PROBLEM SHOOTING
IN STAGE II & ITS
MANAGEMENT
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandental...
Problems Encountered During Begg Trt.
Problems can occur in any stage or can either
be
 Poor tissue response
 Lack of pa...
1.Ant. bite closing
 Lack of bite opening bends
 Remove AW, place proper bite-opening bends

 Bitten out bite opening b...
 Patient not wearing I.M elastics properly
 Educate patient

2. Ant. teeth assuming class III relationship
Excessive wea...
3. Spaces dev. between ant. teeth.
 Failure to give cuspid tie
 Intermax. circles formed too far apart
 Roll one or bot...
 Too much force from horizontal elastics
 Use lighter hor. Elastics
 Tie elastic thread from canine lingual button to
l...
5. Canine roots bulging on labial plate of
alv. bone
 Normal distal tipping of canine crown
causes mesial movement of api...
 Poor arch form
 Poor bracket placement
 if bracket is to far gingival tooth will supra
erupt. Inclined plane relations...
6. Posterior space not closing
 Poor elastic co- operation.
 Educate the patient
 Make sure that pt. can hook the elast...
 A W pinned or caught in PM bracket slot
 Unpin archwire, remove from slot
 Place bypass clamp

 Pt. placing tongue or...
 Ant. teeth not free to tip distally
 Use proper brackets
 Make sure AW is not pinned too tightly
 Make sure AW is sea...
7. Mesial tipping of 2nd PM
 Slight, expected mesial movement of
anchor molar
 proceed with stage II, conti. to guard an...
8. Mand. ant. teeth achieving desired
lingual inclination before space closure
 Careful preservation of anchorage
 Apply...
9. Relapse of crowding
 Intermax. circles not abutting to canines
 Pins dislodged from brackets
10. Too much retraction ...
Anchorage loss
during stage II

www.indiandentalacademy.com
 Lock pin binding the arch wire in bracket
(prevent free tipping of teeth)

 Use proper lock pins
 If possible, pin tai...
 Cuspid forced out into buccal plate
(Improper arch wire form, Causes drag teeth
can not tip freely)

 Place the distal...
 Too strong elastic force
 Use proper intermaxillary elastic force
 2-2½ ounce

 Wearing more than one elastic
 Pt. m...
 Arch wire accidentally engaged in the
slot of second premolar
(Increases friction)

 Use of bypass clamp
 Remove the p...
 Arch wire binding in buccal tube
(If arch wire too short to protrude through the
distal end of molar tube,
When cut to p...
 End of arch wires striking the second
molar
(Retards and sometimes stops the distal sliding
of arch wire (usually in upp...
 End of arch wire penetrating gingival tissue
(Usually distal end of lower arch
Gingival tissue (bone) prevent free slidi...
 Anchorage bends engaging buccal tube
(Once entered in molar tube free sliding is prevented
due to three point contact)
...
 Ligating premolar too tightly to arch wire
Arch wire can not slide distally
 Ligate the arch wire lightly so that arch ...
  Improper toe in
  Results in loss of control of anchor teeth & failure to
reduce ant. deep bite.
• Proper amount of ...
 Starting stage II too soon
 If ant. teeth are not in genuine end to
end contact, not free to tip under the
forces of h...
 Arch wire rolling in buccal tube
 Avoid too much anchorage bend
 and/or too much toe in bend

www.indiandentalacademy....
 Improper ligature tie at canine
 do not pass ligature ties on canines over the
incisal of brackets  prevents free tipp...
Conclusion
A thorough knowledge of basic principles
involved in Begg mechanotherapy is
essential to avoid any form of prob...
www.indiandentalacademy.com
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Problem shooting stg ii /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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Transcript of "Problem shooting stg ii /certified fixed orthodontic courses by Indian dental academy "

  1. 1. PROBLEM SHOOTING IN STAGE II & ITS MANAGEMENT INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Problems Encountered During Begg Trt. Problems can occur in any stage or can either be  Poor tissue response  Lack of patient cooperation  Poor mechanics Identification of problem is imp. for producing successful results. www.indiandentalacademy.com
  3. 3. 1.Ant. bite closing  Lack of bite opening bends  Remove AW, place proper bite-opening bends  Bitten out bite opening bends, arch wire distorted  Pt. edu. for proper diet  Remove, correct & replace archwire  Anchor molar out of occlusion  Discontinue Class II or Class III elastics  Horizontal elastics from molar to intermaxilary hook to move the molars towards one another. www.indiandentalacademy.com  Vertical elastics from U-m to L-m
  4. 4.  Patient not wearing I.M elastics properly  Educate patient 2. Ant. teeth assuming class III relationship Excessive wearing of class II elastics  Discontinue Class II elastics till teeth are in edge to edge relation  place class III elastics. Discontinue class III elastics when ant. teeth are edge to edge www.indiandentalacademy.com
  5. 5. 3. Spaces dev. between ant. teeth.  Failure to give cuspid tie  Intermax. circles formed too far apart  Roll one or both circles mesially, tie with steel lig.  if space is too large, close space with hor. elastic from 3-3 4. Anchor molars rotating distobuccally  Toe-out on arch wire www.indiandentalacademy.com  Remove arch wire & place toe in bend
  6. 6.  Too much force from horizontal elastics  Use lighter hor. Elastics  Tie elastic thread from canine lingual button to lingual hook on molar.  Elastics pulling on distal of molar tube  Place the hook properly  Edu. pt. to place elastic on hook rather than around tube. www.indiandentalacademy.com
  7. 7. 5. Canine roots bulging on labial plate of alv. bone  Normal distal tipping of canine crown causes mesial movement of apices,since canine is located at the curve of arch which causes bulging of plate.This will disappear during stage III as apices moves distally.  Do nothing www.indiandentalacademy.com
  8. 8.  Poor arch form  Poor bracket placement  if bracket is to far gingival tooth will supra erupt. Inclined plane relationship with opposing teeth  rotate mand. cuspid crowns lingually  roots labially www.indiandentalacademy.com
  9. 9. 6. Posterior space not closing  Poor elastic co- operation.  Educate the patient  Make sure that pt. can hook the elastics  AW not free to slide distally through tube  Remove source of resistance  End of wire striking 2nd molar  Anchor bend in molar tube  Arch wire short & caught on burr inside tube www.indiandentalacademy.com
  10. 10.  A W pinned or caught in PM bracket slot  Unpin archwire, remove from slot  Place bypass clamp  Pt. placing tongue or pencil in space  Educate patient  Occlusal interference  ↑ Anchor bend to open bite  Check bracket level www.indiandentalacademy.com
  11. 11.  Ant. teeth not free to tip distally  Use proper brackets  Make sure AW is not pinned too tightly  Make sure AW is seated in bracket slot, not caught on flange of bracket  If tongue habit, place spurs on lingual surface of teeth, refer to speech and swallowing therapy spec. www.indiandentalacademy.com
  12. 12. 7. Mesial tipping of 2nd PM  Slight, expected mesial movement of anchor molar  proceed with stage II, conti. to guard anchorage  Abnormal loss of anchorage  Remove AW, ↑ Anchor bend.  ↓ elastic force  Check for loose molar band or tubes www.indiandentalacademy.com
  13. 13. 8. Mand. ant. teeth achieving desired lingual inclination before space closure  Careful preservation of anchorage  Apply braking mechanics  Apply 6- 10 oz. horizontal elastics with braking mechanics  Excess space present at beginning of trt. (Conginitally small or missing teeth or space from trauma or caries)  Clinical experience & education of patient www.indiandentalacademy.com
  14. 14. 9. Relapse of crowding  Intermax. circles not abutting to canines  Pins dislodged from brackets 10. Too much retraction of U –incisors resulting in gummy smile  Uncontrolled tipping of incisors  Use MAA  Not attaining proper intrusion of U - incisors  Use of Power arms or TPA for wearing class I elastics www.indiandentalacademy.com
  15. 15. Anchorage loss during stage II www.indiandentalacademy.com
  16. 16.  Lock pin binding the arch wire in bracket (prevent free tipping of teeth)  Use proper lock pins  If possible, pin tails should be bend before head strike the arch wire www.indiandentalacademy.com
  17. 17.  Cuspid forced out into buccal plate (Improper arch wire form, Causes drag teeth can not tip freely)  Place the distal ends of arch wire in molar tubes, see if wire lies so far labially in canine region www.indiandentalacademy.com
  18. 18.  Too strong elastic force  Use proper intermaxillary elastic force  2-2½ ounce  Wearing more than one elastic  Pt. must be properly educated in Function of elastics & danger of wearing more elastics www.indiandentalacademy.com
  19. 19.  Arch wire accidentally engaged in the slot of second premolar (Increases friction)  Use of bypass clamp  Remove the premolar band for first 6 weeks www.indiandentalacademy.com
  20. 20.  Arch wire binding in buccal tube (If arch wire too short to protrude through the distal end of molar tube, When cut to proper length, cause internal burring (not removed by ordinary polishing)  Make always slightly longer than necessary  Do not cut the end of wire until all modifications and bends www.indiandentalacademy.com
  21. 21.  End of arch wires striking the second molar (Retards and sometimes stops the distal sliding of arch wire (usually in upper molar)  Extend the arch wire farther distally buccal to 2nd molar  If impossible, cut it short enough to allow it to slide freely until next visit www.indiandentalacademy.com
  22. 22.  End of arch wire penetrating gingival tissue (Usually distal end of lower arch Gingival tissue (bone) prevent free sliding)  instruct pt. to visit orthodontist if they feel discomfort or can not engage elastics www.indiandentalacademy.com
  23. 23.  Anchorage bends engaging buccal tube (Once entered in molar tube free sliding is prevented due to three point contact)  Check the situation every visit  If necessary remove the arch wire, st. it and, make new AB mesially www.indiandentalacademy.com
  24. 24.  Ligating premolar too tightly to arch wire Arch wire can not slide distally  Ligate the arch wire lightly so that arch is free to slide www.indiandentalacademy.com
  25. 25.   Improper toe in   Results in loss of control of anchor teeth & failure to reduce ant. deep bite. • Proper amount of toe in or toe out  by placing the AW in molar tubes & in ant. brackets  The wire should pass st. forward & occlusally as it leaves the mesial end of the tube from the action of anchor bend. www.indiandentalacademy.com
  26. 26.  Starting stage II too soon  If ant. teeth are not in genuine end to end contact, not free to tip under the forces of horizontal elastics www.indiandentalacademy.com
  27. 27.  Arch wire rolling in buccal tube  Avoid too much anchorage bend  and/or too much toe in bend www.indiandentalacademy.com
  28. 28.  Improper ligature tie at canine  do not pass ligature ties on canines over the incisal of brackets  prevents free tipping  It should pass directly distally across the labial surface of canine www.indiandentalacademy.com
  29. 29. Conclusion A thorough knowledge of basic principles involved in Begg mechanotherapy is essential to avoid any form of problems during treatment. An awareness of all possible problems help us in every stage of treatment, leading to excellent treatment results. www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com

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