NON-EXTRACTION
TREATMENT
MODALITY
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
...
Extraction?
OR
Non-extraction?
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Non- Extraction:
1900-1930
Dr.Edward Angle
Extraction:
1930-1970
Dr.Tweed,Dr.Beggs
1980’s to Till now.
Cetlin, Jasper, Jam...
Traditionally Begg practitioners were
branded as extractionists. Advances in
mechanotherapy, and changes in treatment
conc...
The prevalence of indiscriminate extractions
in earlier decades can partly be blamed on
over use of certain cephalometric ...
TWEED : Advocated placing mandibular
incisors upright over basal bone IMPA-900 +
Small Variation to maintain FMIA of 650
-...
RICKETTS : Supported Tweeds, Related
mandibular incisors to APO line. 1 mm ahead of
APO plane (-1 to +3mm and at an Angle ...
The Casko study in 1967 which measured 79
cases with ideal occlusion and acceptable
esthetics, found wide range of incisor...
“These values are all normal in the pleasant faces
in which they were found”.
Creekmore states these values at current tim...
In yet another study by Casko and Walter
Shepherd on same Tweeds sample of 95 cases,
found wide range of incisor positions...
The basis for selecting the sample was entirely
from the standpoint of satisfactory facial
esthetics and good facial out l...
C.J. Burstone, park AJO 1986
Fallacies of Hard tissue standard in treatment planning.
Studied 30 adolescents who were succ...
www.indiandentalacademy.comwww.indiandentalacademy.com
Thus, when antero-posterior Jaw relationships
differ greatly from average, Measurements of
maxillary and mandibular inciso...
In order to achieve these contemporary goals of
placing upright lower incisors, clinicians
invariably considered extractio...
- Now, the concept of diagnosing and treating a
malocclusion depending on the position of lower
incisors, has changed. The...
- This swing of the pendulum towards non-
extraction was essentially due to the marked
advances in diagnosis and mechanoth...
“Beauty lies in beholder eyes”
The concept of beautiful smile is now
changing. Toothy broad smile is now more
appreciated....
Many of this mechanics have evolved
embracing the preadjusted edgewise appliance.
No doubt present day refined Begg has al...
• Slenderization technique as proposed by
Sheridon and popularized by Alexander is now
being done based on sound diagnosis...
• The early reorganization and correction of
malocclusion during the mixed dentition phase.
• The multitude of evolving or...
- One of the paradoxical but pleasant surprises of
Begg non-extraction technique is the Anchorage
potential, which is ofte...
Pre treatment profile, Age:15yrs
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Prakash, 14yrs; skeletal Cl III, concave profile,
crowding in the upper arch, super Cl I molar relation.
www.indiandentala...
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
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Name: Padmini / 10yrs
Severe Class II Div.1
Convex profile
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Anil / 12yrs; Skeletal Class II, Horizontal growth,
severe proclination of upper incisors, Molar relation
- Left Class I, ...
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www.indiandentalacademy.comwww.indiandentalacademy.com
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www.indiandentalacademy.comwww.indiandentalacademy.com
Midline distema,
skeletal class I
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www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
Nagprasad/21yrs, Sk. Class II, Convex profile,
retroclined upper incisors, proclined lower
incisors, reduced lower facial ...
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
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www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
Refined Begg has an distinctive advantage of
anchorage preservation.
The Begg technique, with its modern day
concepts and ...
Thank youThank you
For more details please visitFor more details please visit
www.indiandentalacademy.comwww.indiandentala...
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Non extraction treatment modality

  1. 1. NON-EXTRACTION TREATMENT MODALITY INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. Extraction? OR Non-extraction? www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. Non- Extraction: 1900-1930 Dr.Edward Angle Extraction: 1930-1970 Dr.Tweed,Dr.Beggs 1980’s to Till now. Cetlin, Jasper, James Hilgers, Panchetz, Alexander, ……. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. Traditionally Begg practitioners were branded as extractionists. Advances in mechanotherapy, and changes in treatment concepts have changed this opinion about the Begg technique and curtailed the need for extraction in contemporary treatment. www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. The prevalence of indiscriminate extractions in earlier decades can partly be blamed on over use of certain cephalometric norms routinely followed. Secondly, Camouflaged treatment plan for the underlying jaw discrepancies, with little emphasis on growth modulation and still little on orthognathic surgery. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. TWEED : Advocated placing mandibular incisors upright over basal bone IMPA-900 + Small Variation to maintain FMIA of 650 -680 STEINERS : Positions for max and mand teeth, determined by lines of NA and NB and varied according to angle ANB. www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. RICKETTS : Supported Tweeds, Related mandibular incisors to APO line. 1 mm ahead of APO plane (-1 to +3mm and at an Angle of 220 ). The Maxillary incisors were positioned with a 2-2.5mm over bite and over jet and inter incisal angle 1300 www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. The Casko study in 1967 which measured 79 cases with ideal occlusion and acceptable esthetics, found wide range of incisor` positions and jaw relationships. Mandibular plane angle - 150 to 410 Facial angle - 790 to 950 Max incisor to SN - 930 to 1200 Lower incisor to APO - -4mm to +6mm www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. “These values are all normal in the pleasant faces in which they were found”. Creekmore states these values at current time would classify many of these patients as abnormal and classify them as Class I, Class II, Class III sk pattern’s. www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. In yet another study by Casko and Walter Shepherd on same Tweeds sample of 95 cases, found wide range of incisor positions and Jaw relationships. Low Mean High FMA 15 24.6 36 IMPA 76 86.9 99 FMIA 56 68.2 80 www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. The basis for selecting the sample was entirely from the standpoint of satisfactory facial esthetics and good facial out line. Inspite of wide variation in his own sample of angle IMPA, Tweed Advocated placing the mandibular incisors upright over basal bone for optimum esthetics and stability. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. C.J. Burstone, park AJO 1986 Fallacies of Hard tissue standard in treatment planning. Studied 30 adolescents who were successfully treated with end result as mandibular incisors 1.5mm to A-PO line. Authors have shown even in this uniformly treated group, there was large variation in lip protrusion Rickets Analysis was also built upon mandibular incisor position www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. Thus, when antero-posterior Jaw relationships differ greatly from average, Measurements of maxillary and mandibular incisors to the APO plane misrepresents their positions within jaws In Steiners analysis the position of mandibular incisors remains fairly constant, but the position of maxillary incisors varies a great deal to fit with mandibular arch, the concept of which has proved wrong. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. In order to achieve these contemporary goals of placing upright lower incisors, clinicians invariably considered extraction of teeth. This indiscriminate extractions in earlier decades can also be attributed to the camouflage treatment for basal jaw discrepancies, with little emphasis on growth modulation or orthognathic surgery procedures. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. - Now, the concept of diagnosing and treating a malocclusion depending on the position of lower incisors, has changed. The upper incisor position is being given more importance, along with the soft tissue profile, lip competency, position of chin, and the type of growth pattern. - Clinicians today, agree to err on non-extraction side rather than considering extraction option. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. - This swing of the pendulum towards non- extraction was essentially due to the marked advances in diagnosis and mechanotherapy between early 1970’s and the late 1990’s, which has given the clinician lots of options for rethinking the treatment plan. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. “Beauty lies in beholder eyes” The concept of beautiful smile is now changing. Toothy broad smile is now more appreciated. Orthodontics has kept in pace to this evolving newer concept of non-extraction with upgrading of more mechanics www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. Many of this mechanics have evolved embracing the preadjusted edgewise appliance. No doubt present day refined Begg has also evolved in similar path and boost with advantage of retaining its simple approach and yet incorporating all the modern day mechanics in its non-extraction practice. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. • Slenderization technique as proposed by Sheridon and popularized by Alexander is now being done based on sound diagnosis. • The whole array of modalities for distal driving of the molars. • The use of expansion devices. www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. • The early reorganization and correction of malocclusion during the mixed dentition phase. • The multitude of evolving orthopaedic appliances. • Conservation of E-space, Leeway space and correction of molar rotations. • Long-term stability. www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. - One of the paradoxical but pleasant surprises of Begg non-extraction technique is the Anchorage potential, which is often enhanced if the anchor molars have mesial axial Inclination at the commencement of treatment. The differential force system of controlled tipping of Incisors as against the bodily movement of molars has added to the beauty of anchorage preservation in non- extraction Begg technique. www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. Pre treatment profile, Age:15yrs www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. Prakash, 14yrs; skeletal Cl III, concave profile, crowding in the upper arch, super Cl I molar relation. www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. Name: Padmini / 10yrs Severe Class II Div.1 Convex profile www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. www.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. www.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. Anil / 12yrs; Skeletal Class II, Horizontal growth, severe proclination of upper incisors, Molar relation - Left Class I, Right Class II, Mild retroclination of lower incisors, Overjet 13mm, Overbite 5mm www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. Midline distema, skeletal class I www.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59. Nagprasad/21yrs, Sk. Class II, Convex profile, retroclined upper incisors, proclined lower incisors, reduced lower facial height. www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60. www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. www.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. www.indiandentalacademy.comwww.indiandentalacademy.com
  65. 65. www.indiandentalacademy.comwww.indiandentalacademy.com
  66. 66. www.indiandentalacademy.comwww.indiandentalacademy.com
  67. 67. www.indiandentalacademy.comwww.indiandentalacademy.com
  68. 68. Refined Begg has an distinctive advantage of anchorage preservation. The Begg technique, with its modern day concepts and under the guidance of innovative teachers has definitely evolved to its best. www.indiandentalacademy.comwww.indiandentalacademy.com
  69. 69. Thank youThank you For more details please visitFor more details please visit www.indiandentalacademy.comwww.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com

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