INDIAN DENTAL ACADEMYLeader in continuing dental education
BEGGS TECHNIQUE – 3rd STAGE
Patients at the beginning of third stage show variation in occlussion from a class I to class II relationship through
the buccal segments and an edge to edge bite on the anteriors.
All the anteriors are tipped mesially and the molars upright.
Encompasses procedures to restore the teeth to their correct axial inclination.
Mastery over the intricasies involved in the third stage can mean all the difference between delight and defeat in most cases treated with the Begg appliance
Stage three Begg is Divided into a)Base archwires b)Auxiliaries Base Archwires are the backbone that
shape the outcome of the effort put in. Auxiliaries can be either a) Torquing Auxiliary b) Paralleling Auxiliary
Function of Base archwire
Is mainly to maintain the arch form and arch symmetry achieved during the earlier stages as the auxiliaries used in this stage tend to distort the results achieved previously
To provide anchorage for certain movements carried out by the auxiliaries
Requirements of Base archwire
They need to be a)Sufficiently rigid b)Simple to fabricate c) Should not have a complex nature d)Should not harm the tissues
Consideration during fabrication of Base archwires Diameter of the wire a)Type and extent of root torque
required b)The diameter of the uprighting
spring used c)The design of the springs used
FORM OF THE BASE ARCHES In the Begg technique over retraction of
the anterior teeth place very high torque demands in most extraction cases
such situations would create considerable expansile counter moments hence the base archwires had to be excessively contracted across the molars in the upper arch.
Lower arch wire is slightly expanded to prevent lower molars rolling lingually from continued class II elastic wear during stage III
Both the upper and lower .020 third stage archwires have a slight bite opening bend distal to the cuspids
Anchor bends in the upper archwire are very slight more if the molars are tipped distally whereas lower anchor bends are bit more pronounced
Auxiliaries used in third stage Begg.
Auxiliaries can either be a)Torquing Auxiliaries b) Uprighting /Paralelling
Torquing auxiliary used in the Begg technique is the most important single mechanism in the system.
Chourie in 1965 in his thesis sugested that length of the torque spur loop exerts an affect upon the amount of force delivered to the root tip.
Newmann in 1963 presented a formula for calculating the force at the apex of the incissors
2Ld Ø is the angle in radians G is the average modulus of rigidity of
stainless steel ¶ is a constant L is length of the wire D is the distance from root apex to bracket area r is the radius of the wire
Barrer in 1963 suggested the acuteness of the angle between the torquing spur and the horizontal plane
Brandt in 1962 was aware that the acuteness of the angle between the torquing spurs and the horizontal plane of the arch wire
Factors which alter the force values of an auxiliary are
Type of wire Diameter of the wire Size of the circle length of the spurs angle the spur makes with the plane of the
auxiliary Axial inclination of the teeth Intercanine distance of the maxillary denture
THE VARIOUS TORQUING AUXILLARIES
USED ARE Four spur anterior torquing auxiliaries Two spur Reciprocal torquing auxiliary Short four spur auxiliary Individual torquing One to one reciprocal torquing Lower reverse torquing auxiliary Mouse trap torque and U-springs- udder arches----
Other Torquing Auxiliaries are
Art four spur Modified four spur arch Kitchton two finger spring F & J two spur arch Von Der Heydt two spur arch Modified reverse torque arch Sain reverse torque arch
Kitchton Torquing Auxiliary
It is recommended that this auxiliary be used in conjunction with a heavy archwire
Modification done on the archwire distal to the central incissors
To counteract the raising of the arch distal to the lateral hooks of the auxiliary
Two types of auxiliaries a)two tooth b)four tooth Base of the helix is opened and the auxiliary
stradles the archwire secured by a ligature Modification to the Four tooth auxiliary is
done by making the horizontal part half moon shaped to contact the lateral incissor area.
Problems encountered during torquing. Undesirable changes in the arch form
Mesial migration of posterior teeth
Uprighting or Root paralelling Auxiliaries The helical “Uprigting spring”is the most
efficient root tipping auxiliary Consists of a leg to fit through the vertical
slot in the attachment,a helical loop and an arm into which a hook is incorporated running parallel to the main arch
The helices and the arms of the spring has to be in the same plane as to the long axis of the tooth and the arch.
Constucted of .014/.016 for cuspids and premolars.
In extraction cases springs should be used on both teeth adjacent to the extraction site
More recently springs with smaller helices and shorter arms have been utilized
Made from .010’supreme wires
can be usable on any bracket
they can be used in conjunction with lock pins
Advantages are a) improved aesthetics b) improved hygiene c)these springs were kinder to the
anchorage Disadvantages a)they fall out easily
Modern Begg The principles have not changed but it
looks different. The use of 2 spur is more as this leads to
less flaring of molars and better control. Uprighting springs used are of the short
self locking type. More attention is paid to the second
. The extensive use of reciprocal torque on central and lateral incissors have been advocated
Recent trends indicate more of a non extraction treatment plan
this means more use of auxiliaries like head gears , lip bumper, sliding jigs etc.
cases with vertical growth pattern use of class II elastiscs is avoided as much as possible
Thompson -CAT system tries to combine the favours of Begg technique with the finishing of straight wire
A new approach to the finishing stage was suggested by Dr.Barry Mollenuer in 1988.
He suggested using Alpha-Beta-Titanium rectangular wires.
These wires are more comfortable to the patient in comparison with other wires of similar dimensions
Drawback being these wires become brittle after six weeks
Sequence of insertion of Archwires and Auxiliaries The base arch wires are inserted
unpinned but fitting well upto the Begg slot
Arch wires are cinched distal to the molars to prevent the spaces from opening up
Depending on the need for torquing the torquing auxiliary is fabricated
In the lower arch only uprighting springs are inserted unless labial/lingual torque is needed
direct the lower arms towards the root movement intended
insert the vertical leg into the pin slot pull it occlusally so the spring lock holds the archwire firmly
bend this vertical leg towards the root movement intended
to activate hook the lever arm to the main archwire.
After the root tipping movements of the third stage are completed remove the torquing and paralleling auxiliaries and make adjustments in the base archwire to complete the treatment.
To flatten the occlusial plane make localized vertical offset bends to level individual teeth
to obtain bilateral symmetry make definate localized horizontal offset bends to expand or contract induividual teeth and make the arch symmetrical
Overcorrection and overrotation are maintained
Additional finishing is done with the tooth positioner
the tooth positioner helps to attain a precise positioning of individual teeth than that attainable with the third stage auxiliaries
Summary and Conclusion
One needs a lot of perseverence to reach proficiency as shown the various auxiliaries and modification in the Begg technique have given the orthodontist inumerable ways of achieving the objectives of the procedure. We as Orthodontists should go ahead and put them to judicious and profitable use.
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