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 Dr. Begg 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
 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 decidous 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.
 Phenomenon to support attritional occlusion
• Third molars- only teeth that have their root formation
completed before eruption in civilized man’s non attritional
dentition.
• At the age of 12 to 13 years the third molar begin to erupt in
attritional occlusion.
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 E F I N E D AS A FO RC E THAT RESULTS I N A
DIFFERENT 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

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 auxillaries.

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 GR A D E :

- Hardness and resiliency of 0.016” wire, is excellent for

supporting anchorage, and reducing deep overbites.
- Must be bent with care.

5. EXTRA SP EC I A L PLUS G R A D E :
- Also called premium plus

- This grade is unequalled in resiliency and

hardness.
- More difficult to bend and more subjected to

fracture.
6. S U PR E M E GR A D E :

- 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.
- Although supreme exceeds the yield strength of
E.S.P, 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.
By changing the lock pins, the size of the arch wire slot can be
changed to accept properly either a 0.016 inch or a 0.020
inch arch wire

MODIFIED RIBBON ARCH BRACKET ( TP

-256- 500)
 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.
 TYPE
S
1. Full flange
2.Half flange

1. Bondable
2. Weldable
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.
 AUXILLARY 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.
- Alsoused 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

• To correct the mesiodistal relationship of
buccal segments
• To close the anterior spacing
• Corection of rotation
• Posterior crossbite corection
 CLASS I
ELASTICS

CLASS II ELASTICS

CLASS III ELASTICS

ELASTIC THREAD T I E D
I N FIGURE O F ‘8’
PATTERN
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
Material

• 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.
Anterior Segement:

• Portion of the wire b/w intermaxillary hooks lies

gingival to buccal segment for effective intrusion
• 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
CHECKING
• Amount of bend varies from case to case

• The aaverage 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

FORMING ARCH WIRE CONTAINING VERTICAL LOOPS
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

- 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:

• The second premolars

• Teeth initially so far displaced
• Upper laterals which are lingual to
centrals
• 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 binding of the archwire in them.
 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 O F M O L A R S
• 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
- Check the level of mandibular molar tubes, lower
them, if necessary.
- Check position of anchor bends, if too far mesially,
move them closer to molar tube.
- Loose molar band
- 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

1.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

- If tipped mesially : there is no anchor bends. If

tipped distaly too much anchor bends.
- Improper placement of molar band or tube
- Excessive elastic force
- Oversize arch wire – molar tipped distally
4. N O APPRECIABLE C H A NG E
- Patient not wearing elastics
- Arch wire bend out of shape
- patient seen too soon

5. VERTICAL LOOPS BURIED IN THE GINGIVA

- Original, looped arch wire left in the mouth too
long
- Misjudgment in the proper direction of vertical

loops when the arch wire was placed

6. ELASTICS 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
-use steel pin
- 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:

- May be an optical illusion with roots actually

moving lingually.
- Binding of the arch wire in bicuspid brackets
-Binding of ends of the arch wire inside distal ends of
buccal tube
10. ANTERIOR OPEN BITE NOT CLOSING:

- patient not wearing anterior vertical elastics

- Persistent tongue thrust or other adverse habits
- Too much anchor bend.
STAGE 2 AND STAGE 3 - BEGGS
TECHNIQUE
 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

CONTROL OF BICUSPID HEIGHT
• 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.
 SHORTENING LENGTH OF
DOUBLED-BACK ARCH WIRES
PROBLEM ENCOUNTERED DURING
SECOND STAGE

• Anterior bite closing:

a. Not enough anchor bend
b. Bite – opening bends bitten out
- Educate patient , correct the archwire
c. Patient not wearing the classII 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:

- Slight, expected mesial movement of

anchor molar
- Abnormal loss of anchorage, if second
bicuspids are tipping excessively.
STAGE III
 STAGE 3 UPPER AND LOWER ARCH WIRE
• Made from 0.020 SS
 STAGE III

• OBJECTIVES:

1.Maintain all corrections achieved during first and

second stages.

2. Achieve desired axial inclinations of all teeth.

HOW TO ACHIEVE THE
OBJECTIVES?
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.
• Original Spring: Smaller & fewer coils.
A longer lever arm.

Refinement of original spring: Larger more resilient coils

Short lever arm.
ACTIVE ARM WITH HELIX
HOOK AT THE END

RETENTIVE ARM
 UPRIGHTING SPRING

• 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
• A problem inherent in all uprighting springs is that:

when engaged and under tension, the coil presses

against the gingival edge of the bracket

If arch wire is not ligated the coils can cause

the bracket to move away from the arch wire

subsequent elongation of the tooth

 SPRING PIN

• A Combination of a Lock Pin and an Uprighting

Spring
LINGUAL LOCK PIN
TEETH REQUIRING
UPRIGHTING:
TORQUING AUXILLARY
• 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 TORQUEING
AUXILLARY

• Used for torquing the upper anterior roots palatally

• Bend with 0.014 or 0.016” wire

BENDING THE FOUR SPUR
AUXILIARY
ACTIVATING THE
AUXILIARY
 APPLICATION OF THE THIRD STAGE
ARCH WIRES AND THE AUXILIARIES TO
THE TEETH
OTHER TORQUING AUXILIARIES USED:
 TWO SPUR TORQUEING
AUXILLARY

• Used when lateral

incisors do not require
palatal root
 RECIPROCAL TORQUEING
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 TORQUEING
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 TORQUEING
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.
VERTICAL SPUR IN THE MAIN ARCH WIRE
TORQUEING AUXILLARY FOR
LOWER INCISORS
REVERSE TORQUEING AUXILIARY
• Indicated if lower anterior teeth are becoming too
proclined.

• For labial root torque

• 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. Torqueing auxillary 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 auxillary
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
1. Not enough force from maxillary torquing
auxiliary
2. Maxillary incisal edges caught lingual to lower
anterior teeth

Lower anterior teeth labially inclined

1. 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.