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BEGG’S PHILOSOPHY AND

TECHNIQUE
VIBHATI
P.G.III Year
DEPARTMENT OF ORTHODONTICS
 Contents
2
• HISTORY

• BEGGS PHILOSOPHY

• BEGGS TECHNIQUE

COMPONENTS

STAGE I

STAGE II

STAGE III

• ADVANTAGES/DISADVANTAGES OF BEGG’S TECHNIQUE

• DIFFERENCE B/W EDGEWISE AND BEGG’S TECHNIQUE

• CONCLUSION & REFRENCES

 3

Dr P.R Begg was born in 1898 in a small, gold mining town

Coolgardie, West, Australia.

Grew up in south Australia. As a boy he saw the sketch of

Australia aborginal and noticed their teeth were worn flat and
no one thought to tell him why or how it happened.
 4

• In his early twenties he worked as a Jackaroo at Boonoke-

a sheep and cattle station in New south Australia, looking
after both cattle and sheep.

• 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 dentistry.

 5

• In 1923 he received his Bachelor of Dental Science from

the University of Melbourne and then spent two years at
the Angle School of Orthodontia in Pasedena, California,
under Dr. Edward Angle, who is remembered as the
father of modern orthodontia.

• At the commencement of third year of training, Dr Begg

decided to practice orthodontics after graduating in
dentistry.
 6

• 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.
 7

• In 1924-1925, Dr. Spenser Atkinson demonstrated to the

students that it was normal for the upper first permanent
molars to move continuously mesially throughout life. Dr.
Angle referred to this as the ‘anterior component of

force’.

• He observed that the process of mesial migration is

intimately related to tooth attrition. Mesial migration and
attrition of teeth, acting together, play an important role in
the development of human dentition and in the anatomy
of dental arches.
 8

• 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
Orthodontics in Adelaide, South Australia.
 9

• However in many of his patients he was’nt satisfied with

post treatment profiles and there was the serious
problem of relapses.

• In February of 1928 he began to routinely remove the

teeth or reduce tooth width by mesio distal stripping in
patients with excess tooth substance.
 10

• He learnt from experience and his ever – growing appreciation

of the role of attritional occlusion in the development of man’s
dentition, that such reduction was often necessary to permit

the proper repositioning of the teeth to enhance function,

stability and esthetics.

 11

 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 0.020’’ 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.
 12

• He soon realized that if round arch wire were engaged in

edgewise brackets, indiscriminate and often undesired
root moving forces could be created and this prolonged
the anterior bite opening and taxed intraoral anchorage.

Anterior movement of dental arches

 13

• Dr. Begg faced the openings of the brackets slots of the

ribbon arch brackets gingivally, instead of incisally as
advocated by 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 and tooth control with the use of

smaller round wires in the Ribbon Arch Brackets, Dr. Begg
filled their bases before soldering them to the bands. This
reduced the widths of the arch wire slots.
 14

 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.

 15

• This unusual wire permitted to open anterior over bites,

while controlling arch form and providing molar stability.

 16

• Dr. Begg's first publication in 1926 and subsequent articles

reflected his interest in normal occlusion and etiology of
malocclusion. A Doctorate of Dental Science from the
University of Adelaide was conferred on him in 1935. The
title of his dissertation was ‘Some Aspects of the Etiology of
irregularity and Malocclusion of the Teeth’.
 17

• The series of articles on "Stone Age Man's Dentition" and

the "Light Arch Wire Technique" which appeared in the
AMERICAN JOURNAL OF ORTHODONTICS during 1954
and 1956 established him as an orthodontist of international
renown.

• In 1956 (Am Jr) Dr. Begg had another article published

entitled, Differential Force in orthodontic Treatment.
 18

• 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.
 In the years between Dr. Kesling’s first visit in 1957 and
19

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.
 20

3. Developed root torqueing auxiliaries separate from the

main arch wire.

4. Introduced mesiodistal uprighting springs.

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.
 21

BEGG’S PHILOSOPHY
 22
They were:

1.Theory of attritional occlusion

2.Theory of differential forces

• The Begg differential force technique is a unique approach

to orthodontic treatment. The philosophy behind it,
including diagnosis, method and direction of tooth
movement, is keyed to attritional occlusion.
 23

 Dr.Begg’s studies of stone age Man’s dentition indicate

that man’s occlusion is not static, but an ever changing
one.The teeth continually migrate mesially and vertically
and compensate for the attrition of their proximal and
occluso – incisal surfaces. The absence of attrition
caused by civilized man’s soft diet does not eliminate the
migration of teeth.
 24

 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 is removed.

 The differential force technique is designed to permit

teeth to move towards their anatomically correct positions
in the jaws under the influence of very light forces – as
would occur naturally in the presence of attrition.
 25

 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.
 26
 Another feature is that the movement of all the teeth
towards and beyond their desired final positions is initiated
at the start of treatment i.e, the movement of the teeth is not
segmented into groups with one group waiting for another.

 Both archwires and intermaxillary elastics are applied at a

appointment causing immediate reduction of deep overbite
and over jets. The discomfort caused by the initiation of
tooth movement produces a change in eating and biting
habits that lessens the chance for appliance damage.
 27

 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 28

A diagnosis and treatment plan that recognizes the

persistence of hereditary forces of mesial migration and
vertical eruption of teeth and has its objectives for the over
correction of malrelationships of both teeth and jaws.

The simultaneous movement of all teeth. From the beginning

of treatment each tooth is directed towards its final position in
the dental arch.
 29

 The total separation of root moving forces from arch wire

forces during the final third stage of treatment.

 The application of proper elastic forces to create the desired

differential movement of the teeth.

 The use of light round continuous arch wire bend 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.
 30

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.

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.
31
 32

Dr. Begg described a treatment approach based on the

following hypotheses which were backed to some extent by
his own researches.

 Theory of attritional occlusion

 Theory of differential forces

 The employment of a modified form of ribbon arch bracket

and light guage round archwire.

 33

THE THEORY OF ATTRITIONAL OCCLUSION

• 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.
 34

Dr. Begg noticed that the teeth of Aborigines. They had:

1. not only extensive occlusal and interproximal wear

2. total lack of :
I. Caries
II. periodontal disease
III. tooth crowding.
•Hard, coarse and gritty food 35

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.
 36

• 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
 37
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.
• This eruption is often clinically misinterpreted as gingival
38
recession, when in fact it is the teeth that are erupting,
and the gingival margin that is remaining relatively
stationary. The rate of eruption and varies among
individuals

• The course and gritty diet that causes attrition also

controls caries and help prevent periodontal problems.
Pit and fissures are quickly reduced by occlusal wear,
thereby eliminating the focus of most caries in civilized
man

• The diet itself is low in carbohydrates and its coarseness

and high volume prevents the tendency for plaque
accumulation without which there will be no dental
decay.
 39

• In primitive man the excessive occlusal forces of mastication

retard this eruption to a rate harmonious with the progression
of attritional wear. If an individual lived long enough, continual
eruption and attritional occlusion would result in the shedding
of the apical portion of the root.
 40

• Gingival embrasure areas

(black triangles) in
civilized Man become
larger with age, due to
lack of proximal wear.

• In primitive man the

interdental space remains
small, since the teeth
move together as the
proximal surfaces are
worn flat –creating large
broad contact areas.
 Eruption of first permanent molars
41

The edge to edge anterior tooth relationship

lower teeth being further forward in relation to

the upper teeth

the mandibular second deciduous molars are

mesial to the maxillary deciduous second
molars.

The lower first permanent molar is then able to

erupt in a more mesial position and proper
initial relationship with the maxillary first
permanent molar is achieved.
 42
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
 43
Proximal wear

• In attritional occlusion, deciduous teeth are worn away

quickly, both proximally and occlusally. The proximal wear
can result in increased space for later erupting canine.

• In civilized man due to lack of proximal attrition ,the

permanent canines frequently lack adequate space for
eruption.
 Eruption of third molars 44

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.

At the age of 12 to 13 years

the third molar begin to
erupt in attritional occlusion.
 45
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.
 46
Incidence of crowding

• Since attrition especially interproximally causes a

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

• The persistence of large teeth and the processes of

mesial migration in civilized man explain the current
relatively high incidence of tooth crowding.
 47

Normal occlusion in young

adult of present day

Normal occlusion in
primitive times.
 48

Dr.Begg used the findings from his study of australian aboriginal

occlusions as a justification to extraction. He argues that if in
this present era tooth material is not lost through attrition, it
would be reasonable to cause a commensurate reduction
artificially through extraction.

However, care should be taken to restrict the employment of

extraction within logical limits. Thus the extraction approach in
orthodontic treatment came into existence.
 THEORY OF DIFFERENTIAL FORCES 49

• The theory of differential forces in it’s original form was

described by Dr.Begg in an article AJO{1956}, his observation
was based to a large extent on the work of Storey and Smith.

• The range of light pressures which would cause the teeth to

move at an optimum rate with minimal disturbance of the
supporting tissues.

• Pressures below this range would produce a slow rate of

response while those above incurred a reaction within the
bone support, referred as “undermining resorption”.
 50

Applying these principles to the begg technique, the force of the

intermaxillary elastics used in stage I of treatment ,was kept
light so that the upper labial segment was retracted while the
lower anchor molars has negligible mesial movement. Later, if it
was required that the residual extraction spaces should be
closed largely by the mesial movement of the posterior teeth,
the elastic forces are increased so that the anterior segment
with their relatively small root area received an excess of force
sufficient to delay their movement, while the posteriors moved
forward.
a. A force of less than 150
grams causes no distal bodily
movement of canine.
b. A force of 150 -200 grams
is optimum to move canine
distally.
c. A force of 300-500 grams
causes the molars to move
easily. This high force is
resisted by the tissues
investing the canine root, thus
affording anchorage for
mesial movement of molars.

51
 The meaning of differential orthodontic52
force.

In physics and mechanics, differential is defined as the

difference of two or more motions or pressures. The
orthodontic force values used in this technique cause:
1. Minimum discomfort
2. Minimum loosening of teeth.
3. Minimum damage to tooth investing tissues.
4. Rapid tooth movement
5. Easily controllable forces.
 53
The forces that are most favorable for tooth movement on
the standpoint of rapidity and tissue tolerance are according
to Storey and Smith much lower than that exerted by edge
wise archwire.
According to Halderson, Johns and Moyers, the force
exerted by edgewise archwire is of very high value of over 2
pounds or 900 grams which causes a pathogenic tissue
response.
Hence, they advocated the use of light round wires as;
• It takes as much advantage of tipping movements as is
possible.
• It utilizes forces much lighter than are possible with a
standard edgewise wire.
 54

Concept of undermining resorption

According to the concept of undermining resorption, excessive
orthodontic forces ,when exerted on teeth cause the periodontal
membrane and tooth-investing bone to be compressed. This
causes the occlusion of blood vessels and the blood supply is cut
off in these areas. This inadequate blood supply causes necrosis
of the compressed parts of the periodontal membrane and bone
which leads to no tooth movement until phagocytic action
removes the necrosed tissues and until new living tissues form.
This excessive force also causes pain and loosens teeth.
The effect of this process is that teeth do not move continually
55 but
intermittently and much slower than when lighter orthodontic
force is used.

On the other hand, if lighter and appropriate orthodontic force is

applied ,the periodontal blood vessels are not occluded so that the
bone on the side of pressure is continually and rapidly resorbed
and new bone is simultaneously formed on the side of negative
pressure without any discomfort and loosening of teeth.

heavy force – intermittent movement.

light force - continual flow of uninterrupted tooth movement.

 Case selection criteria for selection of 56

Begg case

 The patients interest in his personal appearance and

health

 Patient interest matches with practical ability to attend

regularly at prescribed intervals over the treatment period

 The parent and patient have been given to understand

precisely the nature and duration of proposed treatment
and what is required if success is to be achieved
 57
Clinically:

 Low mandibular plane angle

 Adequate thickness of labial cortical bone
 58

BEGG’S TECHNIQUE
 59
COMPONENTS OF BEGG APPLIANCE

ARCH WIRE MATERIAL

Round austenitic stainless steel

wire of 0.016 inch diameter, which
has been heat treated and cold
drawn down to its proper diameter,
in order to give it the required
properties of resiliency, toughness
and tensile strength. – without
which this technique could not
have been developed and cannot
be employed.
 60
SIX TYPES OF AUSTRALIAN WIRE

Regular grade
- Lowest grade – easy to bend
- Used for practice bending and forming auxiliaries.

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.

Special grade
- Highly resilient yet can be formed into shape.
 61

Special plus grade

- Hardness and resiliency of 0.016” wire, is excellent for
supporting anchorage, and reducing deep overbites.
- Must be bent with care.

Extra special plus grade

- Also called premium plus
- This grade is unequalled in resiliency and
hardness.
- More difficult to bend and more subjected to fracture.
 62

Supreme grade:
- 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.
 63
BAND MATERIAL

• These bands made of stainless steel strips of different

size and thickness are recommended for different teeth.
These are available in 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
 BANDS 64

 Pinched or preformed bands

 Bands extended to the gingival margin for added protection
in patients with high caries rate.
 The additional coverage can be achieved by spot welding
aprons to conventional bands or by pinching bands from
specialy formed blanks.
 Preformed bands with prewelded brackets
 Buccal tube 65

 Round molar tubes with 0.036”ID and 0.250” length are routinely
used.
 Flat oval buccal tubes with 0.072x0.024”ID and 5mm length are
used with double back round arch wires than rectangular tubes
 Flat oval and double back arch wire is used when second permanent
molar is used as the anchor and also when the lower premolar is
missing
 Interchangeable type of molar tube permits switching from a double
arch wire to a straight back arch wire without losing mechanical
advantages
 BRACKETS 66

 The high flange brackets are preferred over the taper

flange because high flange possess a wider welding
surface which makes them less liable to distortion.
Modified ribbon arch bracket (TP256-500) in the light wire
technique
 The brackets are manufactured to accept 0.016”
diameter arch wire or a 0.020” diameter wire.
 The depth of the slot is 0.020” and height been 0.045”.
The dimensions of bracket base been 3mmx3mm.
 67
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.

These brackets are fabricated from stainless steel strips,

hence it is economical.
 TYPES 68

A. 1. Full flange
2.Half flange

B. 1. Bondable
2. Weldable

C. 1.Flat
2. Curved

 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.
 LOCKPINS 69

1. One-point safety lock pin:

 First stage of treatment with .016 inch archwire.
 Shoulder on labial surface of the head strikes bracket to
prevent impingement of pin and the archwire.
 Beveled undersurface of head leaves adequate space for
tipping.
2. Second stage lock pin: 70

Safety shoulder prevents binding on archwires.

The body of the pin is dimensioned to fit properly the bracket

in conjunction with 0.020 inch arch wire, as recommended
during stage II.

3. Hook lock pin:

Used on all teeth that do not require mesiodistal up righting

during stage III.

4. High hat lock pin:

 When vertical elastics are to be worn.

 ELASTICS 71

 Elastics (latex or rubber) is used which will exert a

force of 60 to 70 gm.

 Elastic tie material is used to provide force rotate or

erupt teeth.

 Elastic thread or elastomeric filament is used for

extreme light forces
To open the bite 72

To correct the mesiodistal relationship of buccal

segments
To close the anterior spacing
Corection of rotation
Posterior crossbite corection
 LINGUAL BUTTON 73

 This is to permit free mesio distal tipping or uprighting of

the teeth.
 Should be positioned directly opposite the areas of
archwire engagement on the opposite side of the teeth.
This is necessary to permit free mesiodistal tipping and
uprighting of the teeth.
 If the lingual button is placed incisal or occlusal to the
level of base of arch wire the steel ligature would loosen
or tighten during mesio distal uprighting.
 74
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 75

 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
 76
SEPARATING SPRING
 BRACKET PLACEMENT 77

Brackets are centered mesio distally on the labial or buccal

surface with the base of the arch wire slot 4mm from the
incisal edge of cusp tips. Only exception is maxillary lateral
incisor where 3.5mm from the incisal edge is placed.
 BUCCAL TUBE PLACEMENT 78

Molar tubes should be parallel to the occlusal surface

when viewed from buccal and parallel with a line bisecting
the occlusal surface mesiodistally.
 79

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 80

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 81

• 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
 82

Intermaxillary Hooks – ( IMH )

Small loops for engaging elastics and cuspid ties.

 2 types –
 Z shaped/boot type
 Circle/ oval

 Adv. of Circle hook

 Mesial & Distal rolling possible
 Less space requirement
 Less distortion
Location 83

• Well aligned anteriors – 1-2 mm mesial to the cuspid

bracket.
• Spaced anteriors – Further mesially.
• Mildly crowded anteriors – impinging on the bracket.

• Z shaped: are angulated buccaly away from the

vertical, in order to avoid any possibility of wedging
of distal arm of loop.
 Cuspid Offset bend 84

• 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.
 85
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
 86

 Amount of bend varies from case to case

 The leverage force incorporated on the incisors should be

around 65mg

 Greater force tend to eventually cause lingual rolling and

distal tilting of molars

 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
 87
Checking
 88

Angulation depends on

• Stage of treatment - decreases as stage progresses.

• Depth of overbite - decreases with bite opening.

• Rate of progress of case.

 VERTICAL LOOPS 89

 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
90
 91

Contraction Loop in midline

with incisor stops to tip
crowns of upper centrals

Vertical loops bent in

case of high frenum
attachment
 92
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 93

 In the Stage I of treatment of Class II 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 94

No ties between intermaxillary hooks and cuspid brackets

cuspid tip distally the arch wire

Spacing
 OFFSET BENDS 95

 In Anterior segment
Vertical offset - To Intrude or Extrude
Horizontal offset - to Expand, contract and rotate
 In posterior segment
Gingival offset - to avoid occlusal distortion and
interference with bicuspids
 BAYONET BENDS 96

 It is inadvisable to use bayonet bends for active correction,

because of the tendency for round archwire to rotate
within bracket slots causing the bayonet bend to become
ineffective or supply movement in wrong plane

 Commonly used passively to retain overcorrection brought

about via previously looped arch.
 ROTATIONS OF CUSPID AND BICUSPID 97

Correction may be achieved by using either :-

1. elastic threads

2. rotating springs
Rotation springs 98

• Most efficient & versatile mean

• 0.014” & 0.016”
• Vertical leg inserted in bracket slot from gingival side, holding
activating arm perpendicular to labial surface.
 ROTATION OF MOLARS 99

• Incorporation of toe-in or toe-out bends

• Elastic ligature ties

• Recurved arch wire for molar tilt

Attaching the archwire to severely rotated 100
molar
Placement of offsets and bayonet bends in 101

plain arch wire

 PROBLEMS ARISING IN STAGE I
102

• Bite not opening

• Molar width narrowing ( usually the mandibular molars)

• Adverse tipping of anchor molars

• No appreciable changes

• Elastics which break or do not stay on

• Lock pins lost

• Extremely mobile molars

• Lower anteriors tipping labially

• Anterior open bite not closing

• Tooth not rotating

• Midline discrepancy
103
 104

STAGE II
OBJECTIVES:

1. Maintain all corrections achieved during first stage.

2. Close any remaining posterior space.

ARCH WIRE ( 0.018 OR 0.020 SS)

LOCK PIN: Stage 2 safety lock pins

 105

CLOSING OF ANY REMAINING

POSTERIOR SPACE

• Proper application of elastics

106
 107
CONTROL OF BICUSPID HEIGHT
 108

• Sometimes in stage 2 mesialisation of the anchor

tooth is desirable..

• Achieved 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 109

• To establish anchorage in the anterior segment..

1. Passive uprighting springs on mandibular canine.

2. The lower anterior braking arches
 110

FUNCTION OF THESE AUXILIARIES

Establish two point contact between the teeth and

archwire

prevent free tipping

Starts to function as anchor teeth

 111
SHORTENING LENGTH OF DOUBLED-
BACK ARCH WIRES
 PROBLEM ENCOUNTERED DURING 112

SECOND STAGE

• Anterior bite closing

• Anterior teeth assuming a Class III relationship
• Space developing between the anterior teeth
• Anchor molars rotating distobuccally
• Cuspid roots bulging on labial plate of alveolar bone.
• Posterior spaces not closing
• Second bicuspids tipping mesially in first bicuspid
extraction space.
• Mandibular anteriors achieving desired lingual
inclination before posterior spaces are completely
closed.
At the end of second stage 113
 114

STAGE III
 115

STAGE III

• OBJECTIVES:

1. Maintain all corrections achieved during first

and second stages.

2. Achieve desired axial inclinations of all teeth.

 116
STAGE 3 UPPER AND LOWER ARCH WIRE
Molar offset bends along with
• Made from 0.020 SS constriction of the archwire in
distal ends

Permit the engagement of the

archwire in the bicuspid
brackets and to counteract the
widening effect of max.
torquing auxillary

Gingival bend distal to Counteract the occlusal vectors of force

cuspid created by ant. lingual auxillaries
 117
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 torqueing auxiliaries.
Original Spring: Smaller & fewer coils. 118

A longer lever arm.

Refinement of original spring: Larger more resilient coils

Short lever arm.
 119

ACTIVE ARM WITH HELIX

HOOK AT THE END

RETENTIVE ARM
 120

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.
 121

• 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.
 122

 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

 123

SPRING PIN

• A Combination of a Lock Pin and an Uprighting

Spring
 124

TEETH REQUIRING UPRIGHTING

 125
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..

 126

FOUR SPUR TORQUEING AUXILLARY

• Used for torqueing the upper anterior roots palatally

• Bend with 0.014 or 0.016” wire

ACTIVATING THE AUXILIARY 127
128
 129

OTHER TORQUING
AUXILIARIES USED:
 130

TWO SPUR TORQUEING AUXILLARY

• Used when lateral incisors

do not require palatal root
torquing.
 131

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.
 132

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.
 133

ONE TO ONE TORQUEING AUXILIARY

• Indicated when two adjacent teeth require root
torque in opposite directions.
 134

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 torqueing “bars” do
not extend to the gingiva.
 135

VERTICAL SPUR IN THE MAIN ARCH

WIRE
 136

REVERSE TORQUEING AUXILIARY

• Indicated if lower anterior teeth are becoming too

proclined.

• For labial root torque

 137

For lingual root torque By Dr. John Kitchton

 138
PROBLEMS ENCOUNTERED DURING
STAGE III

• Maxillary Molars Widening

• Mandibular molars narrowing
• Anterior bite deepening
• Teeth not up righting mesiodistally
• Max. anterior teeth not torqueing palatally
 STAGE MODELS. 139

The importance of stage models as told by Dr. A Rocke:

1.To check the arch contour and width.
2.To check the inclination of upper and lower anterior teeth.
3.Self-discipline to complete each stage before proceeding
to the next.
4.To determine the teeth movement.
5.To gain insight into anchorage maintained in the
treatment.
6.Visual aid for patients and parents.
7.Visual aid for referring dentists the possibility of anterior
torquing..
 BEGG TECHNIQUE-TIME SAVING PROCEDURE
140

The light round archwire differential force treatment technique:

1.Gives superior final treatment results
2.Gives less patient discomfort
3.The overall treatment time is materially shortened
4.Fewer interim appliance adjustments are required
5.Chairside time is greatly reduced
 Most other methods involve 25 or more adjustments of
appliances which must be worn from 2 to 4 years with patient
visits spaced at 2 to 3 week intervals. In contrast, begg
technique normally requires an appliance to be worn for 10-20
months ,with far fewer adjustments and with patient visits
spaced at 6 week intervals..
 Advantages of Begg’s appliance:
141
 Efficiency of treatment , because many corrective tooth
movements occur simultaneously with relative little
appliance adjustment

 Minimal patient discomfort and minimal trauma to the

hard and soft tissues as a result of the use the light and
continuous force

 Rapid esthetic improvement, achieved by early reduction

of overjet and alignment of anterior teeth

 Early correction and overcorrection of rotations, possibly

reducing relapse after treatment

 Short treatment time resulting from the rapidity of the

tooth movement
 Disadvantages: 142

 Patient cooperation is critical for successful treatment

with Begg technique
 Distortion of the light arch wires by mastication of tough
foods or biting hard objects
 Auxiliary used in stage III constitute a hazard to
maintenance of oral hygiene
 Tissue trauma is thought to occur at the alveolar crest as
a result of tipping & root resorption from excessive
tipping of the apices of maxillary incisors
 143

 Steepening of an existing high mandibular plane angle

may occur as a result of Class II intermaxillary traction
 Unpleasing flattening of the lips may occur during Stage I
and Stage II
 Lack of understanding of the complex dynamics of force
 Difference between Begg and Edge wise144
Appliance
 In an Edge wise when the rectangular arch wire is held to
each tooth by being engaged in its bracket that accurately
fits the arch wire, force is immediately exerted that moves
the ROOT of each tooth.
 It is impossible to tip crowns when the rectangular arch
wires either Ribbon arch or Edgewise arch, engage their
brackets.
 The light wire differential force technique employs forces
which are most physiologically acceptable to the tissues
and move teeth most rapidly.
 The excessive force delivered by edgewise limits tooth
moving efficiency.
 145

 In edgewise there is simultaneous movement of the anchor &

the teeth to be moved. Periodontal tissues resist high forces;
therefore the distance a teeth can be torqued is relatively
small.
 With edgewise mechanism there is considerable anterior
movement of the dental arch as a whole because of greater
mesio distal dimension of the bracket.

In Begg the small mesio distal dimension of the bracket freely

permits mesial or distal tipping of tooth crowns with less mesial
or distal force on the roots.
 146

A. When the arch wire is engaged in an edgewise bracket

with wide mesiodistal slot, force is transmitted to the root of
the tooth. This can cause midline discrepancies and anterior
movement of the dental arches.
B. Ribbon arch bracket and round arch wire allow freedom
of tipping in all directions and prevent undesirable forces to
the root.
 147

 In the Edgewise arch wire appliance the need for

extra oral anchorage is great in order to counteract
the tooth root-moving forces that cause anterior
movement of the dental arches.

 The light arch wire technique has eliminated the need

for extraoral anchorage.
 CONCLUSION 148

Inspite of the fact that Dr.Begg was born to an industrial

executive, and that he could have very well made a fortune
in business, he chose to bring smiles in people’s lives
around the world.

The development of Dr.Begg’s different way of orthodontic

therapy was not the result of a single discovery but rather, the
product of a long tedious ,well organised trial and error
process.
 149
.
When correctly applied,his light archwire technique can
produce universal tooth movement with light optimum
forces,least discomfort to patients ,minimum loosening of teeth
and least injury to tooth investing tissues.

Dr.Begg’s theory does not depend upon cephalometrics to

establish angulations nor does it require complicated
engineering formulae for moving teeth.

Because the begg technique,requires shorter time,it does not

mean that it is a “snap” method requiring less orthodontic skill
or ingenuity
 150

REFERENCES

BEGG ORTHODONTIC THEORY AND TECHNIQUE :

BEGG AND KESLING.