Finishing and retention in Begg appliance / fixed orthodontics courses

FinishingFinishing
&&
RetentionRetention
in Begg Appliancein Begg Appliance
www.indiandentalacademy.comwww.indiandentalacademy.com

INTRODUCTIONINTRODUCTION
Finishing is the last step ,before activeFinishing is the last step ,before active
treatment is discontinuedtreatment is discontinued
Ensuring that the teeth and relatedEnsuring that the teeth and related
structures are positioned in such a way asstructures are positioned in such a way as
will lead to better stability of results,will lead to better stability of results,
enhancement of esthetics, optimizedenhancement of esthetics, optimized
functions of stomato-gnathic system andfunctions of stomato-gnathic system and
an improvement of health of periodontiuman improvement of health of periodontium..

Greatest blow to popularity to beggGreatest blow to popularity to begg
technique came from realization thattechnique came from realization that
obtaining precision finishing with Beggobtaining precision finishing with Begg
appliance was difficult.appliance was difficult.
But these deficiencies can be overcome,But these deficiencies can be overcome,
if one is prepared to put in some extraif one is prepared to put in some extra
effort.effort.

There was no separate finishing stageThere was no separate finishing stage
documented by Dr. Raymond Begg.documented by Dr. Raymond Begg.
The proper time for appliance removal is when allThe proper time for appliance removal is when all
the teeth have been moved beyond thethe teeth have been moved beyond the
positioned they are finally intended to occupy.positioned they are finally intended to occupy.

After that upper & l appliances were removedAfter that upper & l appliances were removed
as a whole unitas a whole unit
Dr. Begg used to give only upper retainerDr. Begg used to give only upper retainer
containing circumferential wire around all teethcontaining circumferential wire around all teeth
No lower retention was usedNo lower retention was used

ObjectivesObjectives
Intra Arch ObjectivesIntra Arch Objectives
Good inter dental contactsGood inter dental contacts
Proper facio-lingual positioning of all teethProper facio-lingual positioning of all teeth
All rotations over corrected to a small extentAll rotations over corrected to a small extent
Complete space closureComplete space closure
Proper vertical leveling of all teeth for wellProper vertical leveling of all teeth for well
aligned marginal ridges & flat curve of speealigned marginal ridges & flat curve of spee
Proper tip & torque of all teeth for esthetics andProper tip & torque of all teeth for esthetics and
functionfunction
Proper arch formProper arch form
Maintenance of lower intercanine dimensionsMaintenance of lower intercanine dimensions

Inter Arch ObjectivesInter Arch Objectives
Normal overjet & overbiteNormal overjet & overbite
Class I molar, premolar & canine relationshipClass I molar, premolar & canine relationship
Tight inter-digitation of all cusp of posterior teethTight inter-digitation of all cusp of posterior teeth
Mid line should coincideMid line should coincide
Functional RequirementsFunctional Requirements
matching CO-CR without any anterior or lateralmatching CO-CR without any anterior or lateral
glideglide
No cuspal interference during functionNo cuspal interference during function
Normal cuspid and incisor guidanceNormal cuspid and incisor guidance
Healthy & well functioning TMJHealthy & well functioning TMJ

Control of etiological factorsControl of etiological factors
Soft tissue factors taken care of bySoft tissue factors taken care of by
Frenectomy or CSF etcFrenectomy or CSF etc..
Most of over corrections held of 11/10Most of over corrections held of 11/10
relationship (10% overcorrection) duringrelationship (10% overcorrection) during
treatmenttreatment  10½ /10 relation (5%10½ /10 relation (5%
overcorrection) during finishing stageovercorrection) during finishing stage

So the Objectives can be summarizedSo the Objectives can be summarized
Establishment of Andrews six keys ofEstablishment of Andrews six keys of
normal occlusionnormal occlusion
Midline alignment & fine tuningMidline alignment & fine tuning
Stabilization of all the movementsStabilization of all the movements
achieved until stage IIIachieved until stage III

PrerequisitesPrerequisites
Meticulous conduct in earlier stagesMeticulous conduct in earlier stages
Pre finish CephalogramPre finish Cephalogram
objectives framed at the commencement of trt. hasobjectives framed at the commencement of trt. has
been achievedbeen achieved
Gives one more opportunity to review and achieveGives one more opportunity to review and achieve
the goals of various previous stages if stillthe goals of various previous stages if still
unachieved.unachieved.
OcclusogramOcclusogram Esp. in lower archEsp. in lower arch ,,
enable disposition of roots &enable disposition of roots &
relation to symphyseal anatomyrelation to symphyseal anatomy
Appropriate I,2,3 order bendAppropriate I,2,3 order bend

Pre finishing stage modelsPre finishing stage models
Requirements for first, second and third orderRequirements for first, second and third order
corrections of every tooth & group of teethcorrections of every tooth & group of teeth
Esp. useful for checking the levels of marginal ridgesEsp. useful for checking the levels of marginal ridges
& lingual and palatal cusps, lingual occlusion,& lingual and palatal cusps, lingual occlusion,
Amount of overcorrection –rotations planned &Amount of overcorrection –rotations planned &
executedexecuted
Bracket positions should be just rightBracket positions should be just right
Loose bands should be recementedLoose bands should be recemented
Sevens if not banded earlier should beSevens if not banded earlier should be
banded at this juncture.banded at this juncture.

Different modalities for FinishingDifferent modalities for Finishing
According to Dr. SwainAccording to Dr. Swain
After root tipping movement of stage 3After root tipping movement of stage 3
completed torquing & IIing aux. are removed &completed torquing & IIing aux. are removed &
in base arch wire adjustments are madein base arch wire adjustments are made
To flatten occlusal planeTo flatten occlusal plane localized verticallocalized vertical
offset bends to level ind. Teeth & generalizedoffset bends to level ind. Teeth & generalized
curve to level segmentscurve to level segments

To obtain bilateral symmetryTo obtain bilateral symmetry if wire is symm.if wire is symm.
but arch is not, definite localized horizontal offsetbut arch is not, definite localized horizontal offset
to expand or contract individual teethto expand or contract individual teeth
If both wire and dental arch are asym., makeIf both wire and dental arch are asym., make
wire sym. or with slight compensatory asymmwire sym. or with slight compensatory asymm..
Overrotations & other over corrections areOverrotations & other over corrections are
maintained.maintained.
Edge to edge relationship of deep biteEdge to edge relationship of deep bite
cases is maintainedcases is maintainedwww.indiandentalacademy.comwww.indiandentalacademy.com

Point of band removalPoint of band removal
Depends uponDepends upon
nature of movements still unfinished (positionernature of movements still unfinished (positioner
not efficient for root movements or rotation ofnot efficient for root movements or rotation of
round teeth)round teeth)
Patients record of cooperationPatients record of cooperation
Closing space with elastic or elastomericClosing space with elastic or elastomeric
threadsthreads
When bands are removed impression is takenWhen bands are removed impression is taken
for positioner and molar bands replacedfor positioner and molar bands replaced

In maximum anchorage cases additionalIn maximum anchorage cases additional
retraction is done by placing elastic orretraction is done by placing elastic or
elastomeric threads around the dental archelastomeric threads around the dental arch
In minimum discrepancy cases retraction isIn minimum discrepancy cases retraction is
undesirableundesirable
If over rotation is present do not close the spaceIf over rotation is present do not close the space
After this positioner is deliveredAfter this positioner is delivered

Tooth positionerTooth positioner
Described by H. D. Kesling in 1945,Described by H. D. Kesling in 1945,
a one piece resilient appliance made froma one piece resilient appliance made from
rubber or plastic that fills the free-way space andrubber or plastic that fills the free-way space and
covers the clinical crowns of the teeth and acovers the clinical crowns of the teeth and a
portion of gingiva, both buccal and lingual. Noportion of gingiva, both buccal and lingual. No
adjustment is required for this applianceadjustment is required for this appliance
Dr. begg did not use tooth positionersDr. begg did not use tooth positioners
P.C kesling used for finishing & retentionP.C kesling used for finishing & retention

Eugene L. GottlickEugene L. Gottlick in 100 cases to testin 100 cases to test
efficacy 60% success,26% partial successefficacy 60% success,26% partial success
& 14% Failure& 14% Failure
Inherent elasticity to move teeth slightly toInherent elasticity to move teeth slightly to
their final positiontheir final position

ConstructionConstruction
Tooth positioner is constructed over aTooth positioner is constructed over a
predetermined pattern the – setup.predetermined pattern the – setup.
Teeth that are repositioned in the patientsTeeth that are repositioned in the patients
mouth are removed from the patients modelsmouth are removed from the patients models
and placed in desired positions.and placed in desired positions.
The gum area of the setup is contoured toThe gum area of the setup is contoured to
normal form after changing the teeth.normal form after changing the teeth.

Positioners are then formed often of elasticPositioners are then formed often of elastic
material above the arches in rest position.material above the arches in rest position.
Result in upper and lower teeth are slightlyResult in upper and lower teeth are slightly
separated and lower arch slightly distal to upper.separated and lower arch slightly distal to upper.
Space closure with in reason can beSpace closure with in reason can be
accomplished with tooth positioner.accomplished with tooth positioner.
Within limitation positioners can be used to helpWithin limitation positioners can be used to help
maintain or change the amount of anteriormaintain or change the amount of anterior
overbite.overbite.

Adv.Adv.
Fixed appliance can be removed quickly than withFixed appliance can be removed quickly than with
use of finishing wiresuse of finishing wires
Gingival stimulation – rapid return to normalGingival stimulation – rapid return to normal
gingival contourgingival contour
Disadv.Disadv.
Considerable amount of lab fab. time (expensive)Considerable amount of lab fab. time (expensive)
Settling with it increases overbite >eq. settling withSettling with it increases overbite >eq. settling with
light elasticslight elastics
Does not maintain correction of rotated teeth wellDoes not maintain correction of rotated teeth well
Good cooperation is essentialGood cooperation is essential

IndicationsIndications
gingival condition with more than usual degree ofgingival condition with more than usual degree of
inflammation & swellinginflammation & swelling
Open bite tendency, settling by mild depression ofOpen bite tendency, settling by mild depression of
post. teethpost. teeth
ContraindicationsContraindications
Severe malalig. And rotated teethSevere malalig. And rotated teeth
Deep bite tendencyDeep bite tendency
Uncooperative patientUncooperative patientwww.indiandentalacademy.comwww.indiandentalacademy.com

Duration of wearDuration of wear
first 2 days full wearfirst 2 days full wear
After that 4 hours during day time & during SleepAfter that 4 hours during day time & during Sleep
In cooperative patients produce results inIn cooperative patients produce results in
3 weeks after that acts as retainer (not3 weeks after that acts as retainer (not
good retainer)good retainer)

Finishing Wires in Begg Trt.Finishing Wires in Begg Trt.
Round Finishing WiresRound Finishing Wires
0.020”,0.018” premium grade0.020”,0.018” premium grade
0.020” sectional wire (with settling0.020” sectional wire (with settling
elastics)elastics)
Rectangular wiresRectangular wires
0.022” x 0.018” ribbon (alpha titanium)0.022” x 0.018” ribbon (alpha titanium)
0.019” x 0.025” (blue elgiloy)0.019” x 0.025” (blue elgiloy)
0.020” Sq. (alpha titanium)0.020” Sq. (alpha titanium) mollenhauermollenhauer

Round wires (Fabrication)Round wires (Fabrication)
0.020” normally0.020” normally
0.018” vertical movement req.0.018” vertical movement req.
0.020” sectional closing open bites0.020” sectional closing open bites
Often req. to continue aux.Often req. to continue aux.
Ach wire fabricated according to individual archAch wire fabricated according to individual arch
formform

First Order BendsFirst Order Bends
Upper archUpper arch
To tuck in lateral incisorsTo tuck in lateral incisors
Canine offset (diff. in lab.lin. Thickness of U-2 &U- 3)Canine offset (diff. in lab.lin. Thickness of U-2 &U- 3)
Offset between premolars and molars (to compensateOffset between premolars and molars (to compensate
for diff. in buccal contour)for diff. in buccal contour)
Toe in bend for 1Toe in bend for 1stst
& 2& 2ndnd
molars for good class I molarmolars for good class I molar
(not req. for cases finished in class II)(not req. for cases finished in class II)
Flat segment between U-3 & U-6Flat segment between U-3 & U-6

Lower archLower arch
To tuck L – 3(minimize relapse of lowerTo tuck L – 3(minimize relapse of lower
crowding)crowding)
diff. in thickness of L-3 & L-2 pushes L-3 slig.diff. in thickness of L-3 & L-2 pushes L-3 slig.
Ling. without offset (no offset in well alig. Or mildLing. without offset (no offset in well alig. Or mild
crowding cases)crowding cases)
in severely crowded cases inset between L-2 &in severely crowded cases inset between L-2 &
L-3 and offset between L-3 & adj. premolarL-3 and offset between L-3 & adj. premolar
Offset between premolars and molarsOffset between premolars and molars

Second order BendsSecond order Bends
If necessary to intrude U-2 vertical stepIf necessary to intrude U-2 vertical step
Mild occlusal (tip down) bend in U molar region (slig. MesialMild occlusal (tip down) bend in U molar region (slig. Mesial
ang. Of U-6 for seating its D.B cusp against M.B cusp of L-7ang. Of U-6 for seating its D.B cusp against M.B cusp of L-7
A slig. Distal tip of L-6 for proper fit against U-6 takes placeA slig. Distal tip of L-6 for proper fit against U-6 takes place
its own (AB)its own (AB)
Continue uprighting spring on U-3 so cusp tip occlude withContinue uprighting spring on U-3 so cusp tip occlude with
distal half of lab. surface of L-3distal half of lab. surface of L-3
Third order CorrectionThird order Correction
Over correct all teeth 10-15% in 3Over correct all teeth 10-15% in 3rdrd
stage if not possiblestage if not possible
during 3during 3rdrd
stage continue stage III aux.stage continue stage III aux.

Rectangular wiresRectangular wires
Dr. Mollenhauer suggested and popularizedDr. Mollenhauer suggested and popularized
rectangular wires for finishingrectangular wires for finishing
The original tech. consisted in converting the roundThe original tech. consisted in converting the round
tubes by crimping using a template into ribbon tubestubes by crimping using a template into ribbon tubes..
He recommended use of 0.020” sq. or 0.018”He recommended use of 0.020” sq. or 0.018”
x0.022” alpha titanium wirex0.022” alpha titanium wire
Adv. of rectangular wiresAdv. of rectangular wires
Bucco-lingual root torque particularly for post. Seg.Bucco-lingual root torque particularly for post. Seg.
Eff. AppliedEff. Applied

Extent of overcorrection can be reducedExtent of overcorrection can be reduced
Individual tooth positions in terms of in out, rotationsIndividual tooth positions in terms of in out, rotations
and overcorrection easily establishedand overcorrection easily established
Root & crown movements are stabilizedRoot & crown movements are stabilized
Arch form, arch coordination & occlusal relationshipsArch form, arch coordination & occlusal relationships
can be fine tunedcan be fine tuned
Retention is likely to be more stableRetention is likely to be more stable
Gnathological/functional occlusal relationships canGnathological/functional occlusal relationships can
achieve betterachieve better
Stabilizing wires for orthognathic surgeryStabilizing wires for orthognathic surgery
Debonding & debanding easier (less mobile teeth)Debonding & debanding easier (less mobile teeth)www.indiandentalacademy.comwww.indiandentalacademy.com

The strap upThe strap up
Combination tubesCombination tubes Consist of gingival round tubeConsist of gingival round tube
0.036”diametre x 6.2mm long & rectangular0.036”diametre x 6.2mm long & rectangular
(ribbon) occlusal tube 0.025”x 0.018” dia x 5.5 mm(ribbon) occlusal tube 0.025”x 0.018” dia x 5.5 mm
long it has 6º offsetlong it has 6º offset
Second molars can be banded withSecond molars can be banded with
this tube or only ribbon tubesthis tube or only ribbon tubes
good Quality Begg Brackets (thick walled)good Quality Begg Brackets (thick walled)

Wire SelectionWire Selection (directly related to modulus of elasticity)(directly related to modulus of elasticity)
Based upon-Based upon- cases that req. only passive torque &cases that req. only passive torque &
stabilizationstabilization (0.020”sq. or 0.018” x 0.022’ alpha(0.020”sq. or 0.018” x 0.022’ alpha
titanium)titanium)
cases that req. active torque (ss or elgiloy alloy)cases that req. active torque (ss or elgiloy alloy)
Alpha TiAlpha Ti has modulus of elasticity intermediate to ss &has modulus of elasticity intermediate to ss &
TMA .TMA .
It has adv .of intraoral adjustmentIt has adv .of intraoral adjustment
shows ↑ in str. in oral cavity due to absorption of Hshows ↑ in str. in oral cavity due to absorption of H
ions but it become brittle (due to vanadium content) inions but it become brittle (due to vanadium content) in
6 weeks of insertion.6 weeks of insertion.

Incorporation of torqueIncorporation of torque
Best wayBest way in ant. Segment with 0.022” torquingin ant. Segment with 0.022” torquing
turret (permit 20º torque) either torque or reverseturret (permit 20º torque) either torque or reverse
torquetorque
Individualized torque – Rose torquing plier.Individualized torque – Rose torquing plier.
General rule 15º and 25º buccal root torque in U &General rule 15º and 25º buccal root torque in U &
L pos. respectivelyL pos. respectively
First and second order bends are placed as inFirst and second order bends are placed as in
round wiresround wires

Fabrication and placement of arch wireFabrication and placement of arch wire
A st. length of app. 8” of .018 x.022 wireA st. length of app. 8” of .018 x.022 wire
Placed in turret so that middle of wire coincidesPlaced in turret so that middle of wire coincides
with centre mark on turretwith centre mark on turret
Turret is given firm & brisk turn for arch formTurret is given firm & brisk turn for arch form
11stst
& 2& 2ndnd
order bends place with Tweed plierorder bends place with Tweed plier
Individual torque when req.– Rose torquing plier.Individual torque when req.– Rose torquing plier.
Place the arch wire in slots and pin themPlace the arch wire in slots and pin them
securely with steel T pinssecurely with steel T pinswww.indiandentalacademy.comwww.indiandentalacademy.com

Checklist on finishingChecklist on finishing
Establish all the Andrews keys of normal occlusionEstablish all the Andrews keys of normal occlusion
Midline should coincideMidline should coincide
Cheek occlusion in centric positionCheek occlusion in centric position
Cheek occlusion in functional movementsCheek occlusion in functional movements
Cheek for excellent interdigitation, where neededCheek for excellent interdigitation, where needed
section archwire & place W or M elastics to settlesection archwire & place W or M elastics to settle
the teeththe teeth
Overcorrection generally not req. or at most 10½ /Overcorrection generally not req. or at most 10½ /
10 overcorrection10 overcorrection

Finishing to achieve Gnathological goalsFinishing to achieve Gnathological goals
Gnathological ObjectivesGnathological Objectives
A stable CR of the mandible and to have the teeth intercuspA stable CR of the mandible and to have the teeth intercusp
maximally at this mandibular position. All centric stopsmaximally at this mandibular position. All centric stops
should hit equally and simultaneously and the stress ofshould hit equally and simultaneously and the stress of
closure should be directed, down the long axes of theclosure should be directed, down the long axes of the
posterior teeth. There should be no actual contact of theposterior teeth. There should be no actual contact of the
anterior teeth in centric closure (.0005" clearance).anterior teeth in centric closure (.0005" clearance).
Incisal guidance adequate to disclude the posterior teeth asIncisal guidance adequate to disclude the posterior teeth as
the mandible glides forward from centric position. Therethe mandible glides forward from centric position. There
should be sufficient overbite and overjet at the maxillaryshould be sufficient overbite and overjet at the maxillary
incisor tips to allow for a gentle glide path.incisor tips to allow for a gentle glide path.

The cuspids should be the main gliding inclinesThe cuspids should be the main gliding inclines
on lateral excursion and the six maxillaryon lateral excursion and the six maxillary
anterior teeth should articulate with the sixanterior teeth should articulate with the six
mandibular anterior teeth and the mandibularmandibular anterior teeth and the mandibular
bicuspids (first bicuspid in nonextraction cases),bicuspids (first bicuspid in nonextraction cases),
so that the protrusive load is spread over 14so that the protrusive load is spread over 14
teeth."teeth." mutually protectivemutually protective" occlusal" occlusal
The teeth should no way interfere with theThe teeth should no way interfere with the
normal envelop of border movementnormal envelop of border movement

A centrically related occlusion and a mutuallyA centrically related occlusion and a mutually
protective excursive occlusal scheme areprotective excursive occlusal scheme are
dependent upon:dependent upon:
1. Proper individual tooth positioning.1. Proper individual tooth positioning.
2.2. Knowing when the mandible is in centric andKnowing when the mandible is in centric and
when it is not.when it is not.
3. Coordination of arch form and arch width.3. Coordination of arch form and arch width.
4.4. Control of the vertical dimension.Control of the vertical dimension.
5. Anteroposterior correction between maxilla and5. Anteroposterior correction between maxilla and
mandible.mandible.
6.6. Clinical awareness of excursive interferences.Clinical awareness of excursive interferences.

Roth Accepts the Six Keys to normalRoth Accepts the Six Keys to normal
occlusion and adds his functional req.occlusion and adds his functional req.
1. Lower incisors at the +1 to A-Po; for facial1. Lower incisors at the +1 to A-Po; for facial
esthetics, for planning anchorage control, andesthetics, for planning anchorage control, and
for selection of mechanotherapy.for selection of mechanotherapy.
2. Tips of the upper incisors 2-2.5mm below the lip2. Tips of the upper incisors 2-2.5mm below the lip
embrasure of the upper and lower lips, when theembrasure of the upper and lower lips, when the
lips are closed with no lip strain.lips are closed with no lip strain.
3. No more than 1 mm of attached gingiva showing3. No more than 1 mm of attached gingiva showing
upon a full smile.upon a full smile.

4.4. App. 2.5mm overjet-overbite relationshipApp. 2.5mm overjet-overbite relationship
(.0005" clearance with the lingual surface of the(.0005" clearance with the lingual surface of the
upper incisor.)upper incisor.)
5. A flat occlusal plane, at the end of therapy that5. A flat occlusal plane, at the end of therapy that
would return to a 1 to 1.5mm curve, at itswould return to a 1 to 1.5mm curve, at its
deepest point, after appliance removal anddeepest point, after appliance removal and
settling of the occlusionsettling of the occlusion
6.6. A curve of Wilson that would allow seating ofA curve of Wilson that would allow seating of
centric cusps, but clearance upon excursions.centric cusps, but clearance upon excursions.

7.7. Lower incisors aligned contact point-to-contactLower incisors aligned contact point-to-contact
point with the roots in the same plane, whenpoint with the roots in the same plane, when
observed from the occlusal, and a mesioaxialobserved from the occlusal, and a mesioaxial
inclination of 2 degrees.inclination of 2 degrees.
8. L- 3 crowns angulated mesially 5 degrees, with8. L- 3 crowns angulated mesially 5 degrees, with
the incisal tip 1mm higher than the incisal edgethe incisal tip 1mm higher than the incisal edge
of, the lateral incisors. The lower cuspids shouldof, the lateral incisors. The lower cuspids should
have a slightly exaggerated mesial rotation inhave a slightly exaggerated mesial rotation in
extraction cases.extraction cases.

9. The lower bicuspids should be uprighted 1 degree9. The lower bicuspids should be uprighted 1 degree
from their normal mesial inclination and shouldfrom their normal mesial inclination and should
have a slight distal rotation (more so on anhave a slight distal rotation (more so on an
extraction case). The contact point should beextraction case). The contact point should be
adjacent to the contact point on the lower cuspidadjacent to the contact point on the lower cuspid
distal surface.distal surface.
10. The lower molars should be uprighted 1 degree10. The lower molars should be uprighted 1 degree
from their normal 2-degree mesial inclination, andfrom their normal 2-degree mesial inclination, and
should have a slight distal rotation.should have a slight distal rotation.

11. The lower buccal segment should have11. The lower buccal segment should have
progressive torque close to Andrews'progressive torque close to Andrews'
measurements for establishing the curve ofmeasurements for establishing the curve of
Wilson, and there should be no rotations orWilson, and there should be no rotations or
spaces.spaces.
12. The upper 1st molars should have sufficient12. The upper 1st molars should have sufficient
distal rotation, mesioaxial inclination, and buccaldistal rotation, mesioaxial inclination, and buccal
root torque, so as to fit with the lower 1st molars,.root torque, so as to fit with the lower 1st molars,.
The same would follow for the upper 2The same would follow for the upper 2ndnd
molars.molars.
(14 degrees torque and 0 degrees tip).(14 degrees torque and 0 degrees tip).

13. The upper bicuspids should be uprighted to 013. The upper bicuspids should be uprighted to 0
degrees from their normal 2-degree mesialdegrees from their normal 2-degree mesial
inclination, with no rotation.inclination, with no rotation.
14. The U-3 must have its contact points adjacent14. The U-3 must have its contact points adjacent
to the contact points of the upper bicuspid andto the contact points of the upper bicuspid and
lateral incisor, to establish proper length forlateral incisor, to establish proper length for
cuspid guidance. ( +11 to +13 degrees of mesialcuspid guidance. ( +11 to +13 degrees of mesial
crown tip)crown tip)

15. The U-2 & U-1 should be almost equal in15. The U-2 & U-1 should be almost equal in
incisal edge length, with no more than 0.5mmincisal edge length, with no more than 0.5mm
height differential.height differential.
16. There should be no rotations or spaces in the16. There should be no rotations or spaces in the
upper arch, and the buccal segments from theupper arch, and the buccal segments from the
cuspids distally should have 14 degreescuspids distally should have 14 degrees
nonprogressive buccal root torque.nonprogressive buccal root torque.

17. The arch form should be a modified catenary17. The arch form should be a modified catenary
curve consisting of five separate radii —curve consisting of five separate radii —
one for the front of the arch form, one for eachone for the front of the arch form, one for each
cuspid-bicuspid area and one for each buccalcuspid-bicuspid area and one for each buccal
segment from the first bicuspid distally.segment from the first bicuspid distally.
The widest point of the lower arch would be at theThe widest point of the lower arch would be at the
mesiobuccal cusp of the mandibular first molarsmesiobuccal cusp of the mandibular first molars
and at the first bicuspids.and at the first bicuspids.
The widest point of the maxillary arch would be atThe widest point of the maxillary arch would be at
the mesiobuccal cusps of the first molars.the mesiobuccal cusps of the first molars.

Attainment of Gnathological Goals in BeggAttainment of Gnathological Goals in Begg
TechniqueTechnique
Banding the 2Banding the 2ndnd
molar in early stage 3molar in early stage 3 toto
prevent hindrance in arch form establishment,prevent hindrance in arch form establishment,
leveling of curve of spee & to prevent occlusalleveling of curve of spee & to prevent occlusal
interference in lateral excursions.interference in lateral excursions.
 control there b-l torque with ribbon Alphacontrol there b-l torque with ribbon Alpha
titanium wires in finishing stage.titanium wires in finishing stage.

To prevent loss of incisal guidance andTo prevent loss of incisal guidance and
under torque incisorsunder torque incisors
Establish 1 mm overjet and 1 mm overbiteEstablish 1 mm overjet and 1 mm overbite
To control torque use torqued ribbon archTo control torque use torqued ribbon arch
wires or torqued bracketswires or torqued brackets
Lack of torque in upper and lower molarsLack of torque in upper and lower molars
 balancing and centric interferencesbalancing and centric interferences
torque with ribbon Alpha titanium wirestorque with ribbon Alpha titanium wires

In begg roots of lower incisors are notIn begg roots of lower incisors are not
uprighted enoughuprighted enough
Roots should be in same plane with apicesRoots should be in same plane with apices
divergent. Lower cuspid should have crowndivergent. Lower cuspid should have crown
torque enough to give cuspid guidancetorque enough to give cuspid guidance
Individual root torquing Auxiliary with ribbon wireIndividual root torquing Auxiliary with ribbon wire
Pantamorphic arch formPantamorphic arch form can be used in beggcan be used in begg
in Alpha titanium wires or 0.019 x0.25 bluein Alpha titanium wires or 0.019 x0.25 blue
elgiloyelgiloy www.indiandentalacademy.comwww.indiandentalacademy.com

Vertical controlVertical control anchor bendanchor bend  extrusionextrusion
(high angle cases)(high angle cases) alteration in centricalteration in centric
• Molar fulcrumMolar fulcrum  either an anterior open bite oreither an anterior open bite or
postero-inferior displacement of condylespostero-inferior displacement of condyles
relapserelapse
• Judiciously avoiding classII elastics in casesJudiciously avoiding classII elastics in cases
Molar fulcrum is likely to produceMolar fulcrum is likely to produce
Towards the end of trt.Towards the end of trt. Test followingTest following
Excursions : protrusive, left & right lateralExcursions : protrusive, left & right lateral
excrusions,see 2excrusions,see 2ndnd
molar interferencemolar interference

Most important entities to establish areMost important entities to establish are
Anterior group functionAnterior group function
Minimal posterior disclusionMinimal posterior disclusion
Cuspid guidance in lateral excursionCuspid guidance in lateral excursion
Absence of balancing interferencesAbsence of balancing interferences

Gnathological positionerGnathological positioner
objective of place the appliance over theobjective of place the appliance over the
patient's maxillary teethpatient's maxillary teeth
and hinge the patient's mandible on the centricand hinge the patient's mandible on the centric
relation arc into the lower portion of therelation arc into the lower portion of the
appliance,appliance,
have the teeth seat into the sockets without thehave the teeth seat into the sockets without the
necessity of the mandible moving forward off ofnecessity of the mandible moving forward off of
the centric relation arc.the centric relation arc.

RetentionRetention
Retain (L retinere, Re + tenere - to hold) Means
to hold back or to hold secure.
“The holding of teeth in ideal, aesthetic and
functional position.” - Richard A. Riedel
History of retention
Hellman “we are in almost complete ignorance
of specific factor causing relapse”
Diff. Philosophies have developed, present day
concept combine several of these theories

The occlusal school –The occlusal school –
KingsleyKingsley –” the occlusion of teeth is the most–” the occlusion of teeth is the most
potent factor in determining the stability in newpotent factor in determining the stability in new
position”. Other authors also agree on it.position”. Other authors also agree on it.
Apical base school –Apical base school –
In 1920’sIn 1920’s Axel LundstormAxel Lundstorm –– “apical base was“apical base was
one of the most important factors in correctionone of the most important factors in correction
of malocclusion and maintenance of correctof malocclusion and maintenance of correct
occlusion”occlusion”
McCuleyMcCuley – “intercanine and intermolar width– “intercanine and intermolar width
should be maintained as of originally present.”should be maintained as of originally present.”

NanceNance- “Arch length may be permanently- “Arch length may be permanently
increased only to limited extent”increased only to limited extent”
Mandibular incisor school –Mandibular incisor school –
Grieve and TweedGrieve and Tweed –– “mandibular incisors must“mandibular incisors must
be kept upright &over the basal bone.”be kept upright &over the basal bone.”
Muscular school –Muscular school –
RogersRogers considered the necessity of establishingconsidered the necessity of establishing
of proper functional muscle balance.of proper functional muscle balance.

Theories of retentionTheories of retention
RiedelRiedel summarized the different concepts &summarized the different concepts &
philosophies into nine theorems.philosophies into nine theorems.
MoyersMoyers added another theory mentioned as 10added another theory mentioned as 10thth
theoremtheorem
Theorem ITheorem I – “– “Teeth that have been moved tendTeeth that have been moved tend
to return to their former original positionto return to their former original position”.”.
Reasons for this can be- muscular, apical base,Reasons for this can be- muscular, apical base,
trans septal fibers and bone morphology.trans septal fibers and bone morphology.

Theorem IITheorem II – “– “Elimination of cause of malocclusionElimination of cause of malocclusion
will prevent recurrencewill prevent recurrence”.”.
This can be applied where cause is obvious.This can be applied where cause is obvious.
Theorem IIITheorem III –– ““malocclusion should be overmalocclusion should be over
corrected as a safety factor”corrected as a safety factor”
Overcorrection of class II to edge to edge bite may beOvercorrection of class II to edge to edge bite may be
result of overcoming muscular balance rather thanresult of overcoming muscular balance rather than
absolute tooth movementabsolute tooth movement
Over rotation is usually carried out but little evidenceOver rotation is usually carried out but little evidence
of its success in preventing relapseof its success in preventing relapse

Theorem IVTheorem IV –– ““Proper occlusion is a potent factor inProper occlusion is a potent factor in
holding teeth in their corrected positions”.holding teeth in their corrected positions”.
Orthodontist should not restrict trt. to goodOrthodontist should not restrict trt. to good
intercuspation but aim for good functional occlusionintercuspation but aim for good functional occlusion
It is doubtful that proper intercuspation of interlockingIt is doubtful that proper intercuspation of interlocking
is the most potent factor in retentionis the most potent factor in retention
Theorem VTheorem V –– “Bone and adjacent tissues must be“Bone and adjacent tissues must be
allowed time to reorganize around the newlyallowed time to reorganize around the newly
positioned teeth”.positioned teeth”.

Theorem VITheorem VI –– “If lower incisors are places upright over“If lower incisors are places upright over
the basal bone they are more likely to remain in goodthe basal bone they are more likely to remain in good
alignment”.alignment”.
Uprighting means bringing lower incisors perpendi. toUprighting means bringing lower incisors perpendi. to
mandibular plane or some specific angulation tomandibular plane or some specific angulation to
occlusal plane or F.H planeocclusal plane or F.H plane
But it is difficult to specify where basal bone begins orBut it is difficult to specify where basal bone begins or
endsends
Theorem VIITheorem VII –– ““Corrections carried during periods ofCorrections carried during periods of
growth are less likely to relapsegrowth are less likely to relapse”.”.
Orthodontic trt. Should be initiated at the earlier ageOrthodontic trt. Should be initiated at the earlier age
possiblepossible

Theorem VIIITheorem VIII –– “The farther the teeth have been“The farther the teeth have been
moved the less the likelihood of relapse”.moved the less the likelihood of relapse”.
Little real evidence.Little real evidence.
Opp. May be true, more desirable throughOpp. May be true, more desirable through
guidance of eruption and early interception ofguidance of eruption and early interception of
skeletal dyspla. to minimize the need of futureskeletal dyspla. to minimize the need of future
extensive tooth movement.extensive tooth movement.
Theorem IXTheorem IX –– “Arch form particularly in the“Arch form particularly in the
mandibular arch cannot be permanently alteredmandibular arch cannot be permanently altered
by appliance therapy”.by appliance therapy”.

So arch form should be maintained presented bySo arch form should be maintained presented by
original malocclusionoriginal malocclusion
Theorem XTheorem X –– “Many treated malocclusions“Many treated malocclusions
require permanent retaining device”.require permanent retaining device”.
This is true only in cases that have not beenThis is true only in cases that have not been
treated to achieve occlusal goals that stand fortreated to achieve occlusal goals that stand for
stabilitystability

Why retention is necessary?Why retention is necessary?
Gingival and periodontal fibers, req. time toGingival and periodontal fibers, req. time to
reorganize themselves after trt.reorganize themselves after trt.
Teeth may be in unstable position after trt, soTeeth may be in unstable position after trt, so
soft tissue pressure may produce relapsesoft tissue pressure may produce relapse
tendenciestendencies
Changes produced by growthChanges produced by growth

Cheek/lip
/tongue
pressure
Intra arch
irregularity
Differential
jaw
growth
Changes in
Occlusal
relationship
Elastic
recoil of
gingival fibers

Reorganization Of Periodontal & GingivalReorganization Of Periodontal & Gingival
TissuesTissues
Widening of PDL and disruption of collagenWidening of PDL and disruption of collagen
bundlesbundles
Even if the orthodontic tooth movement stopsEven if the orthodontic tooth movement stops
before appliance is removed restoration ofbefore appliance is removed restoration of
normal periodontal architecture will not reoccurnormal periodontal architecture will not reoccur
as long as the tooth is strongly splinted to itsas long as the tooth is strongly splinted to its
neighbors.neighbors.
Reorganization of PDL occurs over a 3 to 4Reorganization of PDL occurs over a 3 to 4
months.months.
Teeth will be unstable in the face under occlusalTeeth will be unstable in the face under occlusal
and soft tissue pressure.and soft tissue pressure.

Gingival FibersGingival Fibers
Both collagen and elastic fibers occur in gingivaBoth collagen and elastic fibers occur in gingiva
and reorganization occurs slowly than PDL.and reorganization occurs slowly than PDL.
Collagen fibers In 4 to 6 monthsCollagen fibers In 4 to 6 months
Elastic supra crestal fibers >1 year. (In patientElastic supra crestal fibers >1 year. (In patient
with severe rotation, sectioning the supra crestalwith severe rotation, sectioning the supra crestal
fibers around rotated teeth )fibers around rotated teeth )

Principles of retention against intra arch stabilityPrinciples of retention against intra arch stability
Teeth tend to come back because of elastic recoil ofTeeth tend to come back because of elastic recoil of
gingival fibers & tongue and lip forces.gingival fibers & tongue and lip forces.
Full time retention for first four months after fixedFull time retention for first four months after fixed
orthodontic appliance is removed except duringorthodontic appliance is removed except during
mastication to promote PDL reorganizationmastication to promote PDL reorganization
Because of slow response of gingival fibers ,Because of slow response of gingival fibers ,
--continue for at least 12 months if teeth were irregularcontinue for at least 12 months if teeth were irregular
initiallyinitially
-can be reduced to part time after 3 to 4 months.-can be reduced to part time after 3 to 4 months.

After 12 months discontinued in non growingAfter 12 months discontinued in non growing
patient.patient.
Patient who will still grow, continue the retentionPatient who will still grow, continue the retention
until growth has reduced to low leveluntil growth has reduced to low level
Occlusal Changes Related To GrowthOcclusal Changes Related To Growth
Continuation of growth is troublesome whoseContinuation of growth is troublesome whose
initial malocclusion results from pattern ofinitial malocclusion results from pattern of
skeletal growthskeletal growth..

Transverse growth is completed first and longTransverse growth is completed first and long
term transverse changes are less of a problemterm transverse changes are less of a problem
clinically than changes from antero-posterior andclinically than changes from antero-posterior and
vertical growthvertical growth..
Tendency of skeletal problem to recur, becauseTendency of skeletal problem to recur, because
most patients continue to their original growthmost patients continue to their original growth
pattern as long as they are growing.pattern as long as they are growing.
In late adolescence continued growth in theIn late adolescence continued growth in the
pattern that caused class II, class III deep bite,pattern that caused class II, class III deep bite,
or open bite , is the major cause of relapse.or open bite , is the major cause of relapse.

Timing of retentionTiming of retention
Essential full time wear of First 3-4 months,Essential full time wear of First 3-4 months,
except while eating (unless periodontal boneexcept while eating (unless periodontal bone
loss or other special circumstances req.loss or other special circumstances req.
permanent splinting)permanent splinting)
Continued on part-time bases for at least 12Continued on part-time bases for at least 12
monthsmonths
If significant growth remains, continue part timeIf significant growth remains, continue part time
until completion of growthuntil completion of growth
In case of skeletal dispro. part time use ofIn case of skeletal dispro. part time use of
functional appliance or extraoral force.functional appliance or extraoral force.

Eliminating Lower RetentionEliminating Lower Retention (Raleigh(Raleigh Williams)Williams)
Six treatment keysSix treatment keys
First KeyFirst Key
The incisal edge of the lower incisor - A-PThe incisal edge of the lower incisor - A-P
line or 1 mm in front of it.line or 1 mm in front of it.
optimum position l. i stabilityoptimum position l. i stability

Creates optimum balance of soft tissues inCreates optimum balance of soft tissues in
the lower third of the face.the lower third of the face.
The angulation of lower incisors has notThe angulation of lower incisors has not
proven to be relevant to their stability.proven to be relevant to their stability.
If the l. incisor advanced too far beyondIf the l. incisor advanced too far beyond
the A-P linethe A-P line relapse and crowdingrelapse and crowding

Second KeySecond Key
The lower incisor apices shouldThe lower incisor apices should
be spread distally to the crownsbe spread distally to the crowns
apices of the l lateral incisors > capices of the l lateral incisors > c
incisors.incisors.
l incisor roots convergent, or ll,l incisor roots convergent, or ll,
crowns tend to bunch up and a fixedcrowns tend to bunch up and a fixed
lower retainer is usually neededlower retainer is usually needed

Third KeyThird Key
The apex of the lower cuspid - positionedThe apex of the lower cuspid - positioned
distal to the crowndistal to the crown
The occlusal plane, used asThe occlusal plane, used as
a positioning guide.a positioning guide.
reduces the tendency ofreduces the tendency of
cuspid crown to tip forward into the incisor area.cuspid crown to tip forward into the incisor area.www.indiandentalacademy.comwww.indiandentalacademy.com

Fourth KeyFourth Key
All four lower incisor apices must be inAll four lower incisor apices must be in
the same labiolingual planethe same labiolingual plane
Maintain labiolingual apical control during theMaintain labiolingual apical control during the
spreading process— using uprighting springs inspreading process— using uprighting springs in
the third stage of Begg treatment -the third stage of Begg treatment - safety barsafety bar

Fifth KeyFifth Key
The lower cuspid root apex must beThe lower cuspid root apex must be
positioned slightly buccal to the crownpositioned slightly buccal to the crown
apex.apex.
If the apex of the l. cuspid is lingual to theIf the apex of the l. cuspid is lingual to the
crown at the end of trt., the forces ofcrown at the end of trt., the forces of
occlusion can more easily move the crownocclusion can more easily move the crown
lingually toward the space reserved for thelingually toward the space reserved for the
lower incisorslower incisors

Sixth KeySixth Key
The lower incisors should beThe lower incisors should be
slenderized as needed after treatment.slenderized as needed after treatment.
Flattening lower incisor contactFlattening lower incisor contact
pointspoints flat contact surfaces,flat contact surfaces,
resist labiolingual crownresist labiolingual crown
displacement.displacement.

Types of retentionTypes of retention (Clinically)(Clinically)
Retention planning is divided intoRetention planning is divided into

Limited retentionLimited retention

Moderate retention in terms of both time andModerate retention in terms of both time and
appliance wearappliance wear

permanent or semi permanent retentionpermanent or semi permanent retention

Limited retentionLimited retention

corrected cross bites anterior and posteriorcorrected cross bites anterior and posterior

dentition treated by serial extractiondentition treated by serial extraction

correction achieved by retardation of maxillarycorrection achieved by retardation of maxillary
growth (dental or skeletal) after patient hasgrowth (dental or skeletal) after patient has
pass through growth periodpass through growth period

maxillary and mandibular teeth have beenmaxillary and mandibular teeth have been
separated to allow for eruption of teethseparated to allow for eruption of teeth
previously blocked out.previously blocked out.

Moderate retentionModerate retention

Class I non extraction cases with protrusion andClass I non extraction cases with protrusion and
spacing (req. until normal lip & tongue fun.spacing (req. until normal lip & tongue fun.
achieved)achieved)

Class I and class II extraction casesClass I and class II extraction cases

Corrected deep over bitesCorrected deep over bites

Early correction of rotated teeth (before rootEarly correction of rotated teeth (before root
formation)formation)

Class II div 2 casesClass II div 2 cases

Permanent or semi permanent retentionPermanent or semi permanent retention
 cases with expansion, particularly in mandibularcases with expansion, particularly in mandibular
archarch
 cases with considerable generalized spacingcases with considerable generalized spacing
 severe rotationsevere rotation
 midline diastemamidline diastema
 Expanded arches in cleft casesExpanded arches in cleft cases
 Patients exhibiting abnormal musculature orPatients exhibiting abnormal musculature or
tongue habitstongue habits www.indiandentalacademy.comwww.indiandentalacademy.com

RetainersRetainers
Retainers are passive orthodontic appliances that helpRetainers are passive orthodontic appliances that help
in maintaining and stabilizing the position of teeth longin maintaining and stabilizing the position of teeth long
enough to permit reorganization of supportingenough to permit reorganization of supporting
structures after active phase of orthodontic therapystructures after active phase of orthodontic therapy
Criteria of good retainerCriteria of good retainer
Retain all teeth that have been moved in desiredRetain all teeth that have been moved in desired
positionposition
Should permit normal fun. forces to act freely on theShould permit normal fun. forces to act freely on the
dentitiondentition
Self cleansing &permit oral hygiene maintenanceSelf cleansing &permit oral hygiene maintenance
As inconspicuous as possibleAs inconspicuous as possiblewww.indiandentalacademy.comwww.indiandentalacademy.com

Types of retainersTypes of retainers
RemovableRemovable
FixedFixed
ActiveActive
Removable retainersRemovable retainers
Hawley retainersHawley retainers ––
most commonmost common Designed in 1920 by CharlesDesigned in 1920 by Charles
HawleyHawley
Classic design consists of clasps on molar and aClassic design consists of clasps on molar and a
short labial bow extending from 3-3 havingshort labial bow extending from 3-3 having
adjustment loopsadjustment loops

ModificationsModifications

Begg wrap around retainerBegg wrap around retainer ––
Consists of labial wire extends till the last eruptedConsists of labial wire extends till the last erupted
molar and curves around it to get embedded inmolar and curves around it to get embedded in
acrylic that spans palate.acrylic that spans palate.
Dr. begg advocated only U retention plate and inDr. begg advocated only U retention plate and in
rare instances in L retainer (open bite due torare instances in L retainer (open bite due to
enlarged tongue)enlarged tongue)

It facilitates closure of space following bandIt facilitates closure of space following band
removal.removal.
Adv. over Hawley retainer that its wire doesAdv. over Hawley retainer that its wire does
not keep crowns of premolars and caninenot keep crowns of premolars and canine
apart.apart.
It permits the occlusion to adjust vertically,It permits the occlusion to adjust vertically,
while offering restraint against antero-while offering restraint against antero-
posterior and bucco-lingual relapse.posterior and bucco-lingual relapse.

The labial bow holds the upper anteriors firmlyThe labial bow holds the upper anteriors firmly
and lower anteriors are prevented fromand lower anteriors are prevented from
proceeding further by the degree of interincisalproceeding further by the degree of interincisal
angleangle
Can be used as working retainer, when everCan be used as working retainer, when ever
teeth are slightly out of position it can be use toteeth are slightly out of position it can be use to
correct the faultcorrect the fault
Over moved tooth should not be moved backOver moved tooth should not be moved back
and held in position of over movement untiland held in position of over movement until
retention plate is discardedretention plate is discarded

Newer type of Begg RetainerNewer type of Begg Retainer
Tightening loop at the mesial to last erupted (orTightening loop at the mesial to last erupted (or
about to erupt molar)about to erupt molar)
Thicker wire used (0.9mm) in ant. regionThicker wire used (0.9mm) in ant. region
Adv. Simplicity of construction and reduced risk ofAdv. Simplicity of construction and reduced risk of
irritation of buccal frenumirritation of buccal frenum
A large hole in plate to improveA large hole in plate to improve
retentionretention
An inclined plane is incorporatedAn inclined plane is incorporated
In passive manner to control classIn passive manner to control class
I & to provide strength through bulkI & to provide strength through bulk
in ant. regionin ant. region

Positioner as retainerPositioner as retainer
Can be used as retainerCan be used as retainer
For routine use not a good retainer becauseFor routine use not a good retainer because
Pattern of wear of positioner does notPattern of wear of positioner does not
match the pattern usually desired for retainersmatch the pattern usually desired for retainers
because of bulk diff. in wearing full timebecause of bulk diff. in wearing full time
Do not retain incisor irreg. & rotationsDo not retain incisor irreg. & rotations
as well as standard retainer because retainer isas well as standard retainer because retainer is
needed initially full time wear.needed initially full time wear.

Removable wrap around retainerRemovable wrap around retainer
Also called clip on retainerAlso called clip on retainer
Consists of plastic bar (usually wire reinforced)Consists of plastic bar (usually wire reinforced)
along the labial & lingual surface of teethalong the labial & lingual surface of teeth

Fixed retainersFixed retainers
Maintenance of lower incisor position during theMaintenance of lower incisor position during the
late growthlate growth
Fixed lingual 3-3 retainer can be fabricated withFixed lingual 3-3 retainer can be fabricated with
bandsbands on canines oron canines or bondedbonded to lingual surfaceto lingual surface

Bonded is prfBonded is prf..
Unless bands were used during active trt.Unless bands were used during active trt.
band space can be problemband space can be problem
Labial side of band tend to trap plaqueLabial side of band tend to trap plaque
(gingival margin)(gingival margin) decalcificationdecalcification
0.030” ss wire is used0.030” ss wire is used
Flexible spiral wireFlexible spiral wire
(0.0175” or 0.0215”) in which all teeth in a segment(0.0175” or 0.0215”) in which all teeth in a segment
are bondedare bonded

Diastema maintenanceDiastema maintenance
Maintenance of extraction space closureMaintenance of extraction space closure
in adultin adult

Maintenance of pontic spaceMaintenance of pontic space

Active retainersActive retainers
Spring RetainersSpring Retainers
Used to realignment of irregular incisorsUsed to realignment of irregular incisors
Interproximal width of lower incisors are reducedInterproximal width of lower incisors are reduced
before realigning thembefore realigning them
Decrease the amount of space req. to alignDecrease the amount of space req. to align
Flatten contact areaFlatten contact area  increase stabilityincrease stability
Removed with abrasive strips or thin disks inRemoved with abrasive strips or thin disks in
hand piecehand piece
Canine to canine clip on is used as activeCanine to canine clip on is used as active
retainer to realignretainer to realignwww.indiandentalacademy.comwww.indiandentalacademy.com

Clip - on RetainerClip - on Retainer
Made of wire frame work that runs labially over theMade of wire frame work that runs labially over the
incisors and passes between the canine andincisors and passes between the canine and
premolar andpremolar and
recurved to lie on lingual surface.recurved to lie on lingual surface.
both labial & lingual wire segments are embeddedboth labial & lingual wire segments are embedded
in strip of clear acrylicin strip of clear acrylic
Fabricated on a cast wherein teeth are placed inFabricated on a cast wherein teeth are placed in
ideal positionideal position

Modified functional appliances as activeModified functional appliances as active
retainerretainer
Correction of occlusal discrepanciesCorrection of occlusal discrepancies
Activator (maxillary & mandibular retainer joinedActivator (maxillary & mandibular retainer joined
together by occlusal bite block)together by occlusal bite block)
Used in adolescents that had slipped back 2-3Used in adolescents that had slipped back 2-3
mm towards class II relationshipmm towards class II relationship
Not indicated if more than 3mm occlusalNot indicated if more than 3mm occlusal
correction is soughtcorrection is sought

Adjuncts to retentionAdjuncts to retention
ReproximationReproximation
Pericision or circumferential supra crestalPericision or circumferential supra crestal
fiberotomyfiberotomy
FrenectomyFrenectomy
Occlusal equilibrationOcclusal equilibration

ConclusionConclusion
Begg Tech. is a versatile tool in resolution ofBegg Tech. is a versatile tool in resolution of
severest malocclusionseverest malocclusion
Its Weaknesses have been steadilyIts Weaknesses have been steadily
eliminated from time to timeeliminated from time to time
Finishing with begg appliance is slightlyFinishing with begg appliance is slightly
difficult but not impossibledifficult but not impossible
Use of rectangular wires in finishing makeUse of rectangular wires in finishing make
this stage smooth and comfortable.this stage smooth and comfortable.

As to foreseeable future, the elimination ofAs to foreseeable future, the elimination of
present mode of retaining appliances ispresent mode of retaining appliances is
certainly an aim and objective of clinical &certainly an aim and objective of clinical &
experimental research.experimental research.

Finishing and retention in Begg appliance / fixed orthodontics courses

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