lingually rotated cuspids
• Do not engage the arch wire in the cuspid brackets until these
teeth have been rotated by elastic thread or other means.

3. Adverse tipping of anchor molars

a) If tipped mesially : there is no anchor bends. If tipped distally too
much anchor bends.
b) Improper placement of molar band or tube
c) Excessive elastic force
d) Oversize arch wire – molar tipped distally
4. N o appreciable c h a n g e
a) Patient not wearing elastics
b) Arch wire bend out of shape
c) Patient seen too soon

5. Verti cal loops buried in the gingiva

a) Original, looped arch wire left in the mouth too long

b) Misjudgment in the proper direction of vertical loops when the arch

wire was placed
6. Elasti cs which break or d o not stay on:
a) May just be an excuse for not wearing elastics
b) Elastic will not stay on the intermaxillary circle.
7. Lock pins lost:
a) Occluso incisal force
b) Use steel pin
c) Check anchor bends to facilitate opening the bite

8. Extremely mobile molars:

a) clenching of the teeth
b) intermittent wearing of elastics
c) pathology
d) excessive force applied to molar
• Reduce arch wire size to 0.016 inch
• Reduce elastic force to 2 ½ ounces
• Reduce degree of anchor bends
9. Lower anterior teeth tipping labially:
a) May be an optical illusion with roots actually moving lingually.
b) Binding of the arch wire in bicuspid brackets
c) Binding of ends of the arch wire inside distal ends of buccal tube

10. Anterior open bite not closing

a) Patient not wearing anterior vertical elastics

b) Persistent tongue thrust or other adverse habits

c) Too much anchor bend.

STAGE II
 O BJECTIV ES:

1. Maintain all corrections achieved during first stage.

2. Close any remaining posterior space.
ARCH WIRE ( 0.018 OR 0.022 SS)
• To maintain the corrections already achieved.
• To stabilize the teeth against any adverse reciprocal forces may
occur as a result of the application of elastics or auxiliaries.

LOCK PIN:
• “Stage 2” safety lock pins.
HOW TO ACHIEVE THE
OBJECTIVES?
 Closing Of Any Remaining Posterior Space
• Proper application of elastics
• Sometimes in stage 2 mesialisation of the anchor tooth is desirable.

• Achived by:

1. Strength of horizontal elastics is increased from 21/2 ounces

to 6 or 8 ounces
2. Certain auxiliaries
 Auxiliaries Used In Stage II
• To establish anchorage in the anterior segment.
1. Passive uprighting springs on mandibular canine.
2. The lower anterior braking arches
 FUNCTION OF THESE AUXILIARIES:

Establish two point contact between the teeth and archwire

prevent free tipping

Starts to function as anchor teeth

 Correction Of Midline

• Class II intermaxillary elastics on one side and class III on other

side.
 Problem Encountered During
Second Stage
• Anterior bite closing:
a. Not enough anchor bend
b. Bite opening bends bitten out
c. Patient not wearing the class II elastics
d. Anchor molars out of occlusion
• Discontinue class II or class III elastics. Use horizontal
elastics to get molars in occlusion.

• Anterior teeth assuming class I I I relation

a. Excessive wearing of class II elastics
• Spaces Developing Between The Anterior teeth:
a. Failure to give cuspid tie
b. Intermaxillary circles formed too far apart.

• Anchor molars rotating distobuccally

a.Toe – out on arch wire
b.Too much force from horizontal elastics

• Posterior spaces not closing:

a. Patient not wearing elastics.
b.Arch wire not free to slide distally through buccal tube.
c. Arch wire pinned or caught in bicuspid bracket slot.
• Second bicuspids tipping mesially in first bicuspid
extraction case:
a. Slight, expected mesial movement of anchor molar
b. Abnormal loss of anchorage, if second bicuspids are
tipping excessively.
STAGE III
 STAGE 3 UPPER AND LOWER ARCH WIRE
• Made from 0.020 SS
 OBJECTIVES:
1. Maintain all corrections achieved during first and second
stages.
2. Achieve desired axial inclinations of all teeth.
 Desired Axial Inclinations Of All Teeth

• Changes in the mesiodistal inclinations of teeth are accomplished

by the use of individual root spring or mesiodistal uprighting
spring.

• Lingual or labial root torque is applied to anterior teeth through the

application of torquing auxiliaries.
 UPRIGHTING SPRING

ACTIVE ARM WITH HELIX

HOOK AT THE END

RETENTIVE ARM
• Made from 0.014 for canine and premolars,
0.012 for incisors.
• The helix and the active arm faces the tooth
surface and lie on the gingival aspect of the
arch wire
• The base arch wire is ligated and the ligature
tie beneath the archwire.
• Spring selected should be in the direction of
root movement required.
• The arm carrying the hook should be at an
angle of 45 to the main arch wire before
latching and parallel when latched.
 Spring Pin
• A Combination of a Lock Pin and an Uprighting Spring
TEETH REQUIRING UPRIGHTING:
 Torquing Axillary

• To torque roots of the maxillary anterior root palatally

Originally spurs, were bent into the main maxillary arch wire
(0.016 inch )

The torque transmitted in a spiral manner along the main arch wire to
the anchor molars.

Moved the molars buccally and rotate them distobuccaly..

 Four Spur Torquing Auxiliary

• Used for torquing the upper anterior roots palatally

• Bend with 0.014 or 0.016” wire
Activating The Auxiliary
 OTHER TORQUING AUXILIARIES USED:

Two spur torquing auxiliary

• Used when lateral incisors do not require palatal root

Reciprocal torquing auxiliary

• Upper lateral incisors were blocked out palatally before
treatment.
• Their root apices must be torqued labially to reduce the
tendency for the crowns to relapse lingually.
Individual torquing auxiliary
• Auxiliary should extend at least one tooth pass tooth being
torqued, and around curve of arch, for maximum activation.
• If placed gingivally, torque the root of the lateral lingually.

One to one torquing auxiliary

• Indicated when two adjacent teeth require root torque in opposite
directions.
 RAT - TRAP TORQUEING AUXILIARY
• Main arch wire is formed from 0.020 inch round wire.
• The auxiliary is wound from either 0.014 or 0.016 inch highly
resilient round wire.
• The torquing “bars” do not extend to the gingiva.
 TORQUEING AUXILLARY FOR
LOWER INCISORS
Reverse torquing auxiliary
• Indicated if lower anterior teeth are
becoming too proclined.

• For lingual root torque

 PROBLEMS ENCOUNTERED DURING STAGE III
• Maxillary Molars Widening:
a) Anchor bends present in maxillary arch wire.
b) Too much bite – opening bend between cuspid and
bicuspid
c) maxillary arch wire too small in diameter.
d) Maxillary arch wire too wide.
e) Torquing auxiliary not constricted adequately.

• Mandibular molars narrowing

a) Lower arch wire not wide enough
b) Class II elastics exerting too much force
c) Presence of steel ligature tie from the lingual of the
mandibular cuspid to the lingual of the mandibular molar
• Anterior bite deepening:

a) Too much power in the torquing auxiliary

b) Maxillary arch wire too thin.

c) Patient not wearing class II elastic

• Teeth not uprighting mesiodistally:

a) springs not active
b) Arch wire caught on the edge of the bracket
- Tighten spring – pin to draw arch wire in bracket
- Draw arch wire into bracket with a steel ligature tie
c) Occlusal interference caused by an elevated tooth.
d) Springs placed in backwards
• Maxillary anterior teeth not torquing palatally
a) Not enough force from maxillary torquing auxiliary
b) Maxillary incisal edges caught lingual to lower anterior teeth

• Lower anterior teeth labially inclined

a) Normal mesial migration of teeth during third stage
 REFERENCES

1. Stone age man's dentition. AJODO. 1954;40:7:517–531.

2. Differential force in orthodontic treatment. P.R. BEGG.

AJODO.1956;42:7:481–510.

3. Begg Orthodontic theory and technique-Begg and Kesling

4. Begg: Appliance and technique- G.G.T.FLETCHER.