Conventional begg's stage 3

The Begg ApplianceThe Begg Appliance
and Techniqueand Technique
Stage IIIStage III
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OutlineOutline
► IntroductionIntroduction
► Tooth Relationships at start of Stage IIITooth Relationships at start of Stage III
► Bending of Main Arch Wires for Stage IIIBending of Main Arch Wires for Stage III
► Auxiliaries used during Stage IIIAuxiliaries used during Stage III
- Uprighting Springs- Uprighting Springs
- Torqueing Auxiliaries- Torqueing Auxiliaries
►Application of third stage arch wires and auxiliariesApplication of third stage arch wires and auxiliaries
to teethto teeth
►Additions and modifications in stage III mechanicsAdditions and modifications in stage III mechanics
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IntroductionIntroduction
► The third stage of treatment should beThe third stage of treatment should be
commenced only after the completion of all thecommenced only after the completion of all the
objectives of preceding stages.objectives of preceding stages.
► Objectives of stage IIIObjectives of stage III
1.Maintaining all the corrections achieved
during first and second stages.
2.Achieve desired axial inclinations of all
the teeth.

Tooth Relationships at start ofTooth Relationships at start of
Stage IIIStage III
► The teeth of a fourThe teeth of a four
bicuspid extractionbicuspid extraction
case should appearcase should appear
as shown in the fig.as shown in the fig.
► Bicuspids in goodBicuspids in good
occlusion and theocclusion and the
anterior teeth slightlyanterior teeth slightly
apart.apart.
► Anterior teeth lingually inclined, and
bicuspids and cuspids need root paralleling.

Bending of main arch wires for StageBending of main arch wires for Stage
IIIIII
► To maintain proper dentalTo maintain proper dental
arch form and bite-openingarch form and bite-opening
achieved during treatment,achieved during treatment,
new heavier arch wires arenew heavier arch wires are
used.used.
► Maxillary arch wire bent fromMaxillary arch wire bent from
0.020 inch round arch wire0.020 inch round arch wire
material and slightlymaterial and slightly
constricted in its distal bendsconstricted in its distal bends
to counteract the wideningto counteract the widening
effects of the maxillaryeffects of the maxillary
torqueing auxiliary.torqueing auxiliary.
Proper arch form of stage III
0.020 arch wire.

► The upper arch wire isThe upper arch wire is
passive (vertically) inpassive (vertically) in
the molar tubes.the molar tubes.
► It has a slight gingivalIt has a slight gingival
bend distal to thebend distal to the
cuspid bracket area tocuspid bracket area to
counteract the occlusalcounteract the occlusal
vectors of forcevectors of force
created by all anteriorcreated by all anterior
lingual root torqueinglingual root torqueing
auxiliaries.auxiliaries.
Maxillary 0.020 inch arch wire as viewed
from the buccal.
Anterior portion is offset gingivally to
counteract the incisal force generated by
most torqueing auxiliaries.

► The mandibular archThe mandibular arch
wire used is 0.020 inchwire used is 0.020 inch
round wire.round wire.
► ExpansionExpansion
incorporated (slight).incorporated (slight).
► Anchor bendAnchor bend
continued, but it is notcontinued, but it is not
as pronounced as thatas pronounced as that
present during stage II.present during stage II. Proper mandibular arch form for
stage III made from 0.020 inch
wire.

► A mild bend placedA mild bend placed
distal to thedistal to the
mandibular cuspidmandibular cuspid
bracket area to reducebracket area to reduce
any tendency forany tendency for
recurrence of anrecurrence of an
anterior overbite duringanterior overbite during
stage III.stage III.
► A slight vertical step inA slight vertical step in
the anchor bend area.the anchor bend area.
Buccal view of stage III arch wire. Note
the slight anchor bend and a bend to
depress the anterior teeth.

Auxiliaries used during stage IIIAuxiliaries used during stage III
► TheThe two main auxiliariestwo main auxiliaries ::
► Individual Root Springs or Mesio distal uprightingIndividual Root Springs or Mesio distal uprighting
Springs.Springs.
► Torqueing auxiliaries.Torqueing auxiliaries.

Uprighting SpringsUprighting Springs
► Original Spring.Original Spring.
1.1. Smaller & fewer coils.Smaller & fewer coils.
2.2. A longer lever arm.A longer lever arm.
► Refinement ofRefinement of
original spring.original spring.
1.1. Larger more resilientLarger more resilient
coils.coils.
2.2. Short lever arm.Short lever arm.

► AdvantagesAdvantages ofof
Short Springs:Short Springs:
1.1. They areThey are Self-Self-
retaining.retaining.
2.2. Being short theyBeing short they dodo
not interfere withnot interfere with
springs onsprings on
adjacentadjacent teeth.teeth.

Spring - PinSpring - Pin
► A problem inherent in all uprighting springs isA problem inherent in all uprighting springs is
that, when engaged and under tension, the coilthat, when engaged and under tension, the coil
presses against the gingival edge of thepresses against the gingival edge of the
beacket.beacket.
► If arch wire is not safely tied into the slot of theIf arch wire is not safely tied into the slot of the
bracket, this force from the coils can cause thebracket, this force from the coils can cause the
bracket to move away from the arch wire, withbracket to move away from the arch wire, with aa
subsequent elongation of the tooth.subsequent elongation of the tooth.

► As a solution to thisAs a solution to this
problem authors haveproblem authors have
invented,invented, SpringSpring
Pin.Pin.
► A Combination of aA Combination of a
Lock PinLock Pin andand anan
Uprighting Spring.Uprighting Spring.
► The leg of the pinThe leg of the pin
portion passes lingualportion passes lingual
to the arch wire andto the arch wire and
the tail fits labial to itthe tail fits labial to it
in the space in thein the space in the
bracket that normalybracket that normaly
accepts the lock pin.accepts the lock pin.www.indiandentalacademy.com

► The arch wire is so held securely( yet loose) inThe arch wire is so held securely( yet loose) in
the bracket slot, and the tooth is free to uprightthe bracket slot, and the tooth is free to upright
mesiodistally with no danger of its beingmesiodistally with no danger of its being
elongated.elongated.

Torqueing AuxiliariesTorqueing Auxiliaries
► To torque roots of the maxillary anterior teethTo torque roots of the maxillary anterior teeth
lingually.lingually.
► Torqueing is nearly always necessaryTorqueing is nearly always necessary
(especially with upper incisors) in mild(especially with upper incisors) in mild
discrepancy cases that require extraction of thediscrepancy cases that require extraction of the
four first premolars i,e in cases having only afour first premolars i,e in cases having only a
mild excess of tooth substance relative to jawmild excess of tooth substance relative to jaw
size.size.
► This is because crowns of the incisors tippedThis is because crowns of the incisors tipped
back a long way lingually to close the extractionback a long way lingually to close the extraction
spaces.spaces.

► It is usually unnecessary to torque incisor rootsIt is usually unnecessary to torque incisor roots
lingually in four first premolar extraction cases thatlingually in four first premolar extraction cases that
have considerable excess of tooth substancehave considerable excess of tooth substance
relative to the jaw size.relative to the jaw size.
► The extraction spaces are more prone to closeThe extraction spaces are more prone to close
quickly than in mild discrepancy cases.quickly than in mild discrepancy cases.
► Therefore, the extraction spaces close before theTherefore, the extraction spaces close before the
crowns of the incisors are able to tip very far back.crowns of the incisors are able to tip very far back.

► It is always necessary to torque the incisor rootsIt is always necessary to torque the incisor roots
lingually, usually both the upper and the lowerlingually, usually both the upper and the lower
incisor roots, in severest discrepancy cases.incisor roots, in severest discrepancy cases.
► This is because it is necessary to extract eightThis is because it is necessary to extract eight
teeth in these most severe discrepancy cases i,eteeth in these most severe discrepancy cases i,e
4 first PM’s & 4 first permanent M’s.4 first PM’s & 4 first permanent M’s.
► The extraction of these eight teeth leaves aThe extraction of these eight teeth leaves a
large amount of space that needs to be closedlarge amount of space that needs to be closed
by the tipping of the incisors and in the processby the tipping of the incisors and in the process
they would have moved a long way lingually.they would have moved a long way lingually.

► It is sometimes necessary to torque the rootsIt is sometimes necessary to torque the roots
lingually in non extraction cases also, especiallylingually in non extraction cases also, especially
in those that have an excess of jaw substancein those that have an excess of jaw substance
relative to tooth size.relative to tooth size.
► In most of the patients, by the end of the secondIn most of the patients, by the end of the second
stage of treatment (and sometimes before thisstage of treatment (and sometimes before this
time), it becomes quite obvious that whether it istime), it becomes quite obvious that whether it is
necessary to torque incisor roots lingually or not.necessary to torque incisor roots lingually or not.

► Originally spurs, to rest against the labialOriginally spurs, to rest against the labial
surfaces of the upper centrals and the laterals,surfaces of the upper centrals and the laterals,
were bent into the main maxillary arch wire i,ewere bent into the main maxillary arch wire i,e
0.016 inch arch wire material.0.016 inch arch wire material.
► The torque force was transmitted in a spiralThe torque force was transmitted in a spiral
manner along the main arch wire to the anchormanner along the main arch wire to the anchor
molars.molars.
► Effect was to move the molars buccally andEffect was to move the molars buccally and
rotate them distobuccaly.rotate them distobuccaly.
► By employing a heavier main upper arch wire inBy employing a heavier main upper arch wire in
conjunction with the torqueing auxiliaries bentconjunction with the torqueing auxiliaries bent
from lighter material( 0.014 to 0.016 inch), it isfrom lighter material( 0.014 to 0.016 inch), it is
possible to prevent undesired movement of thepossible to prevent undesired movement of the
maxillary anchor molars.maxillary anchor molars.

► At present, there areAt present, there are
many different designsmany different designs
for anterior rootfor anterior root
torqueing auxiliaries.torqueing auxiliaries.
► Probably the mostProbably the most
popular is the originalpopular is the original
four- spur type.four- spur type.
Four spur torqeing auxiliary. Applied
gingival to the main arch wire. Left in place
until the upper anterior teeth are over-
torqued.

Bending the four-spur auxiliaryBending the four-spur auxiliary
► Root torqueing spurs,Root torqueing spurs,
when used to move towhen used to move to
roots of anterior teeth,roots of anterior teeth,
are formed in suchare formed in such
positions that they willpositions that they will
exert force as close toexert force as close to
the centers of labialthe centers of labial
surfaces of the toothsurfaces of the tooth
crowns as possible.crowns as possible.

► Bend the auxiliaryBend the auxiliary
using 0.014 or 0.016using 0.014 or 0.016
inch diameter archinch diameter arch
wire material, workingwire material, working
from left to right.from left to right.
► The novices can cutThe novices can cut
the wire and straight athe wire and straight a
6 inch length of wire.6 inch length of wire.
► Place thePlace the
straightened wire instraightened wire in
the central incisorthe central incisor
brackets, centered bybrackets, centered by
eye, and the endseye, and the ends
pulled incisally.pulled incisally. www.indiandentalacademy.com

► This automatically beginsThis automatically begins
the bends for the mesialthe bends for the mesial
legs of both centrallegs of both central
incisor spurs.incisor spurs.
► These spurs areThese spurs are
completed, bending themcompleted, bending them
so that they lean slightlyso that they lean slightly
towards the midline.towards the midline.
► The wire is then returnedThe wire is then returned
to the mouth andto the mouth and
grasped by light wiregrasped by light wire
pliers.pliers.

► After being removedAfter being removed
from the mouth, thefrom the mouth, the
mesial leg of the leftmesial leg of the left
lateral incisor spur islateral incisor spur is
formed by bendingformed by bending
the wire around thethe wire around the
pliers.pliers.
► The spur isThe spur is
completed, bending itcompleted, bending it
with the same mesialwith the same mesial
inclination as given toinclination as given to
the central incisorthe central incisor
spur.spur.

► The wire is returned to the mouth, placed in theThe wire is returned to the mouth, placed in the
brackets and the right lateral incisor spur is bentbrackets and the right lateral incisor spur is bent
following the same procedure as was done forfollowing the same procedure as was done for
the left one.the left one.
► The auxiliary which now has four torqueingThe auxiliary which now has four torqueing
spurs, is placed again in the mouth and the distalspurs, is placed again in the mouth and the distal
ends are cut off midway between the cuspid andends are cut off midway between the cuspid and
the second bicuspid brackets.the second bicuspid brackets.
► Ends are curled back on themselves, as aEnds are curled back on themselves, as a
protective measure.protective measure.

Activating the four spur auxiliaryActivating the four spur auxiliary
► Using the light wire pliers, the auxiliary is formedUsing the light wire pliers, the auxiliary is formed
into an arc smaller than that of the anteriorinto an arc smaller than that of the anterior
portion of the patient’s dental arch, with theportion of the patient’s dental arch, with the
spurs in a nearly horizontal position.spurs in a nearly horizontal position.
► This constricted arch form of the auxiliaryThis constricted arch form of the auxiliary
counteracts the reciprocal forces applied to thecounteracts the reciprocal forces applied to the
arch wire when the auxiliary is engaged, whicharch wire when the auxiliary is engaged, which
tend to widen the dental arch.tend to widen the dental arch.
It also guarantees that the
maximum amount of torque
force is derived from each
auxiliary. www.indiandentalacademy.com

► If it is found that the auxiliary needs to be formedIf it is found that the auxiliary needs to be formed
into a smaller arc, the original bends at the baseinto a smaller arc, the original bends at the base
of the distal legs of each spur can be increased.of the distal legs of each spur can be increased.
► Another method is to place a slight “V” bendAnother method is to place a slight “V” bend
midway between the spurs.midway between the spurs.
► Both measures will cause the distal ends of theBoth measures will cause the distal ends of the
auxiliary to move together.auxiliary to move together.

► The final modification in the torqueing auxiliary isThe final modification in the torqueing auxiliary is
the bending of thethe bending of the “Cuspid-Curve”“Cuspid-Curve” in thein the
distal arms.distal arms.
► In the passive state this curve will cause theIn the passive state this curve will cause the
arms to appear to drop below the level of thearms to appear to drop below the level of the
main arch wire.main arch wire.
► When the torqueing auxiliary is applied, theseWhen the torqueing auxiliary is applied, these
distal arms will be rotated by the spurs strikingdistal arms will be rotated by the spurs striking
the labial surfaces of the anterior teeth.the labial surfaces of the anterior teeth.
► This curve will then follow that of the main archThis curve will then follow that of the main arch
below.below.

Pre-Wound Torqueing AuxiliaryPre-Wound Torqueing Auxiliary
► This Pre-Wound (Rat-Trap type) auxiliary wasThis Pre-Wound (Rat-Trap type) auxiliary was
originally devised by one of the author (P. R.originally devised by one of the author (P. R.
Begg) in the early 1950’s.Begg) in the early 1950’s.
► Graduated sizes are available to fit varyingGraduated sizes are available to fit varying
mesiodistal widths of the teeth.mesiodistal widths of the teeth.
► It is simpler to apply and is capable of delivering aIt is simpler to apply and is capable of delivering a
greater force through a greater range ofgreater force through a greater range of
movement than other type of auxiliaries –movement than other type of auxiliaries –
regardless of the size of wire used in itsregardless of the size of wire used in its
construction.construction.

► 0.014/0.016 inch round wire.0.014/0.016 inch round wire.
► A small incisal offset or “V”A small incisal offset or “V”
bend, in the midline of thebend, in the midline of the
main arch wire acts as amain arch wire acts as a
reciprocating stop for thereciprocating stop for the
auxiliary.auxiliary.
► Since this type of auxiliary isSince this type of auxiliary is
activated by meeting theactivated by meeting the
resistance of the stop in theresistance of the stop in the
midline of the arch wire, it ismidline of the arch wire, it is
more effective in torqueingmore effective in torqueing
when only central incisorswhen only central incisors
require torqueing.require torqueing. www.indiandentalacademy.com

► When the maxillary lateralWhen the maxillary lateral
incisors need their roots to beincisors need their roots to be
brought labially, as is usually thebrought labially, as is usually the
case if these teeth werecase if these teeth were
displaced lingually, prior todisplaced lingually, prior to
treatment, the pre-woundtreatment, the pre-wound
auxiliary can be modified.auxiliary can be modified.
► The lateral torque bars areThe lateral torque bars are
overwound so that they fall in aoverwound so that they fall in a
plane approximately 90 to theplane approximately 90 to the
plane of the central incisorsplane of the central incisors
torque bars.torque bars.

Application of the third stage archApplication of the third stage arch
wires and the auxiliaries to the teethwires and the auxiliaries to the teeth
► Place the upper and lowerPlace the upper and lower
arch wires in the mouth.arch wires in the mouth.
The lower arch wire isThe lower arch wire is
pinned in place.pinned in place.
► Place the proper spring-Place the proper spring-
pins in the brackets of allpins in the brackets of all
the mandibular teeththe mandibular teeth
requiring mesiodistalrequiring mesiodistal
uprighting and in theuprighting and in the
maxillary second premolarmaxillary second premolar
brackets.brackets. www.indiandentalacademy.com

► The proportion of the uprighting force deliveredThe proportion of the uprighting force delivered
to each tooth is related to its proximity to theto each tooth is related to its proximity to the
point of engagement of the arm of the spring andpoint of engagement of the arm of the spring and
to the flexibility of the arch wire.to the flexibility of the arch wire.
► The use of heavier arch wires has reduced anyThe use of heavier arch wires has reduced any
ill effects from the reciprocal forces delivered byill effects from the reciprocal forces delivered by
the uprighting springs or torqueing auxiliaries.the uprighting springs or torqueing auxiliaries.
► Normally, in a case requiring pretreatmentNormally, in a case requiring pretreatment
extraction of first premolars, the lower caninesextraction of first premolars, the lower canines
require the greatest amount of mesiodistalrequire the greatest amount of mesiodistal
uprighting.uprighting.

► The order of descending need of the remainingThe order of descending need of the remaining
teeth to be uprighted:teeth to be uprighted:
1.1. Lower caninesLower canines
2.2. Upper caninesUpper canines
3.3. Lower second premolarsLower second premolars
4.4. Upper second premolarsUpper second premolars
5.5. Upper lateral incisorsUpper lateral incisors
6.6. The lower lateral incisors ( requiring the leastThe lower lateral incisors ( requiring the least
amount of force)amount of force)

► The forces on the teeth can be varied by usingThe forces on the teeth can be varied by using
springs fashioned from different sizes of wiressprings fashioned from different sizes of wires
and having either two or three coils.and having either two or three coils.
► The following types of springs, or spring-pins,The following types of springs, or spring-pins,
deliver the amounts of forces that are requireddeliver the amounts of forces that are required
in a four first premolar extraction case duringin a four first premolar extraction case during
1.1. Upper and Lower Canines- 0.016/0.018 inch &Upper and Lower Canines- 0.016/0.018 inch &
2-coils2-coils
2.2. Upper and Lower Second Premolars- 0.016Upper and Lower Second Premolars- 0.016
inch & 2-coilsinch & 2-coils
3.3. Upper Lateral incisors-0.014 inch & 2-coilsUpper Lateral incisors-0.014 inch & 2-coils
4.4. Lower Lateral incisors-0.014 inch & 3-coils.Lower Lateral incisors-0.014 inch & 3-coils.

► Pin the upper torqueingPin the upper torqueing
auxiliary in one of theauxiliary in one of the
maxillary central incisorsmaxillary central incisors
brackets. The distalbrackets. The distal
ends of the auxiliaryends of the auxiliary
wire then pinned into thewire then pinned into the
canine brackets gingivalcanine brackets gingival
to the main arch wireto the main arch wire
with spring-pins.with spring-pins.

► Spring –pins are then placed on the upper lateralSpring –pins are then placed on the upper lateral
incisors, which usually require their roots to beincisors, which usually require their roots to be
torqued distally, and on the upper secondtorqued distally, and on the upper second
premolars.premolars.
► Normally the centrals do not require mesiodistalNormally the centrals do not require mesiodistal
uprighting and are pinned to the arch wire withuprighting and are pinned to the arch wire with
stage III lock pins.stage III lock pins.

► In order to prevent the creation of the spaces in theIn order to prevent the creation of the spaces in the
dental arches due to pressures on the teeth fromdental arches due to pressures on the teeth from
the anterior root torqueing auxiliaries and individualthe anterior root torqueing auxiliaries and individual
uprighting springs, the ends of the arch wires areuprighting springs, the ends of the arch wires are
bent around the distal of the molar tubes.bent around the distal of the molar tubes.
► The upper arch wire can be bent so that it restsThe upper arch wire can be bent so that it rests
against the molar band occlusally to the molar tube.against the molar band occlusally to the molar tube.

► This gives an increased axial inclination control inThis gives an increased axial inclination control in
the bucco-lingual direction, and also helps preventthe bucco-lingual direction, and also helps prevent
maxillary molar flaring during stage III.maxillary molar flaring during stage III.
► When bending the end of the arch wire, careWhen bending the end of the arch wire, care
should taken to prevent the beaks of the pliersshould taken to prevent the beaks of the pliers
from resting against the distal surfaces of thefrom resting against the distal surfaces of the
tubes.tubes.
► This can set up aThis can set up a Camming ActionCamming Action that resultsthat results
in the arch wire being drawn distally through thein the arch wire being drawn distally through the
molar tube with such force during bending that themolar tube with such force during bending that the
arch wire can be permanently distorted in thearch wire can be permanently distorted in the
maxillary hook area.maxillary hook area.

Additions and modifications in stageAdditions and modifications in stage
III MechanicsIII Mechanics
► If the maxillary orIf the maxillary or
mandibular anchor molarsmandibular anchor molars
show signs of rotatingshow signs of rotating
distobuccaly, tie with 0.012distobuccaly, tie with 0.012
inch diameter ligature wireinch diameter ligature wire
from the lingual of thefrom the lingual of the
molar to the lingual buttonmolar to the lingual button
on the cuspid.on the cuspid.
► This tie helps to control theThis tie helps to control the
rotations of the molars.rotations of the molars.

► Some times it is not desirable to torque the rootsSome times it is not desirable to torque the roots
of all four maxillary anterior teeth lingually.of all four maxillary anterior teeth lingually.
► If it is felt that only the central incisors are to beIf it is felt that only the central incisors are to be
torqued, an auxiliary with two spurs is used.torqued, an auxiliary with two spurs is used.
► Maxillary laterals often displaced bodily to theMaxillary laterals often displaced bodily to the
lingual prior to treatment. During stage I & II, thelingual prior to treatment. During stage I & II, the
crowns of these teeth are tipped labially, leavingcrowns of these teeth are tipped labially, leaving
their roots too far lingual.their roots too far lingual.
► Assuming that the central incisors require theAssuming that the central incisors require the
usual lingual torque, an auxiliary shown belowusual lingual torque, an auxiliary shown below
(on right side) can be used.(on right side) can be used.

► Another lingual rootAnother lingual root
torqueing auxiliary that cantorqueing auxiliary that can
be easily applied andbe easily applied and
removed has been inventedremoved has been invented
byby Dr. Jhon Kichton.Dr. Jhon Kichton.
► It can be made to includeIt can be made to include
both the centrals andboth the centrals and
laterals, or shortened tolaterals, or shortened to
torque centrals only.torque centrals only.
• This type of auxiliary is capable of exerting a
great amount force, especially when fashoined
from 0.016 inch wire and used in conjuction
with 0.020 main arch wire.www.indiandentalacademy.com

► The use of a torqueing auxiliary (0.016 inch) inThe use of a torqueing auxiliary (0.016 inch) in
conjunction with a heavy base arch wire (0.020conjunction with a heavy base arch wire (0.020
inch) with a vertical spur in the midline.inch) with a vertical spur in the midline.
► Vertical spur in the midline bent into the mainVertical spur in the midline bent into the main
arch wire, acts as a point of resistance againstarch wire, acts as a point of resistance against
center section of auxiliary.center section of auxiliary.

► Maxillary arch wire with a gingivally directed stopMaxillary arch wire with a gingivally directed stop
bent in the midline being used in conjunction withbent in the midline being used in conjunction with
a 0.014 or 0.016 inch auxiliary to torque the rootsa 0.014 or 0.016 inch auxiliary to torque the roots
of the lateral incisors labially.of the lateral incisors labially.

Reverse Torqueing auxiliaryReverse Torqueing auxiliary
► In a properly treated four first bicuspid extractionIn a properly treated four first bicuspid extraction
case, the anchor molars( entire dental arches)case, the anchor molars( entire dental arches)
are brought farther forward during the third stageare brought farther forward during the third stage
than during previous stages.than during previous stages.
► In the severe tooth mass discrepancy cases, theIn the severe tooth mass discrepancy cases, the
mandibular dental arch may assume its desiredmandibular dental arch may assume its desired
mesiodistal positioning on basal bone beforemesiodistal positioning on basal bone before
stage III is compelted.stage III is compelted.
► In order to retard further anterior movement ofIn order to retard further anterior movement of
the lower dental arch and to upright thethe lower dental arch and to upright the
mandibular incisors, which usually becomingmandibular incisors, which usually becoming
labially inclined, A Reverse Torqueing Auxiliarylabially inclined, A Reverse Torqueing Auxiliary
is applied.is applied. www.indiandentalacademy.com

► The vertical spurs exertThe vertical spurs exert
labial pressure againstlabial pressure against
the lingual surface of thethe lingual surface of the
main arch wire, while themain arch wire, while the
horizontal sections presshorizontal sections press
lingually against thelingually against the
labial surface of the fourlabial surface of the four
incisors.incisors.
► This causes the roots ofThis causes the roots of
these teeth to movethese teeth to move
labially and their crownslabially and their crowns
to attempt to moveto attempt to move
lingually.lingually.

► Since there are no spaces leftSince there are no spaces left
between the crowns of thebetween the crowns of the
teeth in the third stage, lingualteeth in the third stage, lingual
movement of the crowns is notmovement of the crowns is not
possible.possible.
► The force is passed on distallyThe force is passed on distally
through the contact pointsthrough the contact points
between the teeth to thebetween the teeth to the
mandibular molars.mandibular molars.
► This reverse torqueing thusThis reverse torqueing thus
becomes an excellent sourcebecomes an excellent source
of intraoral anchorage duingof intraoral anchorage duing

The BeggThe Begg
Appliance andAppliance and
Technique StageTechnique Stage
IIIIII
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OutlineOutline
►Objectives of stage IIIObjectives of stage III
►How Objectives are achievedHow Objectives are achieved
►Problems and their remedies of stage IIIProblems and their remedies of stage III
►Causes of loss of anchorage in stage IIICauses of loss of anchorage in stage III
►Positions of teeth at the end of stage ThreePositions of teeth at the end of stage Three
►Stage III modelsStage III models
►ConclusionConclusion

Objectives of Stage IIIObjectives of Stage III
1.1. Maintaining all the corrections achievedMaintaining all the corrections achieved
during first and second stages.during first and second stages.
2.2. Achieve desired axial inclinations of allAchieve desired axial inclinations of all
the teeth.the teeth.

How Objectives are achievedHow Objectives are achieved
1. Maintaining all the corrections achieved1. Maintaining all the corrections achieved
during stages I & II.during stages I & II.
 Mesiodistal molar relationship maintainedMesiodistal molar relationship maintained
through the wearing of class II or class IIIthrough the wearing of class II or class III
elastics as required.elastics as required.
 Original spaces between anterior teeth areOriginal spaces between anterior teeth are
prevented from recurring by tyingprevented from recurring by tying
intermaxillry circles to the cuspid bracketsintermaxillry circles to the cuspid brackets
with steel ligature wire.with steel ligature wire.

 Over corrections of cuspids are maintained byOver corrections of cuspids are maintained by
engaging the brackets which have been offset onengaging the brackets which have been offset on
the teeth.the teeth.
 Over corrections of bicuspids are held by replacingOver corrections of bicuspids are held by replacing
elastic threads with steel ligature ties.elastic threads with steel ligature ties.
 Over corrections of central and lateral incisors areOver corrections of central and lateral incisors are
maintained through the continued use of bayonetmaintained through the continued use of bayonet
bends in the arch wires.bends in the arch wires.

 Opening of a deep anterior overbite isOpening of a deep anterior overbite is
maintained through the continued use of bite-maintained through the continued use of bite-
opening bends and class II or class III elastics.opening bends and class II or class III elastics.
 The correction of posterior crossbites isThe correction of posterior crossbites is
maintained by modifying the archwire or bymaintained by modifying the archwire or by
wearing of cross elastics as necessary.wearing of cross elastics as necessary.
 Posterior spaces kept closed by bending thePosterior spaces kept closed by bending the
distal ends of the arch wire around the buccaldistal ends of the arch wire around the buccal
tubes.tubes.
 Arch form and overbite correction maintained byArch form and overbite correction maintained by
using heavier (0.018 to 0.025) main archwire.using heavier (0.018 to 0.025) main archwire.

2. Achieve desired axial inclinations of the2. Achieve desired axial inclinations of the
teeth.teeth.
 Changes in the mesiodistal inclinations ofChanges in the mesiodistal inclinations of
teeth are accomplished by the use ofteeth are accomplished by the use of
individual root-tipping springs.individual root-tipping springs.
 Lingual or labial root torque is applied toLingual or labial root torque is applied to
anterior teeth through the application ofanterior teeth through the application of
torqueing auxilaries.torqueing auxilaries.

1. Maxilary molar widening:1. Maxilary molar widening:
CauseCause RemedyRemedy
A. Anchor bendsA. Anchor bends
present inpresent in
maxillary wire.maxillary wire.
A.A. Remove the maxillary arch wireRemove the maxillary arch wire
and eliminate or reduce theand eliminate or reduce the
anchor bends so that arch wireanchor bends so that arch wire
does not exert excessive gingivaldoes not exert excessive gingival
force on the maxillary molars.force on the maxillary molars.
Problems that may be encountered during
the third stage and their remedies

1.1. Maxilary molar widening:Maxilary molar widening:
B. Too much biteB. Too much bite
opening bendopening bend
between cuspid andbetween cuspid and
bicuspid.bicuspid.
C. Maxillary arch wireC. Maxillary arch wire
too flexible ; i,e tootoo flexible ; i,e too
small in diameter.small in diameter.
A.A. Remove the arch wire andRemove the arch wire and
lessen the degree of bend.lessen the degree of bend.
A.A. Construct a new arch wireConstruct a new arch wire
from hard 0.020 inch roundfrom hard 0.020 inch round
wire.wire.

D. Maxillary arch wire tooD. Maxillary arch wire too
wide .wide .
A.A. Remove and modify theRemove and modify the
arch wire.arch wire.
E. Torqueing auxiliaryE. Torqueing auxiliary
not constrictednot constricted
adequately oradequately or
extended too farextended too far
distally.distally.
A.A. Remove auxiliary andRemove auxiliary and
modify – narrow in posteriormodify – narrow in posterior
or shorten so that it endsor shorten so that it ends
between cuspid andbetween cuspid and
bicuspids.bicuspids.
1. Maxillary molar widening:1. Maxillary molar widening:

A. Lower arch wire not wideA. Lower arch wire not wide
enough.enough.
A.A. Remove and widen distalRemove and widen distal
ends of arch wire.ends of arch wire.
B. Class II elasticsB. Class II elastics
exerting too much force.exerting too much force.
A.A. Use lighter elasticsUse lighter elastics
( 2 to 2 1/2 ounces ).( 2 to 2 1/2 ounces ).
2. Mandibular molars narrowing:

2. Mandibular molars narrowing:2. Mandibular molars narrowing:
Cause:Cause: Remedy:Remedy:
A. Presence of steelA. Presence of steel
ligature tie from theligature tie from the
lingual of thelingual of the
mandibular cuspidmandibular cuspid
to the lingual of theto the lingual of the
mandibular molar.mandibular molar.
A.A. Remove the lingual tie.Remove the lingual tie.
Hold the spaces closedHold the spaces closed
by bending the arch wireby bending the arch wire
around the distal of thearound the distal of the
buccal tube.buccal tube.

2. Mandibular molars narrowing:2. Mandibular molars narrowing:
A. Lack of supportA. Lack of support
through the occlusalthrough the occlusal
contact with thecontact with the
maxillary molars.maxillary molars.
A.A. Use posterior crossUse posterior cross
elastics and checkelastics and check
symmetry of both archsymmetry of both arch
wires.wires.

3. Anterior bite opening:3. Anterior bite opening:
A. Too much power inA. Too much power in
the torqueingthe torqueing
A.A. Less activation inLess activation in
auxiliary, or makeauxiliary, or make
auxiliary from smallerauxiliary from smaller
size wire.size wire.

3. Anterior bite opening:3. Anterior bite opening:
B. Maxillary arch wire tooB. Maxillary arch wire too
thin.thin.
C. Patient not wearingC. Patient not wearing
class II elastics.class II elastics.
D. Bite not open atD. Bite not open at
beginning of stage 3.beginning of stage 3.
A.A. Use heavier main thirdUse heavier main third
stage arch wire.stage arch wire.
A.A. Educate patient.Educate patient.
A.A. Remove all torqueingRemove all torqueing
mechanisms ; return tomechanisms ; return to
stage I.stage I.

4. Teeth not uprighting mesiodistally:4. Teeth not uprighting mesiodistally:
A.A. Springs not active.Springs not active.
A.A. Arch wire caught onArch wire caught on
the edge of thethe edge of the
bracket.bracket.
A.A. Remove and activateRemove and activate
spring.spring.
B.B. Use spring with moreUse spring with more
reseliency.reseliency.
A.A.Tighten spring-pin to drawTighten spring-pin to draw
arch wire in bracket.arch wire in bracket.

4. Teeth not uprighting mesiodistally:4. Teeth not uprighting mesiodistally:
A. Springs placed inA. Springs placed in
backwards.backwards.
A.A. Remove and replace properly.Remove and replace properly.
B. OcclusalB. Occlusal
interferencesinterferences
caused by ancaused by an
elevated tooth.elevated tooth.
A.A. Remove band and moveRemove band and move
bracket incisally to causebracket incisally to cause
leveling of teeth.leveling of teeth.

5.Maxillary anterior teeth not torqueing5.Maxillary anterior teeth not torqueing
palatally.palatally.
A. Not enough forceA. Not enough force
from maxillaryfrom maxillary
torqueingtorqueing
A.A. Remove and reactivate.Remove and reactivate.
B.B. Make a new auxiliary fromMake a new auxiliary from
heavier wire.heavier wire.
B. Maxillary incisalB. Maxillary incisal
edges caughtedges caught
lingual to lowerlingual to lower
anterior teeth.anterior teeth.
A.A. Open the bite by arch wireOpen the bite by arch wire
modification or by placingmodification or by placing
anterior brackets farthe toanterior brackets farthe to
the incisal.the incisal.

A. Normal mesialA. Normal mesial
migration of teethmigration of teeth
during third stage.during third stage.
A.A. If near the end of stage III, doIf near the end of stage III, do
nothing.nothing.
B.B. If in the middle of stage III,If in the middle of stage III,
place reverse torqueingplace reverse torqueing
auxiliary to upright lowerauxiliary to upright lower
anterior teeth.anterior teeth.
6. Lower anterior teeth labially inclined:6. Lower anterior teeth labially inclined:

7. Rotation of teeth other than molars7. Rotation of teeth other than molars
A. Lack of completeA. Lack of complete
bracketbracket
engagement.engagement.
A.A. Seat arch wire completely inSeat arch wire completely in
the bracket slot, using athe bracket slot, using a
spring pin or steel ligature.spring pin or steel ligature.
B. Bracket off centerB. Bracket off center
of labial surface ofof labial surface of
teeth.teeth.
A.A. Recement band with bracketRecement band with bracket
in proper location.in proper location.

Causes of loss anchorageCauses of loss anchorage
►If class II elastics are not worn during theIf class II elastics are not worn during the
third stage, the upper dental arch as athird stage, the upper dental arch as a
whole will move too forward while the rootswhole will move too forward while the roots
of the teeth of both dental arches are beingof the teeth of both dental arches are being
uprighted.uprighted.
►Use of rectangular arch wires during thirdUse of rectangular arch wires during third
stage to torque tooth roots instead of usingstage to torque tooth roots instead of using
root torqueing spurs formed from light roundroot torqueing spurs formed from light round
arch wires.arch wires.

Positions of teeth at the end ofPositions of teeth at the end of
stage IIIstage III
End of Stage III with perfect parallelism
of canine and premolar roots.

Stage III ModelsStage III Models
1.1. Basically for teaching purposesBasically for teaching purposes
2. To check the arch width and the contour2. To check the arch width and the contour
3. Self-discipline to complete the third stage3. Self-discipline to complete the third stage
4. To check the inclination of the upper and4. To check the inclination of the upper and
lower anterior teeth – the impressionlower anterior teeth – the impression
should be deep to appreciateshould be deep to appreciate
5. To see as to how anchorage was5. To see as to how anchorage was
maintained in treatmentmaintained in treatment
6. It is certainly a visual aid for the patient and6. It is certainly a visual aid for the patient and
parentsparents

ConclusionConclusion
The Begg Stage III treatment phase is moreThe Begg Stage III treatment phase is more
complex than for the previous once, involvingcomplex than for the previous once, involving
the application of many auxiliaries.the application of many auxiliaries.
The careful understanding and practicing ofThe careful understanding and practicing of
Begg Technique helps us to provide an optimumBegg Technique helps us to provide an optimum
treatment to the patient.treatment to the patient.
The good beginning brings the good end &The good beginning brings the good end &
the good end should always depict what it meantthe good end should always depict what it meant
to be at the beginning….to be at the beginning….

Conventional begg's stage 3

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Conventional begg's stage 3