Refined begg – modifications and their rationale1

Refined Begg –Refined Begg –
Modifications AndModifications And
Their RationaleTheir Rationale
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Introduction.Introduction.
Change – keyword of every trt. modalityChange – keyword of every trt. modality
Drawbacks become apparent with passage of time.Drawbacks become apparent with passage of time.
Refinements become necessary to incorporate newRefinements become necessary to incorporate new
concepts and technological progress.concepts and technological progress.

Changes introduced on account of followingChanges introduced on account of following
reasons:reasons:
Change in trt. Philosophy:Change in trt. Philosophy:
AO concept - acceptance.AO concept - acceptance.
reconcile Begg trt. with Andrews six keys toreconcile Begg trt. with Andrews six keys to
normal occlusion.normal occlusion.
Change in trt. Approach:Change in trt. Approach:
Adv. of mixed dentition trt. realized.Adv. of mixed dentition trt. realized.
profile considerations imp.profile considerations imp.

To improve finishing and intrusion of upper ant.To improve finishing and intrusion of upper ant.
To take adv. of newly introduced materials.To take adv. of newly introduced materials.
Combine best in Begg + good aspect of otherCombine best in Begg + good aspect of other
techniques.techniques.

Essentials of Begg – Unaltered.Essentials of Begg – Unaltered.
Light orthodontic forces.Light orthodontic forces.
Crown tipping + Root tipping bodilyCrown tipping + Root tipping bodily
movement with least taxation on anchorage.movement with least taxation on anchorage.
Brackets – free tipping in initial stages.Brackets – free tipping in initial stages.
Differential forces.Differential forces.
Sequence of trt. stages.Sequence of trt. stages.

Light intra-oral elastic force.Light intra-oral elastic force.
Enmasse movements of ant. and post. teeth –Enmasse movements of ant. and post. teeth –
overjet & correction of post. Occlusion.overjet & correction of post. Occlusion.
Separation of root moving forces from archwireSeparation of root moving forces from archwire
forces.forces.
Over corrections of all displacements.Over corrections of all displacements.
Use of round high tensile wires.Use of round high tensile wires.

Disadvantages of Conventional Begg.Disadvantages of Conventional Begg.
Round wire – Ribbon bracket combination – noRound wire – Ribbon bracket combination – no
precise control for fine finishing.precise control for fine finishing.
Post – root torquePost – root torque
Rotational control poor.Rotational control poor.
True intrusion of upper incisors – nil or minimal.True intrusion of upper incisors – nil or minimal.

Overuse of Class II elasticsOveruse of Class II elastics
Lack of upper incisor intrusion.Lack of upper incisor intrusion.
Undesirable proclination of lower incisors.Undesirable proclination of lower incisors.
Tipping of mandibular & occlusal planes.Tipping of mandibular & occlusal planes.
Uncontrolled tipping –Uncontrolled tipping –
root resorption.root resorption.
long third stage.long third stage.
Overemphasis on tooth material reduction –Overemphasis on tooth material reduction –
ruined profiles.ruined profiles.
No fail safe mech. To check tipping orNo fail safe mech. To check tipping or
uprighting / torquing movements.uprighting / torquing movements.

Begg practice grouped into:Begg practice grouped into:
Conventional Begg.Conventional Begg.
Modified Begg. – brackets other than RibbonModified Begg. – brackets other than Ribbon
arch brackets – (combination br., edgewise br, tiparch brackets – (combination br., edgewise br, tip
edge br.)edge br.)
Refined Begg.Refined Begg.

‘‘Conventional’Conventional’ vsvs ‘Refined’ Begg.‘Refined’ Begg.
Changes in concepts.Changes in concepts.
Improvements in hardware.Improvements in hardware.
Modification in mechanics ( all stages )Modification in mechanics ( all stages )

Changes in concepts.Changes in concepts.
‘‘Theory of Attritional Occlusion’ & DifferentialTheory of Attritional Occlusion’ & Differential
force concept.force concept.
challenged overemphasis of extns.challenged overemphasis of extns.
ant. teeth remain stationary under heavy forces –ant. teeth remain stationary under heavy forces –
only till hyalinised areas – eliminated.only till hyalinised areas – eliminated.
Treatment objectives.Treatment objectives.
static occlusion – Andrew’s six keys -static occlusion – Andrew’s six keys -
goal of Refined Begg.goal of Refined Begg.

Functional occlusionFunctional occlusion –– Roth.Roth.
 Synchronization of CO & CR.Synchronization of CO & CR.
 Elimination of hanging palatal cusps – upper post.Elimination of hanging palatal cusps – upper post.
Teeth.Teeth.
 Cuspid protected occlusion.Cuspid protected occlusion.
 Incisor guidance.Incisor guidance.

 DiagnosisDiagnosis
Conventional Begg – few criteria.Conventional Begg – few criteria.
ī to A – Pog lineī to A – Pog line
ANB & FMA.ANB & FMA.
Present broad based diagnosis.Present broad based diagnosis.
Skeletal, dental & soft tissue analysis.Skeletal, dental & soft tissue analysis.
Growth estimation.Growth estimation.
VTO.VTO.

Treatment PlanningTreatment Planning..
Cookbook approach – discarded.Cookbook approach – discarded.
Overempahsised need to extract – previouslyOverempahsised need to extract – previously
 Mixed dentition consideredMixed dentition considered
 Growth modulation – before or during fixedGrowth modulation – before or during fixed
appl. phase.appl. phase.
 Molar distalization – selected cases.Molar distalization – selected cases.
 Avoid extractions when possible.Avoid extractions when possible.
 Extn. options – as dictated by diagnosis – allExtn. options – as dictated by diagnosis – all
4’s/5’s/upper4’s/5’s/upper 4’s,lower 5’s/ single arch4’s,lower 5’s/ single arch
extns./single LI.extns./single LI.

Biomechanics.Biomechanics.
controlled tipping – 1controlled tipping – 1stst
two stages.two stages.
Mollenhauer – root control from 1Mollenhauer – root control from 1stst
stage -stage -
MAA.MAA.
Advantages:Advantages:
uncontrolled tipping prevented.uncontrolled tipping prevented.
third stage shorter.third stage shorter.
lingual root torque –lingual root torque – canine roots abuttingcanine roots abutting
against labial cortical plateagainst labial cortical plate..

Archform.Archform.
formerly – no due importance.formerly – no due importance.
present –present –
maintenance – lower archform.maintenance – lower archform.
maintaining or improving upper archform.maintaining or improving upper archform.

Changes in the hardware.Changes in the hardware.
Attachments.Attachments.
built in adjustments – torque ( Kameda ) &built in adjustments – torque ( Kameda ) &
anti –rotation ( Mollenhauer )anti –rotation ( Mollenhauer )
distal offset in molar tubes.distal offset in molar tubes.
Archwires.Archwires.
Higher grade Australian wires – Premium,Premium +,Higher grade Australian wires – Premium,Premium +,
supreme.supreme.
Multistranded ( co-ax )Multistranded ( co-ax )
NiTi.NiTi.
Alpha Ti.Alpha Ti.
Tandem wires.Tandem wires. www.indiandentalacademy.com

Elastics.Elastics.
Ultra light ( “Roadrunner” of Ormco)Ultra light ( “Roadrunner” of Ormco)
Light elastics ( ‘yellow’ ).Light elastics ( ‘yellow’ ).
Other components.Other components.
Bypass hooks.Bypass hooks.
power pins.power pins.
TPA & Jasper Jumper – when indicated.TPA & Jasper Jumper – when indicated.

Stagewise modifications.Stagewise modifications.
Stage I.Stage I.
Multilooped archwires avoided.Multilooped archwires avoided.
MAA.MAA.
Incisor intrusion –imp. in bite opening.Incisor intrusion –imp. in bite opening.
Bypass wires & distalizing archwires.Bypass wires & distalizing archwires.
Base wireBase wire  0.018 as soon as possible.0.018 as soon as possible.
Open bite cases – 0.014 wire initially.Open bite cases – 0.014 wire initially.

Stage II.Stage II.
MAA.MAA.
Base wire – 0.020.Base wire – 0.020.
BrakesBrakes
Stage III.Stage III.
Base wire – 0.020 premium.Base wire – 0.020 premium.
Uprighting springs & torqung aux. – finer higher grades.Uprighting springs & torqung aux. – finer higher grades.
Second molar banding.Second molar banding.
Head gear when necessary.Head gear when necessary.

Finishing stage.Finishing stage.
Rectangular wires.Rectangular wires.
Later – difft. elastic config. with lighter round wires tightLater – difft. elastic config. with lighter round wires tight
buccal occlusion.buccal occlusion.
Pre – finishing ceph.Pre – finishing ceph.
RetentionRetention
Conventional Begg – no emphasis – lower retention.Conventional Begg – no emphasis – lower retention.
Now – retention – till relapse tendency due to – growthNow – retention – till relapse tendency due to – growth
or third molars ruled out.or third molars ruled out.

Refinements.Refinements.
Refinements inRefinements in
Diagnosis.Diagnosis.
Treatment approach.Treatment approach.
Hardware.Hardware.
Mechanics.Mechanics.
Finishing.Finishing.
RetentionRetention..

Refinements in Hardware.Refinements in Hardware.
Attachments on teeth.Attachments on teeth.
BracketsBrackets.. --
retained original dimensions.retained original dimensions.
Built in adjustmentsBuilt in adjustments..
Incisor brackets :Incisor brackets :
Antirotational adjustmentsAntirotational adjustments..
Mesial or distal edge raised – ML/DLMesial or distal edge raised – ML/DL
correctioncorrection

Built in torque.Built in torque.
Raising gingival or incisal edge of bracket base away fromRaising gingival or incisal edge of bracket base away from
tooth surface. (Kameda ).tooth surface. (Kameda ).
Placement of attachments.Placement of attachments.
Upper and lower canine brackets – more incisally placed.Upper and lower canine brackets – more incisally placed.
Lower incisor bracket – more gingivally.Lower incisor bracket – more gingivally.
U/L PM bracket – more occlusally.U/L PM bracket – more occlusally.
Molar tubes – UpperMolar tubes – Upper  occlusally.occlusally.
LowerLower  more occl. than conventionalmore occl. than conventional
gingival position.gingival position.

Mesiodistal location.Mesiodistal location.
Usually kept in the M-D center of crowns.Usually kept in the M-D center of crowns.
If rotated 1mm closer to the proximal surface rotatedIf rotated 1mm closer to the proximal surface rotated
towards the lingual.towards the lingual.
New Material.- Ceramic Begg bracket.New Material.- Ceramic Begg bracket.
““Ceramflex II 256 Begg” – ( TP Ortho ).Ceramflex II 256 Begg” – ( TP Ortho ).
Polycrystalline aluminaPolycrystalline alumina  Injection molding.Injection molding.
Bonding surface – polycarbonate base.Bonding surface – polycarbonate base.
Enable easy debondingEnable easy debonding
To avoid enamel fracture.To avoid enamel fracture.www.indiandentalacademy.com

• Properties.Properties.
– High resistance to torsional forces.High resistance to torsional forces.
– friction.friction.
– debonding characteristics.debonding characteristics.
– No special adhesives / special instruments forNo special adhesives / special instruments for
debonding.debonding.
• Pins used –Pins used – SS/ brass and nylon pins.SS/ brass and nylon pins.

Molar tube.Molar tube.
Round tube – 0.036” x 6mm.Round tube – 0.036” x 6mm.
Oval tubes – 0.072” x 0.024” lumen, 5mm length.Oval tubes – 0.072” x 0.024” lumen, 5mm length.
Combination tubeCombination tube
Round ( gingival ) &Round ( gingival ) & Rectangular ( ribbon )Rectangular ( ribbon ) 0.025 x 0.018,0.025 x 0.018,
5mm.5mm.
Adjustment.Adjustment.
Upper molar tubes – 10° distolingual rotational offset.Upper molar tubes – 10° distolingual rotational offset.
when fixed per. To mesial aspect of molar.when fixed per. To mesial aspect of molar.
Lower molar tube - 5° distolingual rotational offset.Lower molar tube - 5° distolingual rotational offset.

♪ Other attachments.Other attachments.
♪ Hooks:Hooks:
Buccal hook ( centre of MB cusp. )Buccal hook ( centre of MB cusp. )
Palatal cusp ( Centre of distolingual cusp )Palatal cusp ( Centre of distolingual cusp )
♪ Lingual buttons, cleats or eyelets.Lingual buttons, cleats or eyelets.
Placed slightly off center – over correcting rotations.Placed slightly off center – over correcting rotations.
♪ Additional round tubes.Additional round tubes.
For engaging lip bumpers, head gears, distal ends of U loopsFor engaging lip bumpers, head gears, distal ends of U loops
of EVAA appl.of EVAA appl.

Archwires.Archwires.
Still used – Round high tensile SS wires of AJW.Still used – Round high tensile SS wires of AJW.
Earlier used grades-Earlier used grades-
Special plus.Special plus.
Extra special plus – resistant to bite opening.Extra special plus – resistant to bite opening.
Recently – new series of wire grades & sizes.Recently – new series of wire grades & sizes.
Superior propertiesSuperior properties  pulse straighteningpulse straightening, as against, as against
spinner straighteningspinner straightening of older grades.of older grades.

Newer gradesNewer grades Size.Size.
PremiumPremium -- 0.020.0.020.
Premium +Premium + -- 0.010, 0.011, 0.014, 0.016,0.010, 0.011, 0.014, 0.016,
0.018.0.018.
SupremeSupreme -- 0.008, 0.010, 0.011.0.008, 0.010, 0.011.

Spinner straighteningSpinner straightening vsvs Pulse straightening.Pulse straightening.
Disadv. Of spinner straightening.Disadv. Of spinner straightening.
Resultant deformation.Resultant deformation.
Y.S value ( working range, resililency.)Y.S value ( working range, resililency.)
Study by Dr. Abraham Skaria, Dr. JyothindraStudy by Dr. Abraham Skaria, Dr. Jyothindra
Kumar – following parameters of new gradeKumar – following parameters of new grade
wires.wires.
UTSUTS  PS wires – 8 – 10 % higher value.PS wires – 8 – 10 % higher value.
LDRLDR  10% higher for 0.016 wire.10% higher for 0.016 wire.
235% higher for 0.020 wires.235% higher for 0.020 wires.

Working rangeWorking range  increased.increased.
Frictional resistanceFrictional resistance  increasedincreased..
CompositionComposition  Same.Same.
Stress relaxationStress relaxation  No sig. diff.No sig. diff.
Uses.Uses.
Supreme grade wire – 0.008 – 0.011Supreme grade wire – 0.008 – 0.011
Unravelling crowdede ant. teeth.Unravelling crowdede ant. teeth.
Boxed reciprocal torquing aux.Boxed reciprocal torquing aux.
Mini uprighting spring.Mini uprighting spring.

Other materials.Other materials.
Unravelling crowded teeth – early trt. Goals.Unravelling crowded teeth – early trt. Goals.
Several wires –Several wires –
11stst
gen.-gen.- Nitinol.Nitinol.
TMA,TMA,
Chinese NiTi, Superelastic Japanese Niti.Chinese NiTi, Superelastic Japanese Niti.
Recent – Cu Niti.Recent – Cu Niti.
Max. superelastic range.Max. superelastic range.
Low hysteresis.Low hysteresis.
Low modulus.Low modulus.
Rough surface ( ion implantation)Rough surface ( ion implantation)

Polymeric materials.Polymeric materials.
to match esthetics of ceramic brackets.to match esthetics of ceramic brackets.
Alpha Ti – finishing stage.Alpha Ti – finishing stage.
alpha phase – HCP stabilizedalpha phase – HCP stabilized
sizes – 16x22, 18x22.sizes – 16x22, 18x22.
Niobium TiNiobium Ti

Refinements in mechanics.Refinements in mechanics.
- Stage I.- Stage I.
Objectives – remained same – some added &Objectives – remained same – some added &
elaborated.elaborated.
Priorities in Stage I:Priorities in Stage I:
Overbite before overjet.Overbite before overjet.
Alignment of teethAlignment of teeth
proclination to be reduced before applying higherproclination to be reduced before applying higher
intrusive force.intrusive force.

Objectives – described under two substages.Objectives – described under two substages.
Substage I – A.Substage I – A.
Create space for correcting crowded teeth / closeCreate space for correcting crowded teeth / close
spacing if already present.spacing if already present.
Alignment – correction of labolingual displ/rotations.Alignment – correction of labolingual displ/rotations.
Upper incisor inclination -Upper incisor inclination - ++ 10° of normal.10° of normal.
Rotations / BL positions of upper molars corrected.Rotations / BL positions of upper molars corrected.
PM rotations.PM rotations.
Upper arch brodened in canine – PM area – to permitUpper arch brodened in canine – PM area – to permit
mand. advancement.mand. advancement.

Substage I – B.Substage I – B.
Bite opening.Bite opening.
incisor intrusion, molar extrusion.incisor intrusion, molar extrusion.
Retraction of upper ant. to eliminate the overjetRetraction of upper ant. to eliminate the overjet
with control over the root position.with control over the root position.
Mech. of controlled tipping of upper incisors.Mech. of controlled tipping of upper incisors.
Preventing uncontrolled tipping of lower incisor –Preventing uncontrolled tipping of lower incisor –
during bite opening.during bite opening.
Root control – extreme lingual or labial position of someRoot control – extreme lingual or labial position of some
ant. teeth.ant. teeth.

Mandibular plane angle – controlled.Mandibular plane angle – controlled.
Correction of midline.Correction of midline.
Interarch reln. corrected to Cl I.Interarch reln. corrected to Cl I.
Displ. & rotn. of P.M’s corrected – if bonded.Displ. & rotn. of P.M’s corrected – if bonded.

Archwires in Stage I.Archwires in Stage I.
Preferred archwire – 0.018 P or P+.Preferred archwire – 0.018 P or P+.
Initially – 0.016 or 0.014 often in combinationInitially – 0.016 or 0.014 often in combination
with other flexible wires.with other flexible wires.
Dis adv. of multilooped wires.Dis adv. of multilooped wires.
Ill effects of ant. teeth.Ill effects of ant. teeth.
or uneven bite opening.or uneven bite opening.
Labial flaring.Labial flaring.

On post. teeth.On post. teeth.
Loss of control over molar position.Loss of control over molar position.
Loss of anchorage.Loss of anchorage.
Difficulty in construction & adjustment.Difficulty in construction & adjustment.
Difficulty in maintaining archform.Difficulty in maintaining archform.
Difficulty in maintaining oral hygiene.Difficulty in maintaining oral hygiene.

Alignment without multiloop.Alignment without multiloop.
Space created by sliding the teeth along the arch.Space created by sliding the teeth along the arch.
class II elastics – upper arch.class II elastics – upper arch.
class I elastics - lower arch.class I elastics - lower arch.
Base wires – reasonably stiffBase wires – reasonably stiff
- Not worsen existing overbite.Not worsen existing overbite.
- Affect lower arch formAffect lower arch form..
Base wires 0.016 or 0.014 SS with flexible wiresBase wires 0.016 or 0.014 SS with flexible wires
like NiTi.like NiTi.

• Space created – distal tipping of canine.Space created – distal tipping of canine.
– Minor crowdingMinor crowding –– 0.016 SS with cuspid circle lightly0.016 SS with cuspid circle lightly
pressing canine br.pressing canine br.
– crowding ( 1mm )crowding ( 1mm ) –– 0.014 SS – cuspid circle – 0.50.014 SS – cuspid circle – 0.5
distal to canine br.distal to canine br.
– more severemore severe –– sliding canines distally – 0.104 /0.016 SS.sliding canines distally – 0.104 /0.016 SS.
Class II elastics – upperClass II elastics – upper
Class I elastics – lower.Class I elastics – lower.

– Excess tipping of canines – controlled by light uprightingExcess tipping of canines – controlled by light uprighting
springs.springs.
– Molar stops – prevent mesial movemt of lower molars.Molar stops – prevent mesial movemt of lower molars.
o Ant. openbite cases-Ant. openbite cases-
upper archwire – 0.014 SS.upper archwire – 0.014 SS.
anchor bends upright mesially angulatedanchor bends upright mesially angulated
upper molar teeth.upper molar teeth.

• Closing ant. spacingClosing ant. spacing..
Retracting proclined upper ant. teeth.Retracting proclined upper ant. teeth.
- 0.016 SS.- 0.016 SS.
- elastics – class II – upper.- elastics – class II – upper.
- class I lower.- class I lower.
Spacing to be closed without retracting.Spacing to be closed without retracting.
– Fig. of 8 elastomeric tie.Fig. of 8 elastomeric tie.
Active space closure – not attempted till intrusionActive space closure – not attempted till intrusion
is accomplished.is accomplished.

• Improving incisor inclination.Improving incisor inclination.
• ProclinedProclined  class II elastics.class II elastics.
• RetroclinedRetroclined  bite opening bends without elastics.bite opening bends without elastics.
• Molar position correction.Molar position correction.
– Approp. toe in or toe out bends – in SS 0.016 archwire.Approp. toe in or toe out bends – in SS 0.016 archwire.
– Mild B.L disp. – expansion /contraction in archwire.Mild B.L disp. – expansion /contraction in archwire.

Substage I BSubstage I B
Bite opening.Bite opening.
Preference – incisor intrusion & avoiding molarPreference – incisor intrusion & avoiding molar
extrusion.extrusion.
Conventional Begg –Conventional Begg –
bite opening – molar extrusion + lower incisorbite opening – molar extrusion + lower incisor
protrusion.protrusion.
efficacy in intruding upper incisor – questionable.efficacy in intruding upper incisor – questionable.
stereotype approach – all cases.stereotype approach – all cases.

• Intrusive force – bite opening bends - acts labiallyIntrusive force – bite opening bends - acts labially
- labially placed brackets.- labially placed brackets.
Labial crown/lingual root tipping.Labial crown/lingual root tipping.
Resisted by elastics.Resisted by elastics.
Magnitude & direction of net resultant forceMagnitude & direction of net resultant force intrusiveintrusive
& elastic.& elastic.
Anchor bends upper 0.016 wire =Anchor bends upper 0.016 wire = 45 g force/side.45 g force/side.
Extrusive comp. of class II elastic =Extrusive comp. of class II elastic = 30 g / side30 g / side..
Resultant =Resultant = 15 g / side.15 g / side.
on 3 teethon 3 teeth == 5 g/ tooth.5 g/ tooth.
Same combination used irrespective of upper incisorSame combination used irrespective of upper incisor
inclinationinclination..

• Excess proclination or retroclination corrected inExcess proclination or retroclination corrected in
11stst
substage.substage.
• Then intrusive and class II elastic force varied.Then intrusive and class II elastic force varied.
- orientation of resultant kept close to C. Res.- orientation of resultant kept close to C. Res.
Steps.Steps.
– Intrusive force applied 45g, CL II force 60g.Intrusive force applied 45g, CL II force 60g.
– Inclination improves. Intr force - 60g, Cl II - 30g.Inclination improves. Intr force - 60g, Cl II - 30g.
– Incisors upright – elastic applcn.- oblique ( ant.Incisors upright – elastic applcn.- oblique ( ant.
pointing downward direction ).pointing downward direction ).

CR

Gradual increase in intr. force –Gradual increase in intr. force –
anchor bend 30°- 50° - 0.016 archwireanchor bend 30°- 50° - 0.016 archwire
elastic force –using for longer periods –elastic force –using for longer periods –
switching from yellow ( 5/16”) toswitching from yellow ( 5/16”) to
Road runner ( 3/8” ) elasticsRoad runner ( 3/8” ) elastics..
Directional change-Directional change-
changing from class IIchanging from class II  Class IClass I 
from TPAfrom TPA..
Alternative –Alternative – ‘power arms’‘power arms’

Power arms.Power arms.
Long been used in preadusted edgewise appliance.Long been used in preadusted edgewise appliance.
Trivandrum Intrusion Technique –Trivandrum Intrusion Technique –
Dev. By Dr. K. Jyothindra Kumar.Dev. By Dr. K. Jyothindra Kumar.
For selective max. intrusion in the Begg technique.For selective max. intrusion in the Begg technique.
Analysis of force vectors of pure Begg technique –Analysis of force vectors of pure Begg technique –
– Intrusive vector of the max. arch wire &Intrusive vector of the max. arch wire &
– Extrusive vector of the Class II elastics.Extrusive vector of the Class II elastics.
Equal & opp.Equal & opp.
Class II vector – lower molar extrusion & lingual rolling.Class II vector – lower molar extrusion & lingual rolling.
Intrusion, extrusion or no change – incisors.Intrusion, extrusion or no change – incisors.

Present technique:Present technique:
Problem eliminated – elastics -Problem eliminated – elastics -
Molar power armMolar power arm I/M circle anteriorly.I/M circle anteriorly.
Vectors – same directionVectors – same direction
- elastic pull & archwire force unidirectional.- elastic pull & archwire force unidirectional.
Little mesial molar movement – elastic force close toLittle mesial molar movement – elastic force close to
the C.R of the molar.the C.R of the molar.
Anteriorly – force vectorAnteriorly – force vector  close to C.R of ant.close to C.R of ant.
pure intrusion.pure intrusion.

Clinical use.Clinical use.
made of 17x25 or larger size wire.made of 17x25 or larger size wire.
optimal length – 5-7 mm,optimal length – 5-7 mm, follows contour of thefollows contour of the
alveolus.alveolus.
Soldered to bands – above molar tubes.Soldered to bands – above molar tubes.
2.0 oz elastic, 0.016 archwire - 40° anchor bend,2.0 oz elastic, 0.016 archwire - 40° anchor bend,
 82 g force82 g force ( agrees with recommendations of( agrees with recommendations of
optimal value for incisor intrusion )optimal value for incisor intrusion )

Location of bite opening bends.Location of bite opening bends.
( Arch wire design modifications ).( Arch wire design modifications ).
Conventional bite opening bends.Conventional bite opening bends.
3mm mesial to the molar tube. Intrusion of3mm mesial to the molar tube. Intrusion of
upper canines & of LI and CI.upper canines & of LI and CI.
Gable bends – distal to canines.Gable bends – distal to canines.
extrusion of canines, intrusion of LI & CI.extrusion of canines, intrusion of LI & CI.
Hocevar’s modificationHocevar’s modification. –. –
a bend on either side of canines.a bend on either side of canines.
CI – intrusion. Canine & LI – extrusion.CI – intrusion. Canine & LI – extrusion.

Bite opening curve ( anchor & gable bends).Bite opening curve ( anchor & gable bends).
Canines – extrusion, LI and CI – intrusion.Canines – extrusion, LI and CI – intrusion.
Modification – Dr. Jayade.Modification – Dr. Jayade.
Mild gingival curve – midpoint 3mm over theMild gingival curve – midpoint 3mm over the
brackets.brackets.
Vertical step up bend – 4 – 5 mm ht., 2 – 3 mmVertical step up bend – 4 – 5 mm ht., 2 – 3 mm
mesial to the molar tube.mesial to the molar tube.
Anchor bend – upper end of the step.Anchor bend – upper end of the step.

Elimination of Overjet – control over rootElimination of Overjet – control over root
positions.positions.
Edge to edge relation – controlled tipping.Edge to edge relation – controlled tipping.
Uncontrolled tipping – hasten root resorption( Reitan).Uncontrolled tipping – hasten root resorption( Reitan).
Controlled tipping – upper incisors during retraction.Controlled tipping – upper incisors during retraction.
elastic force alone- uncontrolled tipping.elastic force alone- uncontrolled tipping.
for controlled tipping – counter moment.for controlled tipping – counter moment.
Ratio – b/w 5:1 and 8:1.Ratio – b/w 5:1 and 8:1.
intrusive force – counter moment.intrusive force – counter moment.
Conventional Begg.- low intrusive force,Conventional Begg.- low intrusive force,
heavy elastic force.heavy elastic force.

higher intrusive forces & light or ultra light elastichigher intrusive forces & light or ultra light elastic
forces – incisor intrusion & controlled tipping.forces – incisor intrusion & controlled tipping.
Bite opens - intrusive force.Bite opens - intrusive force.
Moment augmented – MAA.Moment augmented – MAA.

• Development of MAADevelopment of MAA
Mollenhauer –rectangles made in 0.010 “ wire forMollenhauer –rectangles made in 0.010 “ wire for
reciprocal torque on adjacent incisors (SPECS)reciprocal torque on adjacent incisors (SPECS) tootoo
heavy forceheavy force
In 1984, on request of Mollenhauer , A. J. Wilcock madeIn 1984, on request of Mollenhauer , A. J. Wilcock made
0.009” supreme wire0.009” supreme wire
Initially he used it similar to niti or co-axial wire.Initially he used it similar to niti or co-axial wire.
Later boxed aux. namedLater boxed aux. named
““ An Aligning auxiliary for ribbon arch bracket”.An Aligning auxiliary for ribbon arch bracket”.

• Requirements of MAARequirements of MAA
– Must generate very light root moving forcesMust generate very light root moving forces
– when reciprocal torque is required with the adjacentwhen reciprocal torque is required with the adjacent
rectangle must not diverge by more than 45rectangle must not diverge by more than 4500
– Auxiliary should resist deformation (resilient supremeAuxiliary should resist deformation (resilient supreme
grade pulse straighten wire)grade pulse straighten wire)
– Base wire should be able to resist vertical and transverseBase wire should be able to resist vertical and transverse
reactive forces from MAAreactive forces from MAA

For lingual root torqueFor lingual root torque
Mollenhauer engaged MAAMollenhauer engaged MAA
first & base arch wire piggyfirst & base arch wire piggy
backback
but rectangles lift away frombut rectangles lift away from
the tooth surface. So,the tooth surface. So,
Thickest possible pinsThickest possible pins
(ceramaflex) used.(ceramaflex) used.

ADVANTAGES OF MAAADVANTAGES OF MAA
– simultaneous intrusion and retraction of incisorssimultaneous intrusion and retraction of incisors
– of rapid bodily alignment of anterior teeth with gentleof rapid bodily alignment of anterior teeth with gentle
forcesforces
– Stable resultsStable results
– Reciprocablility of torquing forces on instanding lateralsReciprocablility of torquing forces on instanding laterals
or palatally placed canines.or palatally placed canines.
– Periodontal advantages – gingival dehiscences associatedPeriodontal advantages – gingival dehiscences associated
with prolonged labial root torquing is eliminatedwith prolonged labial root torquing is eliminated

– Short stage threeShort stage three
– Possibility of growing cortical bone at point A & point B.Possibility of growing cortical bone at point A & point B.
Various applications of MAAVarious applications of MAA
– bodily alignment of crowded teethbodily alignment of crowded teeth
– To apply labial root torque on lower incisors in growingTo apply labial root torque on lower incisors in growing
brachyfacial cases.brachyfacial cases.
– Can also be used for labial root torque on upper incisorsCan also be used for labial root torque on upper incisors
in class III cases.in class III cases.

– By bending more +ve Torque as a brakingBy bending more +ve Torque as a braking
mechanismmechanism
– For controlling mesio-distal tipping (MAAFor controlling mesio-distal tipping (MAA
tip)tip)

Modification of MAAModification of MAA
– With available pins holding down the boxes forWith available pins holding down the boxes for
lingual root torque was difficult. So, torquing actionlingual root torque was difficult. So, torquing action
of MAA is directly applied on gingival surface ofof MAA is directly applied on gingival surface of
teeth. For this base wire is engaged first and MAA isteeth. For this base wire is engaged first and MAA is
engaged piggy back.engaged piggy back.

– When reciprocal root torque is required onWhen reciprocal root torque is required on
adjacent teeth the concerned box rides overadjacent teeth the concerned box rides over
the main arch wire with a cross over bend andthe main arch wire with a cross over bend and
pressed against the incisor surface of thepressed against the incisor surface of the
crowncrown

Preventing uncontrolled tipping of the lowerPreventing uncontrolled tipping of the lower
incisors.incisors.
o Brackets bonded – gingivally.Brackets bonded – gingivally.
o MAA – labial root torque – lower incisors.MAA – labial root torque – lower incisors.
o Ends of lower archwire bend distal – molar tubes.Ends of lower archwire bend distal – molar tubes.
Root control – extreme lingual or labial psitionsRoot control – extreme lingual or labial psitions
of the ant.of the ant.
o Labial movement of instanding incisors or canines-Labial movement of instanding incisors or canines-
MAA.MAA.
o Lingual root movement – canines – marked rootLingual root movement – canines – marked root
prominence – for placing into cancellous bone.prominence – for placing into cancellous bone.

Controlling mandibular plane angle.Controlling mandibular plane angle.
open during trt. – molar extrusion – worsening ofopen during trt. – molar extrusion – worsening of
Cl II profile.Cl II profile.
Correcting midline discrepancy.Correcting midline discrepancy.
upper midline - after alignment, uneven Cl IIupper midline - after alignment, uneven Cl II
elastics.elastics.
if both midlines shifted in opp. directions –if both midlines shifted in opp. directions –
midline diagonal elastic.midline diagonal elastic.
lower midline alone – unilateral lower Cl I elasticlower midline alone – unilateral lower Cl I elastic..

Correcting inter - arch relationships toCorrecting inter - arch relationships to
Class I.Class I.
• Growing child – class II – class I – encouragingGrowing child – class II – class I – encouraging
the mandibular growth.the mandibular growth.
• Adults – mesial movement of the lower post.Adults – mesial movement of the lower post.
dental segment.- class II elastics.dental segment.- class II elastics.
• Selected cases – distalizing upper molarsSelected cases – distalizing upper molars

Check list at the end of Stage I.Check list at the end of Stage I.
Incisors – edge to edge relation.Incisors – edge to edge relation.
Midlines matching.Midlines matching.
Molar & canines – class I.Molar & canines – class I.
Upper and lower arch forms – matching.Upper and lower arch forms – matching.
Molar rotations & BL displ. Corrected.Molar rotations & BL displ. Corrected.
Good control – root positions & mandibular planeGood control – root positions & mandibular plane
angle.angle.

Objectives.Objectives.
Common –Common –
– Maintain all corrections – in stage I.Maintain all corrections – in stage I.
– Close all extraction spaces.Close all extraction spaces.
Additional.Additional.
– Controlled tipping – space closure – ant. retraction.Controlled tipping – space closure – ant. retraction.
– Prevent excess tipping – efficient brakes – space closurePrevent excess tipping – efficient brakes – space closure
by protracting post.by protracting post.
– 11stst
pm extn. Cases – rotations & crossbites of 2pm extn. Cases – rotations & crossbites of 2ndnd
pmpm
corrected.corrected.
Stage IIStage II

Archwires in Stage II of Refined BeggArchwires in Stage II of Refined Begg
In extn. & non extn. cases –In extn. & non extn. cases –
0.018” P or P+, or 0.020 P wires.0.018” P or P+, or 0.020 P wires.
If stage corrections involved – extreme deep bite,If stage corrections involved – extreme deep bite,
badly distorted arch forms or severe rotations –badly distorted arch forms or severe rotations –
0.020 archwires effective.0.020 archwires effective.
Anchor bendsAnchor bends
PM bypassed – except when in distobuccalPM bypassed – except when in distobuccal
rotation.rotation.

Controlled tipping of the incisors.Controlled tipping of the incisors.
MAA – lingual root torque – controlled lingualMAA – lingual root torque – controlled lingual
tipping – incisors during retraction.tipping – incisors during retraction.
(( bite opening force - intrusive force supplementedbite opening force - intrusive force supplemented
with moment – MAAwith moment – MAA).).
Lower incisors – sig. retraction – lingual rootLower incisors – sig. retraction – lingual root
torque.torque.
Canines – excess tipping – 0.010 uprighting springsCanines – excess tipping – 0.010 uprighting springs..

Braking mechanics.Braking mechanics.
Second PM extn. Cases – excess space closed bySecond PM extn. Cases – excess space closed by
post. protraction.post. protraction.
Good profile at start of trt.Good profile at start of trt.
‘‘Brakes’ – reverse anchorage site – posteriorBrakes’ – reverse anchorage site – posterior  ant.ant.
Commonly used:Commonly used:
Braking springs:Braking springs: passive uprighting springs – 0.018passive uprighting springs – 0.018
wire.wire.
Angulated T pinsAngulated T pins: prevent further tipping: prevent further tipping

Combination wiresCombination wires: either of SS or Alpha Ti alloy.: either of SS or Alpha Ti alloy.
Ant segment. – 0.022 x 0.018 (ribbon mode).Ant segment. – 0.022 x 0.018 (ribbon mode).
Post. segment – 0.018 round .Post. segment – 0.018 round .
Alpha Ti – easier to engage in ant. br. slots.Alpha Ti – easier to engage in ant. br. slots.
chance of distortion.chance of distortion.
Use SS combination wire - torque than alpha Ti.Use SS combination wire - torque than alpha Ti.
Disadv. – expensiveDisadv. – expensive..
SS 0.022 x 0.018 sectionals – torqued in ribbonSS 0.022 x 0.018 sectionals – torqued in ribbon
mode – piggy back over 0.018 base wire.mode – piggy back over 0.018 base wire.

Strength of elasticsStrength of elastics ––
– Light ( yellow ) Class I or II elastics – ant. retractionLight ( yellow ) Class I or II elastics – ant. retraction..
– Ultra light Class II elastics.Ultra light Class II elastics.
– Stronger ( green ) – class I – posterior protraction.Stronger ( green ) – class I – posterior protraction.
Check list.Check list.
• Spaces closed completely.Spaces closed completely.
• Ant. edge to edge bite or +ve overjet in open bite cases.Ant. edge to edge bite or +ve overjet in open bite cases.
• Canine & molar relations – Cl I or super Cl ICanine & molar relations – Cl I or super Cl I

Pre Stage III.Pre Stage III.
NeedNeed  PM’s not engaged – extn spaces are closed.PM’s not engaged – extn spaces are closed.
PM’s – different vertical level.PM’s – different vertical level.
Horizontal offset reqd. – engagement in PM bracketHorizontal offset reqd. – engagement in PM bracket
& molar tube.& molar tube.
Archwire:Archwire:
0.016 wire – one visit – arch wire engagement in PM0.016 wire – one visit – arch wire engagement in PM
Offset b/w PM & Molar.Offset b/w PM & Molar.
Upper wire – gable bend.Upper wire – gable bend.
Lower wire – mild anchor & gable bend.Lower wire – mild anchor & gable bend.

Objectives.Objectives.
Maintain corrections.Maintain corrections.
To achieve desired root positions.To achieve desired root positions.
Addnl.Addnl. Objectives.( Refined Begg ).Objectives.( Refined Begg ).
Monitor sagittal & vertical anchorage.Monitor sagittal & vertical anchorage.
Monitor & correct inclinations of post. TeethMonitor & correct inclinations of post. Teeth
Correct – 2Correct – 2ndnd
molars – when reqd.molars – when reqd.
Monitor trt. for undesirable sequels – rootMonitor trt. for undesirable sequels – root
resorption, parafunctional habitsresorption, parafunctional habits
Stage III.Stage III.

Problems encountered in Stage III.Problems encountered in Stage III.
Undesired sagittal movements.Undesired sagittal movements.
Mesial movement of upper arch – Corrected Cl IMesial movement of upper arch – Corrected Cl I  ClCl
II.II.
Mesial movement of both arches – BMP.Mesial movement of both arches – BMP.
Individual crown movements – crowding.Individual crown movements – crowding.
Mesial & distal crown movement – extn. Site – openMesial & distal crown movement – extn. Site – open
spaces.spaces.
Undesired vertical movements.Undesired vertical movements.
Undesired transverse movements – upper molars rollUndesired transverse movements – upper molars roll
buccally.buccally.
Root resorption.Root resorption.

Complications – related to :Complications – related to :
1.1. Amount of lingual root torque needed forAmount of lingual root torque needed for
incisors & distal root movement.incisors & distal root movement.
2.2. Amount of force generated – auxiliaries &Amount of force generated – auxiliaries &
springs.springs.
3.3. Use of weak base wiresUse of weak base wires

Remedies:Remedies:
Minimize need for root movementsMinimize need for root movements..
– Correct diagnosis & carefully planning extn.Correct diagnosis & carefully planning extn.
– Using efficient brakes.Using efficient brakes.
– Incisors tipped in a controlled manner.Incisors tipped in a controlled manner.
Use of heavy base wires.Use of heavy base wires.
– 0.020 P wire , stiffness 3x – Special + wires.0.020 P wire , stiffness 3x – Special + wires.

Lighter aux. & Uprighting springs.Lighter aux. & Uprighting springs.
– Because of reduced need to torque – 2 spur used.Because of reduced need to torque – 2 spur used.
– 0.012 wire used.0.012 wire used.
– Uprighting springs-Uprighting springs-
mini springs – 0.009mini springs – 0.009
slightly bigger coils – 0.012 wire – canines & PM’sslightly bigger coils – 0.012 wire – canines & PM’s..
Light Class II elastics.Light Class II elastics.
– Because of lighter reciprocal actions.Because of lighter reciprocal actions.

Reinforcement of the anchorage.Reinforcement of the anchorage.
Extreme MO,Extreme MO,
Sagittal directionSagittal direction
–– reverse torquing in lower incisors.reverse torquing in lower incisors.
– Head gear or TPA – upper molars.Head gear or TPA – upper molars.
– Lip Bumper – lower molars.Lip Bumper – lower molars.
Vertical Augmentation.Vertical Augmentation.
– High pull head gear, post bite blocks.High pull head gear, post bite blocks.
TransverseTransverse
– 0.020 premium grade wires – enough contraction & toe0.020 premium grade wires – enough contraction & toe
in.in.

Archwires.Archwires.
Cuspid circles tightly touching – cuspid brackets.Cuspid circles tightly touching – cuspid brackets.
Post. segment gingivally in reln. to the ant. seg.Post. segment gingivally in reln. to the ant. seg.
Contraction & toe in – upper wire AndContraction & toe in – upper wire And
expansion in lower – less.expansion in lower – less.
decided – looking at original study models.decided – looking at original study models.
Arch wires properly co-ordinated.Arch wires properly co-ordinated.
Wire ends – annealed & tightly cinched.Wire ends – annealed & tightly cinched.

• Elastics:Elastics:
very light class II elastics.very light class II elastics.
• Second molars banded midway in third stage.Second molars banded midway in third stage.
Completion of third stage:Completion of third stage:
Degree of uprighting & torquing assessedDegree of uprighting & torquing assessed
– Visual inspectionVisual inspection
– Palpating – roots.Palpating – roots.
– Radiographs –Radiographs –
Lateral Cephalogram.Lateral Cephalogram.
Panoramic radiograph.Panoramic radiograph.
Occlusal film.- labiolingul alignment – LI rootsOcclusal film.- labiolingul alignment – LI roots

Torquing auxiliaries.Torquing auxiliaries.
Torquing auxiliary with Spurs.Torquing auxiliary with Spurs.
RefinementsRefinements ––
0.012 P+ wire (PS).0.012 P+ wire (PS).
0.014 or 0.016 special + - used previously.0.014 or 0.016 special + - used previously.
Inter spur span is curved – not angulated or keptInter spur span is curved – not angulated or kept
straight.straight.
Modifications:Modifications:
Reverse labial torque – one or both laterals.Reverse labial torque – one or both laterals.
Torquing boxes – canines for lingual root torque.Torquing boxes – canines for lingual root torque.

Other torquing Aux.Other torquing Aux.
Single root torquing Aux.( Kesling ).Single root torquing Aux.( Kesling ).
Buccal root torque – upper PM.Buccal root torque – upper PM.
Direction of curvature – lingual or buccal rootDirection of curvature – lingual or buccal root
moving effect.moving effect.
0.012” P + wire – used.0.012” P + wire – used.

Reciprocal torquing Aux.( ‘SPEC’ ) .Reciprocal torquing Aux.( ‘SPEC’ ) .
Two adjacent teeth – torque in opp. Direction.Two adjacent teeth – torque in opp. Direction.
0.009 or 0.011 wires – Stage I.0.009 or 0.011 wires – Stage I.
0.012” – Stage III.0.012” – Stage III.

Reverse torquing Aux – controlling roots ofReverse torquing Aux – controlling roots of
canines or PM’s.canines or PM’s.
Franciskus Tan – Nov ’87 JCO.Franciskus Tan – Nov ’87 JCO.
– Labial root movement – palatally impactedLabial root movement – palatally impacted
max.canine.max.canine.
– Wire usedWire used  0.012” P+ with 0.018” or 0.020 base0.012” P+ with 0.018” or 0.020 base
wire.wire.
– Inserted in molar tube from distal.Inserted in molar tube from distal.
– Activated – rotating it 90° .Activated – rotating it 90° .

Buccal root torque on molars.Buccal root torque on molars.
Lift palatally hanging cusps.Lift palatally hanging cusps.
Boot design occlusal extensionsBoot design occlusal extensions
Inserted from mesial..Inserted from mesial..
Boot portion – twisted lingually & toe in given.Boot portion – twisted lingually & toe in given.

Labial root torque – only on LI.Labial root torque – only on LI.
0.012 wire.0.012 wire.
Convexity of aux. facing gingivally.Convexity of aux. facing gingivally.
Indication – lower LI – (central & canine – no torqueIndication – lower LI – (central & canine – no torque
reqd.)reqd.)

Uprighting springs.Uprighting springs.
Earlier springs – 0.016 & 0.014Earlier springs – 0.016 & 0.014
Mini springs – Mollenhauer – ( 0.009” dia )Mini springs – Mollenhauer – ( 0.009” dia )
Supreme grae wire.Supreme grae wire.
Differences.Differences.
OlderOlder MiniMini
CoilCoil 4 times – wire4 times – wire
diadia
2 times.2 times.
StemStem Radial to coilRadial to coil TangentialTangential
to coil.to coil.

Securing pins.Securing pins.
• Mollenhauer – jamming – with lock pin labial toMollenhauer – jamming – with lock pin labial to
base arch wire.base arch wire.
• Ligature – passing lig. Wire – through bracket inLigature – passing lig. Wire – through bracket in
front of archwire – passed behind archwirefront of archwire – passed behind archwire
outside bracket.outside bracket.
• Sims – insert pin lingual – main wire – afterSims – insert pin lingual – main wire – after
pinning with Stage III pins.pinning with Stage III pins.

Stage IVStage IV
Finishing with Begg appliance – difficult , not impossible.Finishing with Begg appliance – difficult , not impossible.
Objectives of finishing & detailing.Objectives of finishing & detailing.
• Intra arch objectivesIntra arch objectives..
– good interdental contacts, proper faciolingual positioning ofgood interdental contacts, proper faciolingual positioning of
teeth.teeth.
– All rotations over corrected.All rotations over corrected.
– Complete space closure.Complete space closure.
– Vertical levelling.Vertical levelling.
– Flat curve of spee.Flat curve of spee.
– Proper tip & torque.Proper tip & torque.
– Maintenance of lower I/Canine dimensions.Maintenance of lower I/Canine dimensions.

• Interarch objectives.Interarch objectives.
– Normal overjet and overbite.Normal overjet and overbite.
– Cl I canine & Molar reln.Cl I canine & Molar reln.
– Tight interdigitation of all thecusps of post. TeethTight interdigitation of all thecusps of post. Teeth..
• Functional requirements.Functional requirements.
– Matching CO – CR.Matching CO – CR.
– No cuspal interference during function.No cuspal interference during function.
– Cuspid & incisor guidance.Cuspid & incisor guidance.
• Control of etiologic factors.Control of etiologic factors.
• Soft tissue factorsSoft tissue factors
– Frenectomy , CSF etc.Frenectomy , CSF etc.

• Round & Rectangular Finishing wires used.Round & Rectangular Finishing wires used.
• Round wires.Round wires.
– 0.020 stage II wires used.0.020 stage II wires used.
– Archwires given – ideal shape & co-ordinated.Archwires given – ideal shape & co-ordinated.
– First order & Second order adjustments made.First order & Second order adjustments made.
First order.First order.
– Labio lingual position of upper laterals.Labio lingual position of upper laterals.
– Upper canine prominence.Upper canine prominence.
- Molar offset .Molar offset .
- Toe in for U6 – proper Cl I .Toe in for U6 – proper Cl I .
- Lower canine ‘tucked in’.Lower canine ‘tucked in’.

• Second order adjustments.Second order adjustments.
– U 2 , shorter in reln to U1 and U3.U 2 , shorter in reln to U1 and U3.
– Mesial angulation of U6.Mesial angulation of U6.
– U3’s slightly more mesially angulated.U3’s slightly more mesially angulated.
– L3 & L2 – levels to be adjusted.L3 & L2 – levels to be adjusted.
• Rectangular finishing wires.Rectangular finishing wires.
– Alpha Ti – 0.022 x 0.018 ribbon wires.Alpha Ti – 0.022 x 0.018 ribbon wires.
– Precise torque – build in ant. segment.Precise torque – build in ant. segment.
– Soft – easy to bend. Harder in mouth.Soft – easy to bend. Harder in mouth.
– 0.022 vertical dimension – enough clearence – 0.0400.022 vertical dimension – enough clearence – 0.040
vertical slot – vertical settling of the teeth.vertical slot – vertical settling of the teeth.

• Check list on finish.Check list on finish.
– Establish all Andrews six keys.Establish all Andrews six keys.
– Check the midline.Check the midline.
– Check the occlusion – Centric position.Check the occlusion – Centric position.
– Occlsuion in functional movements.Occlsuion in functional movements.
– Excellent interdigitation.Excellent interdigitation.
– Over correction not required or use 10 ½ / 10 reln.Over correction not required or use 10 ½ / 10 reln.

Conclusion.Conclusion.
Many shortcomings of the Begg appliance haveMany shortcomings of the Begg appliance have
been highlighted at different points in time everbeen highlighted at different points in time ever
since its introduction. But the basic tenets of Beggsince its introduction. But the basic tenets of Begg
mechanotherapy have stood the test of the timemechanotherapy have stood the test of the time
and largely remained unaltered.and largely remained unaltered.
The trend in Refined Begg is in the scientificThe trend in Refined Begg is in the scientific
progression of Dr. Begg’s concepts, especially inprogression of Dr. Begg’s concepts, especially in
the use of ultra light forces. With the advances inthe use of ultra light forces. With the advances in
technology & materials, a better realization oftechnology & materials, a better realization of
these concepts has been possible, ultimatelythese concepts has been possible, ultimately
leading to superior results in treatmentleading to superior results in treatment..

Refined begg – modifications and their rationale1

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