Modern Begg –
Beddtiot & CAT Techniques.
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacade...
Introduction

Conventional Begg – empirical and cook book
trt.
Begg operators
– limitations
- need to diverge from orthodo...
Modern Begg.
Follows Begg principles – large extent.
Brackets – modified ( other than Ribbon arch
type – used in conventio...
BEDDTIOT.
(Begg Edgewise Diagnosis Determined
Totally Individualised Orthodontic
Technique.)
Offers capacity to employ sel...
 Strong points in Begg Technique:
Proficiency in bite opening.( with  elastics )
Differential response to force.
pitting...
Foundations:
Light wire.
Gentle, long range force systems
Min. bracket size – max. interbracket span.
Light undersized wir...
 Differential response to force.
Simple horizontal force  Tooth  tip.
Crestal bone – exp. 3x times more force than
apic...
 Less bone around the neck of the tooth

than apex.

strain near the alveolar crest.
Stress
in apical region.
Above facto...
www.indiandentalacademy.com
Retraction – tipping + uprighting
Adv. – anchorage conserved.
Effective translatory retraction – greater
force – greater a...
Modern orthodontic system – concerned:
Interdental relationships.
Facial str. & appearance.
Orientation of the dentition i...
Brackets.
Dimensions:
Narrow, single width – edgewise br.
( 0.050 inch or 1.3 mm).
Horizontal slot – 0.022” ( height ) x 0...
Torque values - 0°, 5°, 10°, 15°, 20°.
All brackets identical - except for torque.
Torque indicator groove - gingival – li...
Brackets:
bonding preferred.
Prewelded – flat/curved – universal bonding pads.

Advantages:
Facially facing archwire slots...
Interbracket – long resilient span
- archwire.
Wire – less distortion.
Less elastic range requd. force.

Considerable ( l...
Uprighting springs.
Original

Recent

Original.
Helix farther from archwire.
Hook arm – no extra offset reqd.

Recent
More...
Buccal Tubes:
Dimensions:
4.5 mm long, 0.022 x 0.028” – edgewise.
lingual crown torque, 25° – lower.
10° - Upper.
Distal e...
In cases with deep bite/ moderate
- severe anchorage req
Addnl. Rect. Tube – diagonally across –
buccal surface of basic t...
Bite Opening:
Outer tubes – main arch wire – bite opening &
retraction phases.
Gingival angulation – effective built in an...
Bite opening – more potent – check elastics.
Intrusive force - less tendency to tip –
anchor units distally.

www.indiande...
Rotations:
Early belief – rotation control difficult.
Offset bracket – side of tooth disp. lingually.
Overcorrection – thi...
Torque control:
Disadv. Of larger slot – 0.022 x 0.028 – large wires
used – precise control – Rigid.
Overcome – resilient ...
Newer non steel alloy archwires –
Extremely resilient – gentle forces
Approp. size – precise bracket engagement.
Esthetic ...
Important adv. - BEDDTIOT –
Facility for both 3 dimensional control
&
simple bracket
Limited tipping – light forces
Facili...
Combined Anchorage Technique
Variable Anchorage systems.
Design of the attachment –
provides optimum light wire & straight...
Advantages & Disadv. of the two tech.
Begg light wire appl.
Advantages:
Light optimum force –( 60 – 90 g )
Continuous forc...
 Disadvantages.
Diff. – co-ordinating max. & mand. arch
Diff. – bilateral symmetry.
Premolar & molar torque control – dif...
Straight wire appliance.
Advantages:
Precise control – PM & M torque.
Bilateral symmetry – BL inclinations – readily
attai...
 Disadvantages.
force levels – wider bracket, interbracket
span.
Rapid ant. alignment diff.
Overbite correction diff.
Add...
Light wire
Dynamic & Static anchorage. force sys.

Dynamic anchorage
It comprises – physical

forces generated by the

Uni...
Static Anchorage.
Increasing the forces – within the appl. Less
effect of the biologic force sys.
CAT – dynamic & static a...
Four Stage Light wire Appliance:
 Appl. – vehicle – transmitting force –

teeth &indirectly – bone & soft tissue.
 Desig...
 Brackets.
Gingival or Ribbon arch slot – free
tipping, no binding.
Edgewise slot – precise final detailing.
Three bracke...
Molar tube:
0.036 round tube – gingivally.( Begg )
0.018 x 0.025” or 0.022 x 0.028”.
Tubes - 7° offset – addnl. molar cont...
Placement of brackets & tubes:
All teeth except 2nd molars – receive attachment –
as soon as practical: increase force con...
Treatment technique:
Trt. divided into 4 stages.

Stage I - Organization.
Overbite correction.
Cl. II or Cl. III correctio...
Stage II. Consolidation.
Closure of remaining spaces.
Retraction of incisors.
Maintenance of overbite, rotations, antero-p...
Stage IV. Final detailing.
Attainment – ideal arch form & co-ordination of
archwidth.
Attainment – desired torque.
Precise...
Stage I.
Archwires:
Initiated – 0.016 round wires – Begg slot.
Cl II elastic force – lingual rolling – lower molar.
Mild e...
Anchor bendsIntrusive + labial movement.
Extrudes & tips – molars – distally.

Class II elastic force:
Combination of intr...
Stage II.
End of stage I – occl. organized appearance.
St. II begins – consolidation of the dentition.
Goals in Stage I – ...
Archwire:
0.018” round wire.
25° anchorage bend, 5° toe in bend.
Toe in bend – counter act rotational moment –
inter arch ...
Stage III.
Crown & root coordination/ torquing & paralleling
stage.
All spaces closed.
Crown tipping may be considerable.
...
Pre stage III reqd. – occasionally.
Reevaluation of br. ht & posn. – recommended.

Archwires:
Maxillary:
0.020 dia.
Constr...
Mandibular:
0.018 or 0.020 dia.
Exp. ¼ ” bilaterally.
Inset bend – molar tube.
Vertical bend into premolar.
V bend distal ...
Auxiliaries:
Uprighting springs.
Two forms.
Safety ligature – hold tooth – archwire.
Safety lock spring – safety extension...
Stage III – complicated.
Constant monitoring –reqd.
In CAT – absolute determination – final uprighting,
B-L placement, tor...
 Stage IV.
Trt. done in edgewise slot.
Preangulated,pretorqued, in – out
features –
precise crown & root pos’n.
Stage IV ...
Stage IV:
Primarily to increase – effectiveness & precision- final
detailing.
hygiene problems – auxiliary springs.
Lingua...
To get levelling - two preliminary – round wires –
0.016 or 0.018 Nitinol wire.
Edge wise slot mech. – alignment adequate....
Final Detailing.
Adjustments / modifications – archwires Discrepancies – size, symmetry, fn. of teeth.
Repositioning br. /...
Advantages of CAT.

Enhances trt. potentials.
Accumulates trt. advantages.
Reduces response time.
Enhances muscular effect...
Conclusion.
CAT system is a biomechanical approach to
treatment which enables the clinician to vary the
treatment techniqu...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Modern begg – /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Modern begg – /certified fixed orthodontic courses by Indian dental academy

  1. 1. Modern Begg – Beddtiot & CAT Techniques. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Introduction Conventional Begg – empirical and cook book trt. Begg operators – limitations - need to diverge from orthodox trt. Contemporary trt. goals & strategies – incorporated into Begg practice. Modern Begg. Refined Begg. www.indiandentalacademy.com
  3. 3. Modern Begg. Follows Begg principles – large extent. Brackets – modified ( other than Ribbon arch type – used in conventional Begg) www.indiandentalacademy.com
  4. 4. BEDDTIOT. (Begg Edgewise Diagnosis Determined Totally Individualised Orthodontic Technique.) Offers capacity to employ selected principles and features of Begg and Edgewise mechanisms – specific situations – most advantageous. Primary Goal Facility to treat each patient’s needs – most efficient for that individual. www.indiandentalacademy.com
  5. 5.  Strong points in Begg Technique: Proficiency in bite opening.( with  elastics ) Differential response to force. pitting limited tipping x translation. optimal ant. movement, anchorage conservation.  Edgewise appl. Precise control. Facilitates anch. Expenditure. www.indiandentalacademy.com
  6. 6. Foundations: Light wire. Gentle, long range force systems Min. bracket size – max. interbracket span. Light undersized wires. www.indiandentalacademy.com
  7. 7.  Differential response to force. Simple horizontal force  Tooth  tip. Crestal bone – exp. 3x times more force than apical bone. Crestal region – force sufficient – rapid tooth movement. Apical region – insufficient force. www.indiandentalacademy.com
  8. 8.  Less bone around the neck of the tooth than apex. strain near the alveolar crest. Stress in apical region. Above factors – multiply each other. powerful adv. – very light “simple tipping forces”. www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. Retraction – tipping + uprighting Adv. – anchorage conserved. Effective translatory retraction – greater force – greater anchorage loss. Repositioning roots after tipping – reaction strain – insufficient for anchor loss www.indiandentalacademy.com
  11. 11. Modern orthodontic system – concerned: Interdental relationships. Facial str. & appearance. Orientation of the dentition in the face. Oral function. Best approach – determined by diagnosis. Appliance – versatile. www.indiandentalacademy.com
  12. 12. Brackets. Dimensions: Narrow, single width – edgewise br. ( 0.050 inch or 1.3 mm). Horizontal slot – 0.022” ( height ) x 0.028” (faciolingual depth). Vertical slot – 0.020 x 0.020”. Archwire slots – torqued. . www.indiandentalacademy.com
  13. 13. Torque values - 0°, 5°, 10°, 15°, 20°. All brackets identical - except for torque. Torque indicator groove - gingival – lingual root torque. - occlusal – lingual crown torque www.indiandentalacademy.com
  14. 14. Brackets: bonding preferred. Prewelded – flat/curved – universal bonding pads. Advantages: Facially facing archwire slots – engagement of archwire easy. Small dimensions – . lip & cheek irritation.  occlusal interference.  bonding enamel surface.  problems with gingival proximity & oral hygiene. www.indiandentalacademy.com
  15. 15. Interbracket – long resilient span - archwire. Wire – less distortion. Less elastic range requd. force. Considerable ( limited ) tipping . 0.016 wires - 10° distal crown tipping. 0.018 wires - 5° mesial crown tipping (uprighting) “braking” – not required. Vertical slot Uprighting springs Turned 90° - miniature buccal tube. www.indiandentalacademy.com
  16. 16. Uprighting springs. Original Recent Original. Helix farther from archwire. Hook arm – no extra offset reqd. Recent More hygienic. irritation on gingiva. Appearance –less conspicuous www.indiandentalacademy.com
  17. 17. Buccal Tubes: Dimensions: 4.5 mm long, 0.022 x 0.028” – edgewise. lingual crown torque, 25° – lower. 10° - Upper. Distal end of max. tube - 10° outward angulation. ( toe- in). Headgear tube – 0.051” – occlusal & buccal. www.indiandentalacademy.com
  18. 18. In cases with deep bite/ moderate - severe anchorage req Addnl. Rect. Tube – diagonally across – buccal surface of basic tube – mesial end pointing gingivally. Dimensions. 4.5mm long, 0.022 x 0.028”. Outer tube ( Addnl. Tube ) - 15° angulation to inner tube. www.indiandentalacademy.com
  19. 19. Bite Opening: Outer tubes – main arch wire – bite opening & retraction phases. Gingival angulation – effective built in anchor bends.( actual bend - - 25° ). Inner tubes – Rect. sectional wires – lock PM & Molar.  single large tooth – C.R mesial than - C.R of Molar www.indiandentalacademy.com
  20. 20. Bite opening – more potent – check elastics. Intrusive force - less tendency to tip – anchor units distally. www.indiandentalacademy.com
  21. 21. Rotations: Early belief – rotation control difficult. Offset bracket – side of tooth disp. lingually. Overcorrection – thickwalled – elastomeric lig.placed on wire – before insertion. Bayonet bends. www.indiandentalacademy.com
  22. 22. Torque control: Disadv. Of larger slot – 0.022 x 0.028 – large wires used – precise control – Rigid. Overcome – resilient rect. Wires – ribbon mode. Sizes used: 0.020 x 0.016” Square wires. 0.019 0.020 0.021 x 0.016” 0.022 x 0.016” 0.021 0.022 www.indiandentalacademy.com
  23. 23. Newer non steel alloy archwires – Extremely resilient – gentle forces Approp. size – precise bracket engagement. Esthetic & Hygienic. ( eliminate – aux.) Torqued brackets  build trt. into the appl. Facial root torque – lower incisors – augment anchorage. 0.022 x 0.016” , 5° torque. Limit tipping of upper incisors - palatal torque. www.indiandentalacademy.com
  24. 24. Important adv. - BEDDTIOT – Facility for both 3 dimensional control & simple bracket Limited tipping – light forces Facilitate application of the best modality in every situation. www.indiandentalacademy.com
  25. 25. Combined Anchorage Technique Variable Anchorage systems. Design of the attachment – provides optimum light wire & straight wire trt. capabilities. Four stage light wire appliance  successful collaboration b/w Begg practitioners & Unitek Beneficial design features – adv. of Begg & St. wire. www.indiandentalacademy.com
  26. 26. Advantages & Disadv. of the two tech. Begg light wire appl. Advantages: Light optimum force –( 60 – 90 g ) Continuous force. Min. friction. Rapid alignment, leveling , rotation of ant. teeth. Rapid overbite correction. Simultaneous crown tipping. Continuous paralleling of roots at extn. sites. Continuous torquing. Extra oral force unnecessary. www.indiandentalacademy.com
  27. 27.  Disadvantages. Diff. – co-ordinating max. & mand. arch Diff. – bilateral symmetry. Premolar & molar torque control – diff. Diff. in stabilizing teeth – final artistic positioning. www.indiandentalacademy.com
  28. 28. Straight wire appliance. Advantages: Precise control – PM & M torque. Bilateral symmetry – BL inclinations – readily attained. Bilateral symetry of arch form. bends in archwires. Finishing Self limitation of movmt. & stabilization of teethfinal detailing. www.indiandentalacademy.com
  29. 29.  Disadvantages. force levels – wider bracket, interbracket span. Rapid ant. alignment diff. Overbite correction diff. Addnl. anchorage – necessary- friction. Extra oral force – reqd. Alignment – incisors & canines – in sequence. www.indiandentalacademy.com
  30. 30. Light wire Dynamic & Static anchorage. force sys. Dynamic anchorage It comprises – physical forces generated by the Unipoint contacts Anchor bend Archwire Biologic force sys. Muscle action Tooth morph & mass. Cuspal interlock. appl. – in a complex Aux. wire interrelationship – equally Tipping force effective forces – biologic Intr forces environment. Extrusive forces Growth Rot. Forces www.indiandentalacademy.com Freeway & fnl. Paths. Occl. Force & migr. Bone density Habits
  31. 31. Static Anchorage. Increasing the forces – within the appl. Less effect of the biologic force sys. CAT – dynamic & static anchorage resistance dev. - applied – certain stages – trt. program. Stage I & II  Dynamic. Stage III Stage IV  Dynamic / Static.  Static. www.indiandentalacademy.com
  32. 32. Four Stage Light wire Appliance:  Appl. – vehicle – transmitting force – teeth &indirectly – bone & soft tissue.  Design of appl. Elements, positioning, adjustments & manipulations – imp. – max. trt. efforts. Caution: Prudent to use conventional approach – each trt. stage – as long as progress is good. www.indiandentalacademy.com
  33. 33.  Brackets. Gingival or Ribbon arch slot – free tipping, no binding. Edgewise slot – precise final detailing. Three bracket types – optimal rotations, tipping & torque. Base beveled – friction or binding with archwire. Torque, tip, in –out – sp. vary for each tooth. www.indiandentalacademy.com
  34. 34. Molar tube: 0.036 round tube – gingivally.( Begg ) 0.018 x 0.025” or 0.022 x 0.028”. Tubes - 7° offset – addnl. molar control – Stage II. 0.018 x 0.025 slot – recommended. Conventional tubes – preferred to convertible tubes. www.indiandentalacademy.com
  35. 35. Placement of brackets & tubes: All teeth except 2nd molars – receive attachment – as soon as practical: increase force control. Mandibular 1st molar tubes – placed first. 0.036 tube – gingival margin. rect. Tube – middle third of crown. edgewise tube – 3.5 mm – tip of buccal cusp of 1st molar. 3.5 mm – std. for all brackets, EXCEPT, Canines & upper LI br. canine br. – 0.5 mm gingivally, LI br - 0.5 mm incisally. www.indiandentalacademy.com
  36. 36. Treatment technique: Trt. divided into 4 stages. Stage I - Organization. Overbite correction. Cl. II or Cl. III correction. Alignment, levelling, elimination of rotationsincisors. Correction of crossbite & archwidth problems. Overcorrection www.indiandentalacademy.com
  37. 37. Stage II. Consolidation. Closure of remaining spaces. Retraction of incisors. Maintenance of overbite, rotations, antero-post. corrections. Overcorrection. Stage III. Correction of crown & root inclination. Uprighting & paralleling of roots. Torquing of ant. teeth. Maintenance of corrections. www.indiandentalacademy.com
  38. 38. Stage IV. Final detailing. Attainment – ideal arch form & co-ordination of archwidth. Attainment – desired torque. Precise intercuspation & fnl. harmony. Optimal facial & dental esthetics. Commencement of retention. www.indiandentalacademy.com
  39. 39. Stage I. Archwires: Initiated – 0.016 round wires – Begg slot. Cl II elastic force – lingual rolling – lower molar. Mild exp. – ¼ ” – reqd. 45° anchor bend – 1-2 mm mesial – molar tube. In severe crowding – Multiloop – deep bite/ max. anchorage cases. Niti – shallow bites / min. anchorage req. www.indiandentalacademy.com
  40. 40. Anchor bendsIntrusive + labial movement. Extrudes & tips – molars – distally. Class II elastic force: Combination of intrusive + retractive forces – Center of rotn.- more apical – max. lingual crown tipping. Elastics: Very light elastic forces. 2 -3 oz. – 24 hrs a day. www.indiandentalacademy.com
  41. 41. Stage II. End of stage I – occl. organized appearance. St. II begins – consolidation of the dentition. Goals in Stage I – not reduced. Elastics: Intrarch elastics – max. ant. retrcn. & gen. space consolidation. 2-3 oz. Six elastics – used. Elastics eliminated – space closed. Arch wire bent distal to molar tube. www.indiandentalacademy.com
  42. 42. Archwire: 0.018” round wire. 25° anchorage bend, 5° toe in bend. Toe in bend – counter act rotational moment – inter arch elastics. www.indiandentalacademy.com
  43. 43. Stage III. Crown & root coordination/ torquing & paralleling stage. All spaces closed. Crown tipping may be considerable. All corrections – maintained. Molars & canine – Class I reln. post. occlsn. – inter locked – min. anchor losssubsequent – torquing & uprighting. www.indiandentalacademy.com
  44. 44. Pre stage III reqd. – occasionally. Reevaluation of br. ht & posn. – recommended. Archwires: Maxillary: 0.020 dia. Constr. To Omega shape. Anchor bend 0 - 5°. Inset bend into molar tube. Vertical bend – premolar slot. V bend distal to canines. Cinched . Overcorrected. www.indiandentalacademy.com
  45. 45. Mandibular: 0.018 or 0.020 dia. Exp. ¼ ” bilaterally. Inset bend – molar tube. Vertical bend into premolar. V bend distal to canines. Anchor bend of 5° - 10°. Cinched. Overcorrected. www.indiandentalacademy.com
  46. 46. Auxiliaries: Uprighting springs. Two forms. Safety ligature – hold tooth – archwire. Safety lock spring – safety extension – holds wire in gingival slot. Wire size used – 0.014 or 0.016. Torquing Aux. 0.016 wire – four spur/ two spur. www.indiandentalacademy.com
  47. 47. Stage III – complicated. Constant monitoring –reqd. In CAT – absolute determination – final uprighting, B-L placement, torque – not reqd. Straight wire slot – final artistic finishing - teeth. www.indiandentalacademy.com
  48. 48.  Stage IV. Trt. done in edgewise slot. Preangulated,pretorqued, in – out features – precise crown & root pos’n. Stage IV – not a substitute – Stage III – Begg. Excellent bite opening. Enmasse retrcn. of incisors – Stage I & II. Rapid uprighting – canine & PM roots. Torque of incisors – Stage III. All these adv. to be used to greatest extent – Begg mech. www.indiandentalacademy.com
  49. 49. Stage IV: Primarily to increase – effectiveness & precision- final detailing. hygiene problems – auxiliary springs. Lingual crown torque of post. teeth. Establish bilateral symmetry – uprighting. Achieve – proper paralleling & torque. Coordinate arch form & width. Second molars: More optimal occlusal reln. To obtain best arch form. Coordinate crown & root torque of post. teeth. www.indiandentalacademy.com
  50. 50. To get levelling - two preliminary – round wires – 0.016 or 0.018 Nitinol wire. Edge wise slot mech. – alignment adequate. Wires used. 0.017 x 0.025 NiTi. 0.016 x 0.022 , 0,018 x 0.025 – SS. Max. torque benefit – 0.018 x 0.025 ss. Post. teeth good axial incl. – reduce force levels – 0.018 round . www.indiandentalacademy.com
  51. 51. Final Detailing. Adjustments / modifications – archwires Discrepancies – size, symmetry, fn. of teeth. Repositioning br. / 1st order or 2nd order bends. Settling – 0.014 wire + vertical elastics. Finishing & Retention: Bonded canine to canine – lower. Hawleys Appliance – Upper. www.indiandentalacademy.com
  52. 52. Advantages of CAT. Enhances trt. potentials. Accumulates trt. advantages. Reduces response time. Enhances muscular effects. Simplifies co-operation. Variable anchorage effects. Reduced energy losses. Diversity of three slots. Controlled tipping & translation. Goal oriented trt. Establishes positive profile control www.indiandentalacademy.com
  53. 53. Conclusion. CAT system is a biomechanical approach to treatment which enables the clinician to vary the treatment technique, vary the type of movements and vary the resistance anchorage to simplify co-operation and to definitely expand the opportunity to overcome problems and enhance success of trt. www.indiandentalacademy.com
  54. 54. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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