Begg's Technique-OrTHO / Orthodontic Courses by Indian Dental Academy

INDIAN DENTAL
ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
CONTENTS -
1.Introduction
2.Philosophy
3.Advantages
4.Disadvantages
5.The appliance components

INTRODUCTION
An orthodontic technique is defined as

A systematic sequence of clinical
procedures to achieve the correction of
malocclusion with a combination of
appliance
THE PHILOSOPHY
Attritional occlusion

Differential force

Light continuous force
1.ATTRITIONAL OCCLUSION
2.DIFFERENTIAL FORCE
Concept given by Dr.Begg in 1938

Storey and Smith

Optimal range of force values are
there, for every tooth that produces
the max. rate of tooth movement

1.To move the canines distally 150-
200gms

2.To move the molars mesially -300-
500gms

3.Forces less than this will cause no
discernible bodily movement of the
canine

The amount of force required to move
the teeth is in positive ratio to the
surface area of the tooth root,
attached to the periodontium

The ratio of the area of contact in the
canine : molar is appox. 3:8 (Storey and
Smith )
OPTIMAL FORCE VALUES
Thus , by increasing the force values
above the optimal force levels , causes
decreased rate of distal movement of
the canines , which finally approaches
ZERO

Further increase in the force value
causes the molars to move forwards
THE CONCEPT OF STOREY AND
SMITH
The concept of undermining resorption

UNDERMINING RESORPTION
excessive orthodontic forces

periodontal membrane and tooth
investing bone get compressed

Blood vessels compressed

blood supply cut off

inadequate blood supply causes necrosis

Almost no tooth movement till
hyalinized tissue is removed

Movement is intermittent & much
slower,when compared to light wire forces

LIGHT FORCES

Light forces donot cause pain n
discomfort to the patient

no loosening of the teeth,and causes
frontal resorption

Rapid tooth movement
DIFFERENTIAL FORCE
In physics and mechanics Differential
is defined as DIFFERENCE OF 2 OR
MORE MOTIONS OR PRESSURES

Differential force is defined as forces
which aid one another reciprocally when
they are used concurrently

A force that results in a different rate
of tooth movement at one end than the
other. (Mollenhauer)

Location, rate, and degree of the
change is determined by the relative
root areas, and mechanics at each end,
plus the amount of the force applied
EXAMPLES OF DIFFRENTIAL
FORCE APPLICATION
1.Reduction of anterior deep bite
anchor bends are given in upper and
lower 0.016 round arch wires ,mesial to
the molar tubes

Force is so light that anchor molars do
not appear to move at all and nor do
they tip.

Only clinically discernible movements
are, RAPID gingival movements of upper
and lower teeth

2.Closing of extraction spaces

Crowns of the 6-anterior teeth are tipped
back simultaneously by horizontal space
closing elastics rapidly without causing
much mesial movement of the 1
st

permanent molars.

CLOSING OF EXTRACTION
SPACES
Anchor bends in the arch wire prevent
the mesial tipping of the molars.

Anchor bends also give the roots of
anchor molars TOE-HOLD in the bone

TOOTH MOVEMENTS
In the Beggs technique, employment of
differential forces makes various
categories of tooth movements
simultaneously and far more efficiently.

EXAMPLES

1.Aligning crowded teeth

2.Opening deep bites

3.Closing open bites
5.Correcting antero-posterior relations

6.Correcting cross-bites

7.Correcting axial relations and

8.Guiding into occlusion unerupted and
impacted teeth

When several groups of tooth
movements are carried out
simultaneously with differential forces,
each group reciprocally aids all other
groups .Thus, each action is more
successfully and easily accomplished .

Thus, EXTRA-ORAL ANCHORAGE is
not required in the treatment of any
cases with this technique (because light
and differential forces are used)

There is no need to take arch wires off
at each appointment,
BECAUSE ,
the range over which the resilient fine
arch wires will move teeth without
reactivation is great
3.LIGHT FORCES
Excessive forces are unfavorable to the
tissues ( Storey and Smith)

Thus, round arch wires are used to
deliver light forces that result in rapid
tooth movement and less patient
discomfort
THE BRACKET SELECTION
Initially, TIE-BRACKETS were used ,but
they caused binding of thin round arch
wires as soon as the teeth tipped
mesially or distally

This binding of arch wires caused
excessive loss of anchorage and

This required, use of extra-oral
anchorage

A trial was then made with the
STANDARD RIBBON ARCH BRACKET


It was found too loose with 0.018 wire,
later 0.016 wires were THUS used

In light wire technique it is necessary to
use a bracket that will permit simple
labial, lingual, mesial and distal tipping
of the crowns of all teeth except the
anchor molars
EXTAORAL ANCHORAGE
With this technique the dental arches
are, as a result of applying differential
arch force and rubber ligature force
values, taken so far back in the jaws
that ample allowance is made for the
inevitable forward movement of the
dental arches
This usually occurs when axial
inclinations of the teeth are corrected
later in the treatment

Thus , extra-oral anchorage is never
required.

DISTINCTIVE FEATURES OF BEGGS
PHILOSOPHY AND TREATMENT
1.Beggs philosophy recognizes the fallacy
of always maintaining the full
complement of teeth, concludes that
extraction is necessary at times

2.Preparation of anchorage is often
unnecessary

3.Differential force
4.Light continuous force
5.Cold drawn, extra-hard , stainless
steel round wire, with good resiliency
and ZERO-STRESS RELAXATION is
used
6.Modified ribbon arch bracket is used.

(Wire and bracket have a single point of
contact in the vertical plane and
2-point contact in the horizontal plane)

7.Two successive tipping movements are
required to achieve bodily movement -
first to position the tooth crowns and
the second to position the tooth roots

The Begg technique is divided into 3-
stages without any over-lapping
STAGES

This is chiefly to prevent anchorage
failure

All tooth movements in each step are
done simultaneously

ADVANTAGES
Efficiency of treatment, as many
corrective tooth movements occur
simultaneously with little appliance
adjustment

Light forces are used, causes minimal
patient discomfort and tissue trauma

Rapid esthetic improvement,achieved by
early reduction of over-jet and quick
alignment of anterior teeth

Early correction of rotations ,probably
reducing relapse

Short treatment time due to rapidity of
tooth movements and simultaneous
execution of of many corrective tooth
movements

Efficient anchorage control


Quick and effective opening of deep
over-bites

En-masse movement of anterior and
posterior groups of teeth

Roots can be efficiently uprightned and
torqued

ability to torque a single root without
appreciable reciprocal effects on
adjacent teeth

Minimal demand of patient co-operation

Low cost of treatment

DISADVANTAGEOUS
The round arch wire and the ribbon arch
bracket relationship was unable to give
precise control required for fine
finishing.

Posterior root torque is difficult due to
wire-bracket relation

Rotational control is poor in 1
st
and 2
nd

stages of treatment with the use of
under size wire

During bite opening, true intrusion of
upper incisors was nil or minimal

Over-use of class II elastics caused-

1.Lack of upper incisor intrusion
2.Undesirable proclination of lower
incisor
3.Unfovourable tipping of mandibular
and occlusal planes

Uncontrolled tipping of the teeth which
occurs in the 1
st
and the 2
nd
stages
causes ROOT RESORPTION

Excess of uncontrolled tipping in the
first two stages necessitated a long 3
rd

stage for root corrections
Over emphasis on tooth material
reduction often resulted in ruined
profiles

There was no fail safe mechanism to
check the tipping or uprighting/torquing
movements , because the bracket
permitted excessive mesio-distal and
labio-lingual movements
THE BEGG APPLIANCE
COMPONENTS
COMPONENTS
1.Modified ribbon arch bracket

2.Molar tubes
a).Round b).Oval

c).Combination tube
Round molar tube
Internal diameter -0.036
Length 0.025

Oval molar tubes
Internal diameter -0.072x 0.024
Length 0.200

Molar attachments in Begg are designed
to permit free mesio-distal tipping

Usually 1
st
permanent molars are the
anchor teeth

2
nd
molar is used as the anchor tooth,
when 1
st
molar is missing or indicated
for extraction
3.Lock pin
a).First stage pins / One point safety lock
pins

Have shoulders that keeps the head of
the pin outside the bracket slot

shoulder
Head
Tail
Body
bevel
Thus, permits the use of the full height
of the slot

FULL HEIGHT
Permitting full freedom for sliding of
the teeth over the arch wire and their
tipping

Used - in the 1
st
stage of treatment
with 0.016 arch wire

Body of the lock pin reduces the arch
wire slot to 0.016

Beveled (one-point) under-surface of
the head permits free mesio-distal
tipping

BEVEL
b).Second stage safety lock-pin

Shoulder on head insures free mesio-
distal tipping, safety shoulders prevents
binding on arch wire

Body of the pin ,i.e the labio-lingual
width is dimensioned to fit properly in
TP 256-500 bracket in conjunction with
0.020arch wire ,used during stage II

Slot 0.020
3.HOOK PINS

Used in all teeth which donot require
mesio-distal uprighting during stage 3

Also, when more than one wire is to be
engaged


Absence of safety shoulder , along with
hook-shaped head , assures positive
locking of torqueing auxillary and the
main arch wire
4.High hat pin

Used during any stage when vertical
elastics are to be worn, extension over
the head facilitates engagement of
elastics

Allows free sliding
and tipping
5.T-Pin

Meant to be used as BRAKES in the
finishing stage when corrected
angulations of teeth have to be
maintained

There are two types
of t-pins
Angulated and
Non-angulated

ARCH WIRES
Australian arch wire is used (A.J -
WILCOCK)

Round , high tensile strength , stainless
steel wires, heat treated and cold drawn
are used

The various grades of AUSTRALIAN
WIRES available are
1.Regular (White)
2.Regular plus (Green)

3.Special (Black)
4.Special plus (Orange)
5.Extra special plus (Blue)

Recently 3-more newer grades have be
added
6.Premium
7.Premium plus
8.Supreme

PROPERTIES OF AUSTRALIAN WIRE

a).Higher tensile strength
b).Greater working range
c).Good flexibility /Spring back
d).Good resieliency (greater resistance to
permanent deformation as well as
greater release of energy on
deactivation)
e)Zero- stress relaxation
f)Good toughness
The wire is extremely tough and should
be bent slowly or otherwise breaks

A quick bend fractures through the
metallic crystals ,whereas slow bending
gives crystals time to flow into new
shapes without fracturing
Wire is more likely
to break when the
round beak rather
than the flat beak
is used

With round beak the two points of
stress are directly opposite to each
other

Forces
Off-set
Stress-
concentration
Also , bending along the flat beak
provides a greater area to dissipate the
stresses , whereas around the round
beak the stress on the crystalline
structure is confined to a small area

OTHER AUXILLARIES USED
1.Elastics force exerted is 60-70 gms
2.Elastic tie material- To derotate teeth
or to guide eruption of teeth
3.Stainless steel ligatures
4.Elastomeric rings -1.5-2.0 mm dia
5.Lingual buttons
6.Ball-end hooks
SUMMARY
Finally , it is the philosophy of Light
continuous forces , use of differential
forces and balance of arch length and
tooth material which is the key
foundation of this technique of
treatment.
Further advances in the material sciences and
advent of newer wires has refined this
technique to advancement and bettement.
REFERENCES
1.Begg and Kesling -3
rd
edition
2.Mollenhauers manual
3.Fletcher The Begg appliance and
technique
4.Cadman article
5.Refined begg
6.Graber and swain
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