Stages in beggs technique /certified fixed orthodontic courses by Indian dental academy

STAGES IN BEGG’S
•STAGE I
•STAGE II
www.indiandentalacademy.comwww.indiandentalacademy.com

CONTENTSCONTENTS
COMPONENTS OF THE APPLIANCECOMPONENTS OF THE APPLIANCE
STAGE ISTAGE I
PROBLEMS IN STAGE IPROBLEMS IN STAGE I
STAGE IISTAGE II
PROBLEMS IN STAGE IIPROBLEMS IN STAGE II
REFERENCESREFERENCES

COMPONENTS OF BEGGCOMPONENTS OF BEGG
APPLIANCEAPPLIANCE

MODIFIED RIBBON ARCH BRACKET ( TP -256-MODIFIED RIBBON ARCH BRACKET ( TP -256-
500)500)

Requirements for a light wire bracketsRequirements for a light wire brackets
Ease of arch wire engagementEase of arch wire engagement
A means to guide both the tail and head of lock pinA means to guide both the tail and head of lock pin
during lockingduring locking
Positive retention of arch wire in all 3 stagesPositive retention of arch wire in all 3 stages
Free tipping and sliding on arch wireFree tipping and sliding on arch wire
Ability to effect and hold rotationAbility to effect and hold rotation
Ability to prevent accidental tipping in stage III.Ability to prevent accidental tipping in stage III.
These brackets are fabricated from stainlessThese brackets are fabricated from stainless
steel strips, hence it is economical.steel strips, hence it is economical.

TYPESTYPES
A.A. 1. Full flange1. Full flange
2.Half flange2.Half flange
B.B. 1. Bondable1. Bondable
2. Weldable2. Weldable
Full flange brackets will have moreFull flange brackets will have more
friction with arch wire and hence hindrance tofriction with arch wire and hence hindrance to
smooth tipping movement of anterior.smooth tipping movement of anterior.
in half flange brackets, contact of thein half flange brackets, contact of the
flange with arch wire is minimal , thus friction isflange with arch wire is minimal , thus friction is
also minimal.also minimal.

ARCH WIREARCH WIRE

AUSTRALIAN ARCHWIRESAUSTRALIAN ARCHWIRES
Round austenitic stainless steel wire of 0.016 inchRound austenitic stainless steel wire of 0.016 inch
diameter, which has been heat treated and colddiameter, which has been heat treated and cold
drawn down to its proper diameter, in order to givedrawn down to its proper diameter, in order to give
it the required properties of resiliency, toughnessit the required properties of resiliency, toughness
and tensile strengthand tensile strength
It was made thin enough, to distribute force at anIt was made thin enough, to distribute force at an
optimal level for tooth movement over aoptimal level for tooth movement over a
considerable period of time, over long distance andconsiderable period of time, over long distance and
with minimal loss of force intensity while doing so.with minimal loss of force intensity while doing so.

SIX TYPES OF AUSTRALIAN WIRESIX TYPES OF AUSTRALIAN WIRE
1.1. REGULAR GRADE:REGULAR GRADE:
-- Lowest grade – easy to bendLowest grade – easy to bend
- Used for practice bending and forming auxiliaries.- Used for practice bending and forming auxiliaries.
2.2. REGULAR PLUS:REGULAR PLUS:
-- Easy to form, more resilient than regular gradeEasy to form, more resilient than regular grade
- Used for auxiliaries and arch wires when more- Used for auxiliaries and arch wires when more
pressure and resistance to deformation as desired.pressure and resistance to deformation as desired.
3. SPECIAL GRADE:3. SPECIAL GRADE:
-- Highly resilient yet can be formed into shape.Highly resilient yet can be formed into shape.

SPECIAL PLUS GRADE:SPECIAL PLUS GRADE:
-- Hardness and resiliency of 0.016” wire, isHardness and resiliency of 0.016” wire, is
excellent for supporting anchorage, and reducingexcellent for supporting anchorage, and reducing
deep overbites.deep overbites.
- Must be bent with care.- Must be bent with care.
EXTRA SP ECIAL PLUS GRADEEXTRA SP ECIAL PLUS GRADE ::
-- Also called premium plusAlso called premium plus
- This grade is unequalled in resiliency and- This grade is unequalled in resiliency and
hardness.hardness.
- More difficult to bend and more subjected to- More difficult to bend and more subjected to
fracture.fracture.

SUPREME GRADE:SUPREME GRADE:
-- It is ultra light tensile fine round stainless steelIt is ultra light tensile fine round stainless steel
wire.wire.
- It was initially introduce in 0.010” diameter and- It was initially introduce in 0.010” diameter and
then further reduced to 0.009 diameter.then further reduced to 0.009 diameter.
-It is primarily used in the early treatment for-It is primarily used in the early treatment for
rotation. Alignment and leveling.rotation. Alignment and leveling.
- Although supreme exceeds the yield strength of- Although supreme exceeds the yield strength of
E.S.P, it is intended for use in either short section orE.S.P, it is intended for use in either short section or
full arches where sharp bends are not required.full arches where sharp bends are not required.

BAND MATERIALBAND MATERIAL
These bands made of stainless steel strips of differentThese bands made of stainless steel strips of different
size and thickness are recommended for different teeth.size and thickness are recommended for different teeth.
These available on 8 feet rolls or cut of 2 inches to 2.5These available on 8 feet rolls or cut of 2 inches to 2.5
inches.inches.
1. For incisors - 0.125 x 0.003 inch1. For incisors - 0.125 x 0.003 inch
2. For canines, premolars – 0.150 x 0.004 inch2. For canines, premolars – 0.150 x 0.004 inch
3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch

AUXILLARY ATTACHMENTSAUXILLARY ATTACHMENTS
In addition to theIn addition to the
foregoing parts, the lightforegoing parts, the light
round arch wire techniqueround arch wire technique
requires the followingrequires the following
adjustmentsadjustments ..
LINGUAL BUTTONS:LINGUAL BUTTONS:
The name clearlyThe name clearly
indicates the side of theindicates the side of the
teeth where it is to beteeth where it is to be
welded. Used forwelded. Used for
correction of premolarcorrection of premolar
and molar rotation.and molar rotation.

BALL END HOOKS:BALL END HOOKS:
They are attached toThey are attached to
buccal or lingual of molarbuccal or lingual of molar
bands. Positioned as farbands. Positioned as far
gingivally and near thegingivally and near the
mesiodistal centre of themesiodistal centre of the
tooth. Make the placing oftooth. Make the placing of
elastic simple for patient.elastic simple for patient.

ELASTICSELASTICS
Elastics are made of synthetic latex and of uniform sizesElastics are made of synthetic latex and of uniform sizes
and applying uniform forces when stretched to requiredand applying uniform forces when stretched to required
length. These elastics come in different sizes of internallength. These elastics come in different sizes of internal
diameter and different thickness of their wall. Thinnerdiameter and different thickness of their wall. Thinner
walled elastics are called “walled elastics are called “light elasticslight elastics” and thick” and thick
walled elastics are called “walled elastics are called “Heavy elasticsHeavy elastics””
These elastics will exert a force equal to between 60 andThese elastics will exert a force equal to between 60 and
70 gms when they are new and first placed.70 gms when they are new and first placed.

USES OF ELASTICSUSES OF ELASTICS
Anterior retractionAnterior retraction
Posterior protractionPosterior protraction
Correction of deep biteCorrection of deep bite
Correction of class II or class III occlusionCorrection of class II or class III occlusion
Closure of extraction spacesClosure of extraction spaces
Correction of cross biteCorrection of cross bite
Correction of rotationCorrection of rotation
Anterior open bite (box elastics )Anterior open bite (box elastics )
Correction of midline.Correction of midline.

CLASS I ELASTICSCLASS I ELASTICS

Class 2 ElasticsClass 2 Elastics

EFFECTS OF CLASS II ELASTICEFFECTS OF CLASS II ELASTIC
In lower molar region oneIn lower molar region one
vector taking posteriorsvector taking posteriors
mesially and other vectormesially and other vector
extruding force on molar.extruding force on molar.
On upper anteriorsOn upper anteriors
horizontal vector will tipphorizontal vector will tipp
and retract anteriors distallyand retract anteriors distally
and vertical vector willand vertical vector will
counteract the intrusivecounteract the intrusive
effect of upper arch wire oneffect of upper arch wire on
anteriorsanteriors..

CLASS III ELASTICSCLASS III ELASTICS

Ligature wiresLigature wires
These are very thin (0.007 to 0.009) stainless steel softThese are very thin (0.007 to 0.009) stainless steel soft
wires.wires.
- They are very useful in tying of the span of looped arch- They are very useful in tying of the span of looped arch
wire, which are far away from its ideal position, thuswire, which are far away from its ideal position, thus
progressive increase In force and also avoiding plasticprogressive increase In force and also avoiding plastic
deformation of the arch wire.deformation of the arch wire.
- Also used as extra holding devices. When one wants to- Also used as extra holding devices. When one wants to
feel secure about arch wire not getting disengaged fromfeel secure about arch wire not getting disengaged from
the bracket slot by slipping outthe bracket slot by slipping out

BUCCAL TUBESBUCCAL TUBES
Round molar tubes withRound molar tubes with
0.036 internal diameter0.036 internal diameter
and 0.250 length areand 0.250 length are
routinely used.routinely used.
Flat oval molar tubes andFlat oval molar tubes and
doubled back wires aredoubled back wires are
used when secondused when second
permanent molars are thepermanent molars are the
anchor teeth and alsoanchor teeth and also
used in mandibular dentalused in mandibular dental
arch when secondarch when second
premolar is absent.premolar is absent.

LOCK PINSLOCK PINS
Second stage safety lock pin:Second stage safety lock pin: Shoulder on head ensures freeShoulder on head ensures free
mesiodistal tipping. Labiolingual width of tail dimension is reduced tomesiodistal tipping. Labiolingual width of tail dimension is reduced to
fit properly into TP – 256 – 500 bracket in conjunction with inch archfit properly into TP – 256 – 500 bracket in conjunction with inch arch
wire.wire.
One point safety lock pinOne point safety lock pin : Used in stage I and II. The pin has a: Used in stage I and II. The pin has a
shoulder that keeps the head of the pin outside the bracket slot andshoulder that keeps the head of the pin outside the bracket slot and
prevents the impingement of pin on arch wire. The beveledprevents the impingement of pin on arch wire. The beveled
undersurface of head permits free mesiodistal tipping. Thickness ofundersurface of head permits free mesiodistal tipping. Thickness of
pin is 0.019 length 0.200’’ x 0.220”pin is 0.019 length 0.200’’ x 0.220”

Hook lock pinsHook lock pins : Used during III: Used during III
stage. Since there is no safetystage. Since there is no safety
shoulder, they hold the arch wireshoulder, they hold the arch wire
firmly against the base of the archfirmly against the base of the arch
wire slot. Thickness – 0.014” towire slot. Thickness – 0.014” to
0.018” , length – 0.220 to 0.2930.018” , length – 0.220 to 0.293
High hat safety lock pins:High hat safety lock pins:
They have a gingival extension onThey have a gingival extension on
head which provides a positivehead which provides a positive
point for engagement of vertical orpoint for engagement of vertical or
cross elastics.cross elastics.

BRACKET PLACEMENTBRACKET PLACEMENT

BUCCAL TUBE PLACEMENTBUCCAL TUBE PLACEMENT

SEVEN SYNERGISTIC COMPO NENTSSEVEN SYNERGISTIC COMPO NENTS
1. A diagnosis and treatment plan that recognizes the persistence of1. A diagnosis and treatment plan that recognizes the persistence of
hereditary forces of mesial migration and vertical eruption of teeth and hashereditary forces of mesial migration and vertical eruption of teeth and has
its objectives the over correction of malrelationships of both teeth and jaws.its objectives the over correction of malrelationships of both teeth and jaws.
2. The simultaneous movement of all teeth. From the beginning of2. The simultaneous movement of all teeth. From the beginning of
treatment each tooth is directed towards its final position in the dental arch.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 during3. The total separation of root moving forces from arch wire forces during
the final third stage of treatment.the final third stage of treatment.
4. The application of proper elastic forces to create the desired differential4. The application of proper elastic forces to create the desired differential
movement of the teeth.movement of the teeth.

5. The use of light round continuos arch wires bent from the hardest5. The use of light round continuos arch wires bent from the hardest
wire possible – Not only must the wire be of highest quality, but thewire possible – Not only must the wire be of highest quality, but the
aech wire have proper form, including bite opening bends, to controlaech wire have proper form, including bite opening bends, to control
the vertical dimension.the vertical dimension.
6. The use of molar attachments that prevent free mesiodistal6. The use of molar attachments that prevent free mesiodistal
tipping and yet permit the arch wire to slide freely mesio distally.tipping and yet permit the arch wire to slide freely mesio distally.
This permits the rapid retraction of the anterior teeth.This permits the rapid retraction of the anterior teeth.
7. The use of attachments on all teth, except anchor molars, that7. The use of attachments on all teth, except anchor molars, that
control rotations yet permit free tipping in the desired direction andcontrol rotations yet permit free tipping in the desired direction and
free sliding along arch wires.free sliding along arch wires.

The method consist essentially of tipping movements ofThe method consist essentially of tipping movements of
the teeth. Two successive tipping movements arethe teeth. Two successive tipping movements are
required to achieve bodily movement.required to achieve bodily movement.
Simultaneous movement of the upper four incisors andSimultaneous movement of the upper four incisors and
canines in both the upper and lower arches .canines in both the upper and lower arches .
Anchorage considerationsAnchorage considerations

ObjectivesObjectives
►Correction of Deep Anterior Over BiteCorrection of Deep Anterior Over Bite
►Correction of Proclination of the AnteriorsCorrection of Proclination of the Anteriors
►Correction Of Crowding and irregularitiesCorrection Of Crowding and irregularities
including Rotations.including Rotations.
►Correction of Anteriorposterior OcclusalCorrection of Anteriorposterior Occlusal
Relationship of the Buccal SegmentsRelationship of the Buccal Segments

►Corrrection of Buccolingual andCorrrection of Buccolingual and
Labiolingual CrossbitesLabiolingual Crossbites
►Axial Relations of the Anchor molarsAxial Relations of the Anchor molars
correctedcorrected
►Closure of spaces between Anterior teethClosure of spaces between Anterior teeth

Stage I arch wireStage I arch wire

:: - Made from 0.016 heat treated- Made from 0.016 heat treated
high tensile stainless steel wire.high tensile stainless steel wire.
incorporate -: anchor bends,incorporate -: anchor bends,
intermaxillary hooks,intermaxillary hooks,
vertical loop.vertical loop.
Canine contoursCanine contours

VERTICAL LOOPVERTICAL LOOP

FunctionsFunctions -:-:
Correction of CrowdingCorrection of Crowding
,spacing,Rotations of Central and Lateral,spacing,Rotations of Central and Lateral
Incisors, StopsIncisors, Stops
CautionsCautions
1)1) Not given distal to CaninesNot given distal to Canines
2)2) Should not impede on tissuesShould not impede on tissues
3)3) Removed as soon as Function has beenRemoved as soon as Function has been
servedserved

ANCHOR BENDSANCHOR BENDS

Anchor bends placed too farAnchor bends placed too far
mesiallymesially

FunctionsFunctions
Factors affecting the degree of bendsFactors affecting the degree of bends
Location of the bendsLocation of the bends
Actions of the bendsActions of the bends
Checking for degree of bendChecking for degree of bend
Adverse effect of excessive bendAdverse effect of excessive bend

Initially called Tip back BendsInitially called Tip back Bends
Functions :-Functions :- 1)to activate the archwires1)to activate the archwires
so that they can depress the upper andso that they can depress the upper and
lower anterior in their sockets thuslower anterior in their sockets thus helpinghelping
inin opening the biteopening the bite
2) To bestow upon the anchor molars the2) To bestow upon the anchor molars the
power to resist forward pull of class IIpower to resist forward pull of class II
elaticselatics

Factors that effect Anchor bendsFactors that effect Anchor bends
1)1) Degree of Deep –BiteDegree of Deep –Bite
2)2) Diameter of the wireDiameter of the wire
3)3) Meio-Distal inclination of the anchor molarsMeio-Distal inclination of the anchor molars
4) Position of the anchor bends4) Position of the anchor bends
 Action of the anchor bendsAction of the anchor bends on anteriorson anteriors
on posteriorson posteriors
Checking For Degree of Anchor bend…Checking For Degree of Anchor bend…

Adverse effects of excessive anchorAdverse effects of excessive anchor
bendsbends
1)1) Greater tipping forces exerted on anchorGreater tipping forces exerted on anchor
molarsmolars  cause them to tip-back andcause them to tip-back and
elevate their MMRelevate their MMR pseudo bitepseudo bite
openingopening
2)2) Causes rotation of arch wire in molarCauses rotation of arch wire in molar
tubetube

Intermaxillary HooksIntermaxillary Hooks

CANINE CONTOURCANINE CONTOUR

The segment of the arch wire between hooksThe segment of the arch wire between hooks
made to lie gingival to distal segment .made to lie gingival to distal segment .
Arch wire should assume the 6 o’clock – 12Arch wire should assume the 6 o’clock – 12
o’clock positions in molar tubes when arch wireo’clock positions in molar tubes when arch wire
is placed.is placed.
Check for the anchor bends.Check for the anchor bends.
The arch wire is engaged into the bracket slotsThe arch wire is engaged into the bracket slots
and secured in position with stage I lock pins.and secured in position with stage I lock pins.

The arch wire is secured to all the teethThe arch wire is secured to all the teeth
except the :-second bicuspidexcept the :-second bicuspid
teeth placed too farteeth placed too far
horizontally/vertically/severely rotatedhorizontally/vertically/severely rotated
lingually placed lateralslingually placed laterals

Lingually Locked out TeethLingually Locked out Teeth

Lingually Locked out TeethLingually Locked out Teeth
It may be difficult to engage the wire in theIt may be difficult to engage the wire in the
brackets at times if the space betweenbrackets at times if the space between
proximating teeth is less than the length ofproximating teeth is less than the length of
the bracket area for a blocked out tooththe bracket area for a blocked out tooth
The ligate the arch wire to the bracket ofThe ligate the arch wire to the bracket of
blocked out tooth….blocked out tooth….

Free ends of the lock pins are turnedFree ends of the lock pins are turned
mesially around the brackets.mesially around the brackets.
The wire should extend 2-3mm past theThe wire should extend 2-3mm past the
buccal tubes to prevent binding of thebuccal tubes to prevent binding of the
archwire in them.archwire in them.

Tying Intermaxillary hook to cuspidTying Intermaxillary hook to cuspid
bracketbracket

If there is no restraining ties betweenIf there is no restraining ties between
intermaxillary hooks and cuspid bracketsintermaxillary hooks and cuspid brackets
cuspid teeth will continue to tip distallycuspid teeth will continue to tip distally
and slide along the arch wireand slide along the arch wire resulting inresulting in
spacingspacing
Ligation done in figure of eight andLigation done in figure of eight and
always pass ligature through circle and notalways pass ligature through circle and not
through crevice….through crevice….

Achieving objectivesAchieving objectives
Correction of deepCorrection of deep
bitebite
- Intrusion of the upperIntrusion of the upper
and lower anteriorsand lower anteriors
via anchor bendsvia anchor bends

Correction of overjetCorrection of overjet
- Class II elastics which bring about tippingClass II elastics which bring about tipping
of the six upper and lower anteriorsof the six upper and lower anteriors
- Force used 60-70 gms. each sideForce used 60-70 gms. each side
- Importance of simultaneous using of classImportance of simultaneous using of class
II elastics and anchor bendsII elastics and anchor bends

Correction of Molar relationCorrection of Molar relation is brought about by theis brought about by the
following contributing factors acting simultaneouslyfollowing contributing factors acting simultaneously
1)Distal tipping of the maxillary first molars.1)Distal tipping of the maxillary first molars.
2)Mesial movement of the lower first molar.2)Mesial movement of the lower first molar.
3)Extruson of the lower first molar.3)Extruson of the lower first molar.
4)Favourable change in occlusion.4)Favourable change in occlusion.
5)Restriction of normal forward growth of maxilla and5)Restriction of normal forward growth of maxilla and
maxillary denture.maxillary denture.

Alignment of teethAlignment of teeth
Elimination of crowding -: by way of usingElimination of crowding -: by way of using
Vertical loopsVertical loops
Correction of crowdingCorrection of crowding

RotationsRotations
Need to eliminate rotationsNeed to eliminate rotations
Methods which may be employed toMethods which may be employed to
eliminate rotationseliminate rotations
1)using section of wire1)using section of wire
between vertical loopsbetween vertical loops
2)using elastic ligature,2)using elastic ligature,
thread or coil springthread or coil spring
3)using spring auxiliary3)using spring auxiliary

Correction of rotations of labial segmentCorrection of rotations of labial segment
is achieved by offsetting the bracket areais achieved by offsetting the bracket area
between vertical loops.between vertical loops.
Corrections may be maintained by way ofCorrections may be maintained by way of
bayonet bends.bayonet bends.

Rotations of Cuspid and BicuspidRotations of Cuspid and Bicuspid
1)Elastic ties1)Elastic ties

Correction may be achieved by usingCorrection may be achieved by using
either :-elastic threadseither :-elastic threads
rotating springsrotating springs
main archwire kept clear of the bracket somain archwire kept clear of the bracket so
that there is no impedment to the intendedthat there is no impedment to the intended
correctioncorrection
Toe-in or toe-out bends for molars as anToe-in or toe-out bends for molars as an
antirotational control mechanism.antirotational control mechanism.
To maintain teeth in overcorrected positionTo maintain teeth in overcorrected position
slightly offset the bracket position.slightly offset the bracket position.

TOE - IN BENDS:TOE - IN BENDS:
Incorporated in the arch wire as anti – rotationalIncorporated in the arch wire as anti – rotational
bends. The toe in bends should never exceed more thanbends. The toe in bends should never exceed more than
5 degree.5 degree.
TOE – OUT BENDSTOE – OUT BENDS
To correct the disto – buccal molar rotation.To correct the disto – buccal molar rotation.

2)Rotating springs2)Rotating springs

Rotation of molarsRotation of molars
Slightly rotated -: incorporate toe-in or toe-Slightly rotated -: incorporate toe-in or toe-
out bendsout bends
Moderately rotated -: elastic ligature tiesModerately rotated -: elastic ligature ties
Severely rotated -: Bayonet /Toe-in bendSeverely rotated -: Bayonet /Toe-in bend

Closure of anterior spaces -:Closure of anterior spaces -:
1)1) LoopsLoops

2) Plain Arch wire in2) Plain Arch wire in
conjunction withconjunction with
elastics….adv…elastics….adv…
eliminates need foreliminates need for
loopsloops

Correction of crossbiteCorrection of crossbite
Resulting from local tooth displacementsResulting from local tooth displacements
or angulationsor angulationscorrected with the use ofcorrected with the use of
cross-elastics between the buccal hookscross-elastics between the buccal hooks
on the lower molar and buttons/cleats onon the lower molar and buttons/cleats on
lingual surface of the upperslingual surface of the uppers

Position of teeth at the end ofPosition of teeth at the end of
Stage IStage I

ProblemsProblems
Failure to correct the deep-biteFailure to correct the deep-bite
Insufficient retraction of the anteriorsInsufficient retraction of the anteriors
Mandibular molars tipping linguallyMandibular molars tipping lingually
Rotation of the lower molarsRotation of the lower molars
Anterior spaces openingAnterior spaces opening
Rotation/tipping of upper molarRotation/tipping of upper molar

ProblemsProblems
Failure to correct deep overbiteFailure to correct deep overbite
Patient not wearing elasticsPatient not wearing elastics
Arch wire getting distortedArch wire getting distorted
Insufficient anchorage bendsInsufficient anchorage bends
Anchor bends positioned too far mesialAnchor bends positioned too far mesial
from MTfrom MT
Bends displaced in MTBends displaced in MT
Use of Torquing and uprighting springsUse of Torquing and uprighting springs

8) Arch wire in premolar bracket, By pass8) Arch wire in premolar bracket, By pass
clamp …clamp …
9) Incorrect bracket placement9) Incorrect bracket placement
Insufficient retraction of maxillaryInsufficient retraction of maxillary
anterior teethanterior teeth
Patients not wearing class II elasticsPatients not wearing class II elastics
Binding of arch wireBinding of arch wire

3) Hinderance to free tipping of teeth :- loops, pins,3) Hinderance to free tipping of teeth :- loops, pins,
wedging of class II elasticswedging of class II elastics
4) Occlusal interferences :- bite, arch form,bracket4) Occlusal interferences :- bite, arch form,bracket
placementplacement
5) Flaring of incisors caused by excessive5) Flaring of incisors caused by excessive
expansion of loops in initial arch wireexpansion of loops in initial arch wire
Mandibular molars tipping linguallyMandibular molars tipping lingually
1)1) Insufficient expansion in arch wireInsufficient expansion in arch wire
2)2) Excessive and improperly placed anchorExcessive and improperly placed anchor
bendsbends
3)3) Prolonged use of loopsProlonged use of loops
4)4) Excessive traction from class II elasticsExcessive traction from class II elastics

Rotation of Mandibular molarsRotation of Mandibular molars
1)1) Incorrectly formed anchor bendsIncorrectly formed anchor bends
2)2) Distortion of arch wireDistortion of arch wire
3)3) Incorrectly placed molar tubesIncorrectly placed molar tubes
4)4) Excessive elastic tractionExcessive elastic traction
Anterior SpacingAnterior Spacing
1)Intermaxillary hooks not tied back to1)Intermaxillary hooks not tied back to
caninescanines
2)Excessive expansion of loops initially2)Excessive expansion of loops initially

Maxillary Molar Rotation or TippingMaxillary Molar Rotation or Tipping
1)Incorrectly formed anchorage bends1)Incorrectly formed anchorage bends
2)Anchorage bends formed too far mesially2)Anchorage bends formed too far mesially
3)Arch wire distortion3)Arch wire distortion
4)Incorrect Buccolingaul angulation of molar4)Incorrect Buccolingaul angulation of molar
tubetube

ObjectivesObjectives
Maintainence of corrections achieved thusMaintainence of corrections achieved thus
farfar

partially by retraction of anteriorspartially by retraction of anteriors

partially by movement of posteriorspartially by movement of posteriors
Correction of midline discrepanciesCorrection of midline discrepancies

Arch wireArch wire
0.020 inch wire is used0.020 inch wire is used
Usually plain arch wire with -Usually plain arch wire with -
intermaxillary hooksintermaxillary hooks
anchor bendsanchor bends
premolar offsetspremolar offsets
Arch wire kept expandedArch wire kept expanded
wire not engaged in premolar bracketwire not engaged in premolar bracket
but important to ligate to the wirebut important to ligate to the wire
Use Stge II lock pinsUse Stge II lock pins

Maintain the results achieved inMaintain the results achieved in
Stage IStage I
MD molar relation is maintained.MD molar relation is maintained.
Spaces between anterior teeth preventedSpaces between anterior teeth prevented
form openingform opening
Maintaining the bite opening achievedMaintaining the bite opening achieved
Maintainence of corrected rotations …Maintainence of corrected rotations …
incisors by use of bayonet bendsincisors by use of bayonet bends
bicuspids …replacing elastics with ligaturebicuspids …replacing elastics with ligature
threadsthreads

Achieved partially by retraction of anteriorsAchieved partially by retraction of anteriors
and partially by mesial movement ofand partially by mesial movement of
posteriors…best judge of this would beposteriors…best judge of this would be
lateral ceph.lateral ceph.
Need for over retraction of labial segmentNeed for over retraction of labial segment
while closing of extraction spaces.while closing of extraction spaces.

How is this space closureHow is this space closure
achievedachieved
Space closure achieved by wearing class ISpace closure achieved by wearing class I
or horizontal elastics.or horizontal elastics.
Worn from intermaxillary hook to molarWorn from intermaxillary hook to molar
tube of same arch on same sidetube of same arch on same side
Caution….tend to cause molar rotationCaution….tend to cause molar rotation

Intermaxillary elastics also worn…reasonsIntermaxillary elastics also worn…reasons

Braking AuxillariesBraking Auxillaries

Arch SymmetryArch Symmetry

END OF STAGE IIEND OF STAGE II

Problems in Stage IIProblems in Stage II
Anterior bite closingAnterior bite closing
1)Insufficent /distortion of anchor bends1)Insufficent /distortion of anchor bends
2)Patient not wearing class II elastics2)Patient not wearing class II elastics
3)Anchor molars out of occlusion3)Anchor molars out of occlusion
Anterior teeth assuming class IIIAnterior teeth assuming class III
relationrelation
1)Excessive wearing of class II elastics1)Excessive wearing of class II elastics

Opening of anterior spaces
1)Intermaxillary hook not ligated to cuspid1)Intermaxillary hook not ligated to cuspid
2)Hooks formed too far apart2)Hooks formed too far apart
Distobuccal rotation of AnchorDistobuccal rotation of Anchor
molarsmolars
1)Insufficient molar toe-in bends1)Insufficient molar toe-in bends
2)Too much force from horizontal elastics2)Too much force from horizontal elastics
3)Elastics pulling on distal of molar tubes3)Elastics pulling on distal of molar tubes

Posterior spaces not closingPosterior spaces not closing
1)Binding of arch wire…thus not free to1)Binding of arch wire…thus not free to
slide distally through buccal tubeslide distally through buccal tube
2)Lack of wearing of class I elastics2)Lack of wearing of class I elastics
3)Anterior teeth not free to tip distally3)Anterior teeth not free to tip distally
4)Occlusal interferences4)Occlusal interferences

ReferencesReferences
Begg and Kesling:Begg Orthodontic Theory andBegg and Kesling:Begg Orthodontic Theory and
Technique.Technique.
Cadman GR. A Vade mecum for the BeggCadman GR. A Vade mecum for the Begg
technique: Technical principles. Am J Orthodtechnique: Technical principles. Am J Orthod
1975:67;477-5121975:67;477-512
Cadman GR. A Vade mecum for the BeggCadman GR. A Vade mecum for the Begg
technique: Treatment procedures. Am J Orthodtechnique: Treatment procedures. Am J Orthod
1975:67;601-6241975:67;601-624
Huckaba GW. The Begg technique.ClinicalHuckaba GW. The Begg technique.Clinical
dentistry :Vol 2:1- 31.dentistry :Vol 2:1- 31.
Fletcher GGT. The begg appliance andFletcher GGT. The begg appliance and
technique.technique.

STAGE IIISTAGE III
OBJECTIVES:OBJECTIVES:
1. Maintain all corrections achieved1. Maintain all corrections achieved
during first and second stages.during first and second stages.
2. Achieve desired axial inclinations of2. Achieve desired axial inclinations of
all teeth.all teeth.

Arch WireArch Wire
0.020 arch wire is used0.020 arch wire is used
Functions -: maintenanceFunctions -: maintenance
transmitting forcestransmitting forces
stabilizing against adversestabilizing against adverse
reciprocal forcesreciprocal forces

Form -: upper …constrictedForm -: upper …constricted
Lower …expandedLower …expanded
Anchor bends-: decreased in magnitudeAnchor bends-: decreased in magnitude
Molar offsetsMolar offsets
Bends in vertical plane in premolar-molarBends in vertical plane in premolar-molar
area to compensate for verticalarea to compensate for vertical
discrepancy in bracket – tube positiondiscrepancy in bracket – tube position

AuxillariesAuxillaries
1)1) Uprighting springsUprighting springs
2)2) Anterior root torqueing auxillaries-:upperAnterior root torqueing auxillaries-:upper
lowerlower
3)3) Reverse torqueing auxillaryReverse torqueing auxillary
4)4) Pre-Wound torqueing auxillaryPre-Wound torqueing auxillary
5)5)

Uprighting springsUprighting springs

Uprighting springsUprighting springs
Function -:serve to correct the mesiodistalFunction -:serve to correct the mesiodistal
inclination of the teeth …i.e for parallelinginclination of the teeth …i.e for paralleling
of the rootsof the roots
Springs to be made from the most resilientSprings to be made from the most resilient
wireswires
Diameter of wire used will depend on theDiameter of wire used will depend on the
tooth being uprighted…differential forcetooth being uprighted…differential force
conceptconcept

Upper and lower canines-0.016inchorUpper and lower canines-0.016inchor
0.018inch,2- coil0.018inch,2- coil
Upper and lower second premolars- 0.016Upper and lower second premolars- 0.016
inch , 2- coilinch , 2- coil
Upper lateral incisors – 0.014 inch,2- coilsUpper lateral incisors – 0.014 inch,2- coils
Lower lateral incisors – 0,014 inch ,3- coilsLower lateral incisors – 0,014 inch ,3- coils

Important to take into account reciprocalImportant to take into account reciprocal
action of springs.action of springs.
Arch length held by either -:lingual ligatureArch length held by either -:lingual ligature
cinching archcinching arch
wire round MTwire round MT
Use spring – pin combinationUse spring – pin combination

Consists of a leg to fit through the verticalConsists of a leg to fit through the vertical
slot in the attachment,a helical loop andslot in the attachment,a helical loop and
an arm into which a hook is incorporatedan arm into which a hook is incorporated
running parallel to the main archrunning parallel to the main arch
When hook end latched to base wire makeWhen hook end latched to base wire make
sure lever arm lies parallel with the wiresure lever arm lies parallel with the wire

Function -:to torque the roots ofFunction -:to torque the roots of
maxillary anterior teeth.maxillary anterior teeth.
0.014 inch or 0.016 inch arch wire is0.014 inch or 0.016 inch arch wire is
usedused
vertical spurs 3-4 mm in height are bentvertical spurs 3-4 mm in height are bent
into the the arch wire to conform tointo the the arch wire to conform to
points just distal to the central andpoints just distal to the central and
lateral incisor brackets.lateral incisor brackets.
Force generated from horizontal sectionForce generated from horizontal section
of the auxillary when spurs areof the auxillary when spurs are
appplied to the labial surface ….andappplied to the labial surface ….and
transmitted via the spurstransmitted via the spurswww.indiandentalacademy.comwww.indiandentalacademy.com

The spurs must be angled to the labialThe spurs must be angled to the labial
surfaces of the incisorssurfaces of the incisors
the ends should terminate 2-3mm distalthe ends should terminate 2-3mm distal
to the cuspid bracketsto the cuspid brackets
Activation is done by forming it into anActivation is done by forming it into an
arc smaller than that of the anteriorarc smaller than that of the anterior
portion of the patients dental arch.portion of the patients dental arch.
Reason for constricted arch formReason for constricted arch form
thus inclination of teeth govern-: degreethus inclination of teeth govern-: degree
ofof

Reverse Torqueing AuxillaryReverse Torqueing Auxillary
Uses -: to upright labially inclinedUses -: to upright labially inclined
mandibular incisorsmandibular incisors
-: to retard further forward shift of-: to retard further forward shift of
the mandiblethe mandible

Lower Lingual TorqueingLower Lingual Torqueing
AuxillaryAuxillary

Bite deepens-:Bite deepens-:
1 ) class II elastics not worn) class II elastics not worn
1 excessive torque force on maxillaryexcessive torque force on maxillary
incisorsincisors
1 excessive force of caninie and premolarexcessive force of caninie and premolar
uprighting springsuprighting springs
1 insufficient gingival bow in base arch wireinsufficient gingival bow in base arch wire

Reappearance of overjet -:Reappearance of overjet -:
class II elatics not wornclass II elatics not worn
excessive torquing forceexcessive torquing force
Maxillary molars tip bucallyMaxillary molars tip bucally
1) not adequate constriction of base1) not adequate constriction of base
arch wire,torquing auxillaryarch wire,torquing auxillary
2)excessive or prolonged torquing force2)excessive or prolonged torquing force

Base arch wire cinched back withoutBase arch wire cinched back without
the required compensation in arch wirethe required compensation in arch wire
formform
Molars rotate mesiolinguallyMolars rotate mesiolingually
Incorrect placement of molar bucal tubeIncorrect placement of molar bucal tube
Distortion of arch wire in area of molarDistortion of arch wire in area of molar
Chinching back of arch wire withoutChinching back of arch wire without
required compensationrequired compensation

Anterior spaces openingAnterior spaces opening
Intermaxillary hooks contacting theIntermaxillary hooks contacting the
canine bracketscanine brackets
Intermaxillary hooks not ligated to theIntermaxillary hooks not ligated to the
canine bracketscanine brackets
Labial force of lowers against upperLabial force of lowers against upper
Incisors if bite has deepenedIncisors if bite has deepened
ClassIII incisor relation…prolongedClassIII incisor relation…prolonged
wearing of or excessive traction fromwearing of or excessive traction from
classII elasticsclassII elasticswww.indiandentalacademy.comwww.indiandentalacademy.com

Extrusion of teeth being uprightedExtrusion of teeth being uprighted
Failure to ligate base arch wireFailure to ligate base arch wire
too mesial positioning of anchor bendstoo mesial positioning of anchor bends
Failure of teeth to uprightFailure of teeth to upright
Related to springs….incorrectlyRelated to springs….incorrectly
formed,placed,distortion,interference informed,placed,distortion,interference in
their free slidingtheir free sliding
ligature tied on wrong sideligature tied on wrong side
overclosure of extraction spaces…overclosure of extraction spaces…
causing bands of neighbouring teeth tocausing bands of neighbouring teeth to
get caught on one anotherget caught on one anotherwww.indiandentalacademy.comwww.indiandentalacademy.com

Failure to achieve incisor torqueFailure to achieve incisor torque
Insufficient force from torquing auxillaryInsufficient force from torquing auxillary
Binding of arch wireBinding of arch wire
Maxillary incisors locked behindMaxillary incisors locked behind
mandibular incisorsmandibular incisors
Rotaion of canine/premolarRotaion of canine/premolar
Incorrect bracket placementIncorrect bracket placement
Distortion or improper placement ofDistortion or improper placement of
uprighting springuprighting spring
arm of spring not parallel to wire.arm of spring not parallel to wire.www.indiandentalacademy.comwww.indiandentalacademy.com

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