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S begg’s

  1. 1. BEGG‟S PHILOSOPHY AND TECHNIQUE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. CONTENTS        Evolution of Beggs technique Beggs philosophy Beggs technique Components Stage I Stage II Stage III www.indiandentalacademy.com
  3. 3. DEVELOPMENT OF LIGHT WIRE TECHNIQUE www.indiandentalacademy.com
  4. 4.  Dr P.R Begg was born in 1898 in a small, gold mining town Coolgardie, west Australia.  Grew up in south Australia.As a boy he saw the sketch of Australia aborginal and noticed their teeth were worn flat, no one thought to tell him why or how it happened. www.indiandentalacademy.com
  5. 5.  In his early twenties he worked as a Jackaroo at Boonoke- a sheep and cattle station in New south Australia, looking after both cattle and sheep.  He noticed many people with crooked teeth and saw many feeble attempts at correction of these problems with many treatment failures and few successes. www.indiandentalacademy.com
  6. 6. .  As he wanted to help such people he enrolled in the dental course at the University of Melbourne instead of taking the medical course, as he originally intended.  At the commencement of third year of training, Dr Begg decided to practice orthodontics after graduating in dentistry. www.indiandentalacademy.com
  7. 7.  Dr Stanley Wilkinson, a former student of E.H Angle was the lecturer in Orhodontics and used the seventh edition of “Malocclusion of the teeth” as the text book. Dr Begg graduated in 1923 with B.D.Sc Degree the L.D.S Diploma.  His introduction to Dr. Angle‟s work led him to travel to Pasadena, California in 1924 to study with Dr. Angle. www.indiandentalacademy.com
  8. 8. - DR. Begg was with Dr. Angle from February,1924 to November,1925. - At that time Dr. Angle was teaching his followers the Ribbon arch appliance which he introduced in 1916. www.indiandentalacademy.com
  9. 9. - Coincidentally with Begg‟s arrival in California Dr. Angle was developing he Edgwise arch mechanisms, Which he felt was a vast improvement over the Ribbon arch Appliance - Angle instructed Dr. Begg and Fred Ishii of Japan in the use of the Edgewise mechanism, before it was revealed to the profession. Since Dr. Angle was ill, it was they who first treated patients with Edge wise Appliance www.indiandentalacademy.com
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  11. 11.  The relation between Dr,Begg and Dr.Angle was warm and mutually rewarding. Dr.Begg helped Dr.Angle to cut Edgewise brackets on a lathe from milled strips of platinized gold provided by S.S. white dental company.  At that time Dr.Spenser Atkison demonstrated to the students that it was normal for the upper first permanent molars to move continuously mesially throughout life. Dr. angle referred to this as the anterior component of force. www.indiandentalacademy.com
  12. 12.  During Dr. Begg‟s stay Dr.Angle wrote, and read for the first time, his paper entitled. “ The latest and Best in orthodontic Mechanism” ( published in Dent. Cosmos 1928 and 1929 ). It disclosed the use of edge wise Mechanism.  In November, 1925 Dr. Begg sailed back to Australia. In December of the same year he began practicing Orthodonics in Adelaide, south Australia.  Married Nellie Hamilton in 1928. www.indiandentalacademy.com
  13. 13.  Begg the only orhodontist in Adelaide in 1926 practiced Edgewise non extraction, technique.  He was appointed Lecturer in Orthodontics at the university of Adelaide, a position he held until the university‟s retirement age. ( Retirement in 1964).  For two years, Dr. Begg faithfully followed Dr. Angle‟s teaching of retaining the full compliment of teeth. www.indiandentalacademy.com
  14. 14.  However in many of his patients he was‟nt satisfied with post treatment profiles and there was the serious problem of relapses.  In February of 1928 he began to routinely remove teeth or reduce tooth widths by mesio - distal stripping in patients with excess tooth substance. www.indiandentalacademy.com
  15. 15. .  He learnt from experience and his ever – growing appreciation of the role of attritional occlusion in the development of man‟s dentition, that such reduction was often necessary to permit the proper repositioning of the teeth to enhance function, stability and esthetics.  Initially he faced opposition from dentist of his patients. It was only after his superior treatment results were seen to stand the test of time that the criticism relented. He retreated many patients who had relapse due to retention of excessive tooth material. www.indiandentalacademy.com
  16. 16. CHANGING THE MECHANICS - Dr. Begg began to realize the Edgewise mechanism was not designed to rapidly close extraction space or quickly reduce deep overbites. - To facilitate such changes he began using 0.20‟‟ round platinized gold, rather than rectangular, arch wire in 1929. In 1931 he started using .018‟‟ round stainless steel wire, bending the now popular vertical loops and intermaxillary hooks right into the arch wires. www.indiandentalacademy.com
  17. 17. - He soon realized that if round arch wire were engaged in edgewise brackets, indiscriminate and often undesired root moving forces could be created this prolongs the anterior bite opening and taxed intraoral anchorage. - In 1933, about 3 years after switching from rectangular to round arch wire material, he began treating some cases using S.S. White ribbon arch brackets, to which he had been exposed during his stay with Dr.Angle. - Dr. Begg faced the openings of the brackets slots of the ribbon arch brackets gingivally, instead of incisally as advocated by Dr. Angle. He realized that these relatively narrow brackets with vertically facing slots allowed the teeth to move under much lighter forces. www.indiandentalacademy.com
  18. 18.  To improve rotation tooth control with the use of smaller round wires in the Ribbon Arch Brackets, Dr. Begg filed their bases before soldering them to the bands. This reduced the widths of the arch wire slots.  In 1935 Dr. Begg was awarded the title of D.D.Sc. For his thesis entitled, “Some aspects of the etiology of irregularity and malocclusion of teeth‟‟. This was the illumination of his study of attritional occlusion that began with the casual observation in the aborginal prior to World War I, and included studying the skulls of American Indian at the southern Museum in California. www.indiandentalacademy.com
  19. 19. A NEW WIRE  In the early 1940‟s Dr. Begg met Arthur J.Wilcock, director of metallurgical research projects at the University of Melbourne.  After many years of research Wilcock produced a cold drawn heat treated wire that combined the balance between hardness and resilience with the unique property of zero stress relaxation that Dr.Begg was seeking.  This unusual wire permitted to open anterior over bites, while controlling arch form and providing molar stability. www.indiandentalacademy.com
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  21. 21.  He also produced the modified Ribbon arch brackets, lock pins and special buccal tubes to meet Dr.Begg‟s ever-changing requirements in these experimental years  In 1952 Dr Begg began to use 0.16‟‟ round stainless steel wires instead of 0.18‟‟ permitting to open anterior overbites quickly. www.indiandentalacademy.com
  22. 22.  In 1939 DR.Begg wrote his doctoral thesis “ The Evolutionary Reduction and degenaration of Man‟s Jaws and teeth‟‟ in 1939. It relates attrition or more often lack of it, to the etiology of malocclusion and other dental problems in modern man.  In 1954 Dr.Begg published paper entitled, “Stone Age Man‟s dentition” and as the title suggests, it also dealt with attritional occlusion, and explained why it is the anatomically correct occlusion.  At the end of his article he disclosed a new technique which he referred to as the “round wire technique”, advocating at that time the use of 0.18” (0.46mm) diameter stainless steel arch wires in modified Ribbon Arch brackets. www.indiandentalacademy.com
  23. 23.  The technique describe in this 1954 article was much different from what it is today, and the treatment results shown did not include detailed finishing. Even so, it drew relatively large response including correspondance from three prominent orthodontist who expressed an interest in the treatment method disclosed – his found from the Angle school, Dr. Spencer Atkinson; Dr. Robert strang and Dr. CharlesTweed. www.indiandentalacademy.com
  24. 24.  In 1956 (Am Jr) Dr. Begg had another article published entitled, differential Force in orthodontic Treatment.  While he did not specifically define differential force in so many words, its operation was explained. This demonstrated that this techniques and theories of treatment were able to produce acceptable results in unbelievable short treatment times for all types of malocclusion- from the simplest to the most extreme discrepancies of both teeth and jaws. . www.indiandentalacademy.com
  25. 25.  As a result of reading this article several orthodontists visited Dr.Begg in Adelaide, South Australia.  In 1957 Dr.H.D. Kesling and Dr. George Dissham came from the United states. They spent several weeks in Dr.Begg‟s office and home, attempting to learn the technique, which was extremely difficult as there was no organization to it. www.indiandentalacademy.com
  26. 26. INTRODUCTION OF BEGG TECHNIQUE IN THE UNITED STATES  Upon Kesling‟s return from Adelaide,he had plans to implement his new technique in his practice along with Dr.R. A. Rocke not just to selected patients, but every patient.  In 1959 the Kesling and Rocke Orthodontic group invited over 150 orthodontist from across the united states, to assess the results of their results of their 100 consecutively – treated cases by Begg technique. www.indiandentalacademy.com
  27. 27.  Dr .H.D. Kesling, first orthodontist in the United States to practice the Begg Technique, and the one most responsible for popularizing its use through showings and courses www.indiandentalacademy.com
  28. 28.  While the results were not of the quality of the results achieved today, they demonstrated the ability of the Begg technique to quickly open deep anterior open bites. Treatment times were relatively short, and the number of adjustments few. As a result there arose a demand for training in this new technique.  First course in Begg Technique had 31 students, was held in the new orthodontic center in Westville, Indiana on june 1959 (1week course). The brackets used were the new Double - Tab type. www.indiandentalacademy.com
  29. 29.  However, the use of the double tab bracket proved difficult, as arch wires were unnecessarily complicated to permit desired tooth movement. Also, it lacked the ability to overcorrect the teeth which is so necessary to reduce the tendency for relapse.  Dr Begg realized that inorder to make his technique acceptable to leading orthodontist in the united states, most of whom were using Edgewise mechanism at that time, he had to finish his cases with more precision. www.indiandentalacademy.com
  30. 30.  Prior to their visit, Dr. Begg was mainly concerned with repositioning the teeth instable positions over basal bone. The final settling of teeth he left to the forces of occlusion, guided when necessary by an upper retainer with circumferential wire.  Also he realized the growing demand for training in his new technique required that the treatment be organised in some manner to facilitate both teaching and learning. www.indiandentalacademy.com
  31. 31.  The result was that in April of 1960, as Dr. Begg began unpacking his models (which he had brought as part of his presentation before the American Association of Orthodontist), members of the kesling and Rocke group were stunned by his quality of treatment . Hours after seeing the quality of results achieved by Dr.Begg with modified Ribbon Arch brackets, Dr.Kesling made the decision to scrap his double- tab brackets. www.indiandentalacademy.com
  32. 32. In the years between Dr.Kesling‟s first visit in 1957 and his trip to the United states in the spring of 1960, Dr.Begg did the following: 1.Finished his cases with such detail and precision that they could not be discerned from similar cases treated with Edgewise mechanism. 2. Seperated the technique into three distinct stages and established objectives for each stage. 3.Developed root torqueing auxiliaries separate from the main arch wire. 4.Introduced mesiodistal uprighting spring. 5. Emphasized the importance of free tipping of tooth crowns in the early stages of treatment. 6. Suggested taking stage models to discipline the orthodontist. www.indiandentalacademy.com
  33. 33. BEGG‟S PHILOSOPHY www.indiandentalacademy.com
  34. 34.  The Begg differential force technique is a unique approach to orthodontic treatment. The philosophy behind it, including diagnosis, method and direction of tooth movement , is keyed to attritional occlusion.  Dr.Begg‟s studies of stone age Man‟s dentition indicate that man‟s occlusion is not static, but an ever changing one.The teeth continoully migrate mesially and vertically and compensate for the attrition of their proximal and occluso – incisal surfaces. The absence of attrition caused by civilized man‟s soft diet does not eliminate the migration of teeth. www.indiandentalacademy.com
  35. 35. DIFFERENTIAL FORCE  In 1956 Dr Begg introduced the concept of Differential force.  His observations was based on the work of Storey and Smith and their experiments on tooth movement response to different pressure applications. www.indiandentalacademy.com
  37. 37.  A range of light pressures which would cause teeth to move at an optimum rate and with minimal disturbance of the supportive tissues optimum orthodontic force.  Pressures below this produce a slow rate of response, while above incurred a reaction within the bone support (undermining resorption), which also had an effect of retarding tooth movement. www.indiandentalacademy.com
  38. 38.  When a relatively light force is applied reciprocally between small – rooted anterior teeth and larger – rooted posterior teeth, the anterior teeth move relatively rapidly, whereas the larger – rooted posterior teeth remain almost stationary.  Conversely, if a relatively heavy force is applied in the same situation, the posterior teeth tend to migrate mesially while the anterior teeth resist movement. www.indiandentalacademy.com
  39. 39.  Here given elastic force is relatively constant, It is the rate of movement of the teeth on either end of the force that varies. Accordingly, it would perhaps be more appropriate to refer to “ differential reactions” rather than differential forces. www.indiandentalacademy.com
  40. 40.  A. Mechanics at each end of the force permites the force to differentiate as desired.  B. If the mechanics are the same at both ends of the force, the initial reaction will be for the molar, which has a smaller root surface area, to move forward and the anterior teeth remain stationary. www.indiandentalacademy.com
  41. 41.  The significance of this concept is enhanced by the ability to choose mechanics that promote free tipping where the greatest movement is desired and prevent free tipping where stability or anchorage is indicated. www.indiandentalacademy.com
  42. 42.  A goal of Begg‟s treatment is over correction of the teeth to allow for the natural tendency for relapse that occurs when orthodontic appliance removed.  The differential force technique is designed to permit teeth to move towards their anatomically correct positions in the jaw under the influence of very light forces – as would occur naturally in the presence of attrition. . www.indiandentalacademy.com
  43. 43.  The light intra oral forces of Begg Technique do not place undue strain on the anchor molars.  The appliance is designed to permit the teeth to move independently of one another – whether tipping freely in the early stages or during detailed root positioning in the final stage. www.indiandentalacademy.com
  44. 44.  Another feature is that the movement of all the teeth towards and beyond their desired final positions is initiated at the start of treatment ie. The movement of the teeth is not segmented into groups with one group waiting for another.  Both archwires and intermaxillary elastics are applied at the bonding appointment causing immediate reduction of deep overbite and overjets. The discomfort caused by the initiation of tooth movement produces a change in eating and biting habits that lessens the chance for appliance damage. www.indiandentalacademy.com
  45. 45.  The movement of all teeth is due to the synergistic effect of the forces and appliances working together in the presence of proper diagnosis.  The begg synergistic arch graphically demonstrates and emphasizes the importance of the combination of avrious components comprising the Begg theory and technique. www.indiandentalacademy.com
  46. 46. SEVEN SYNERGISTIC COMPO NENTS  1. A diagnosis and treatment plan that recognizes the persistence of hereditary forces of mesial migration and vertical eruption of teeth and has its objectives the over correction of malrelationships of both teeth and jaws.  2. The simultaneous movement of all teeth. From the beginning of treatment each tooth is directed towards its final position in the dental arch.  3. The total separation of root moving forces from arch wire forces during the final third stage of treatment.  4. The application of proper elastic forces to create the desired differential movement of the teeth. www.indiandentalacademy.com
  47. 47.  5. The use of light round continuos arch wires bent from the hardest wire possible – Not only must the wire be of highest quality, but the aech wire have proper form, including bite opening bends, to control the vertical dimension.  6. The use of molar attachments that prevent free mesiodistal tipping and yet permit the arch wire to slide freely mesio distally. This permits the rapid retraction of the anterior teeth.  7. The use of attachments on all teth, except anchor molars, that control rotations yet permit free tipping in the desired direction and free sliding along arch wires. www.indiandentalacademy.com
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  49. 49. ATTRITIONAL OCCLUSION  There is nothing more important for a dental or orthodontic student to learn than the normal attritional development of mans dentition. Only then can he or she understand the true cases of most dental and orhtodontic problems, and take appropriate remedial action. www.indiandentalacademy.com
  50. 50.  Dr. Begg noticed that the teeth of Aborigines had not only extensive occlusal and interproximal wear, but also exhibited total lack of caries, periodontal disease and tooth crowding. He recognized along with several others,that such examples of stone age man‟s attritional occlusion represented the true occlusion for man – not a pathological condition. This occlusion was far more efficient and healthy than “textbook normal occlusion”. Civilized Man‟s unworn dentition with all its related problems is abnormal. www.indiandentalacademy.com
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  52. 52.  Teeth continually erupt vertically, migrate mesially, and usually are collectively too large to be accommodated in the jaws without a reduction of tooth mass. This reduction, which occurs naturally in primitive man from attrition, can be replaced in civilized man by planned mesiodistal stripping and / or tooth extractions. www.indiandentalacademy.com
  53. 53. Attrition causes continual changes in the shapes and sizes of the teeth. Mesial migration and vertical eruption in the presence of attrition result in their moving occlusomesially in the jaws www.indiandentalacademy.com
  54. 54.  It is only recently that man has developed the ability to adapt the elements of the environment to fit his demands. One of the first elements altered was food. Civilized man has refined his food; eliminated the grit and excess fiber, resulting in foods that are soft, pasty, ultra – refined and high in carbohydrates – causing caries.  Dr. Begg feels the present concept of textbook-normal occlusion with its static tooth relationships shapes and sizes, is incorrect. Such an occlusion, and diet that permits it, are actually the causes of the majority of dental problems existing today. www.indiandentalacademy.com
  55. 55.  In civilized man the persistence of an anterior overbite locks the lower incisors in an anatomically and functionally incorrect position. This restraint the natural tendency for the lower incisor to become more procumbent,also encourages further crowding of these teeth. Persistence of anterior overbite also locks the maxillary incisors in an anatomically and functionally abnormal labial location. www.indiandentalacademy.com
  56. 56.  Hard, coarse and gritty food quickly causes incisal and occlusal wear. Initially the incisal wear is oblique, but becomes horizontal as wear progress. The lower incisors tip labially, while the upper incisors become more upright until they assume an edge to edge relationship. www.indiandentalacademy.com
  57. 57. Gingival Recession And Vertical Eruption  The physiologic process of continual tooth eruption has evolved to compensate for occlusal attrition. It persists in modern man, even in the absence of attrition. As a result of this, there is often continual increase in the vertical dimension between maxilla and mandible. Consequently civilized Man‟s face grows „‟longer‟‟ with age. www.indiandentalacademy.com
  58. 58.  This eruption is often clinically misinterpreted as gingival recession, when in fact it is the teeth that are erupting, and the gingival margin that is remaining relatively stationary. The rate of eruption and varies among individuals.  The course and gritty diet that causes attrition also controls caries and help prevent periodontal problems.Pit and fissures are quickly reduced by occlusal wear,thereby eliminating the focus of most caries in civilized man. www.indiandentalacademy.com
  59. 59.  In primitive man the excessive occlusal forces of mastication retard this eruption to a rate harmonious with the progression of attritional wear.If an individual lived long enough, continoual eruption and attritional occlusion would result in the shedding of the apical portion of the root. www.indiandentalacademy.com
  60. 60.  The course and gritty diet that causes attrition also controls caries and help prevent periodontal problems.Pits and fissures are quickly reduced by occlusal wear,thereby eliminating the focus of most caries in civilized man. The diet itself is of low in carbohydrates and its coarseness plus high volume prevents the accumulation of dental plaque, without which there can be no dental decay. www.indiandentalacademy.com
  61. 61.  Gingival embrassure areas (black triangles) in civilized Man become larger with age, due to lack of proximal wear.  In primitive man the interdental space remains small,since the teeth move together as the proximal surfaces are worn flat –creating large broad contact areas. www.indiandentalacademy.com
  62. 62. ERUPTION OF FIRST PERMANENT MOLARS  The edge to edge anterior tooth relationship results in the lower teeth being further forward in relation to the upper teeth and therefore, the mandibular second deciduous molars are mesial to the maxillary decidous second molars. The lower first permanent molar is then able to erupt in a more mesial position and proper initial relationship with the maxillary first permanent molar is www.indiandentalacademy.com achieved.
  63. 63. ANATOMY OF TMJ  Attritional occlusion can also affect anatomy of the temporomandibular joint.Primitive man exhibits a shallow glenoid fossa and flattened condylar head, not the deep fossa and round head found in modearn man. www.indiandentalacademy.com
  64. 64. Eruption of succedaneous teeth.   Attrition brings about enough reduction in mesiodistal dimensions of teeth to allow adequate space for the erupting permanent canines. In the absence of attrition there is often not enough space for the canine www.indiandentalacademy.com
  65. 65. PROXIMAL WEAR   In attritional occlusion decidous teeth are worn away quickly, both proximally an occlusally. The proximal wear can result in increased space for later erupting canine such as the canines. In civilized man due to lack of proximal attrition ,the permanent canines frequently lack adequate space for eruption. www.indiandentalacademy.com
  66. 66. ERUPTION OF THIRD MOLARS   In civilized man as no proximal wear occurs causes inadequate room distal to the second molars for normal eruption of third molars which leads to delayed eruption and complete impaction. At the age of 12 to 13 years the third molar begin to erupt in attritional occlusion. www.indiandentalacademy.com
  67. 67. CHANGE IN CURVE OF WILSON  As the permanent molars erupt the bucco – lingual plane is oblique. As wear progress, the plane becomees horizontal, then begins to slant downwards and cusp of carabelli serves to increase overall occlusal surface area.  In civilized man the buccolingual plane is oblique throughout life. www.indiandentalacademy.com
  68. 68. SECONDARY DENTINE AND PULPAL PAIN  Value of pulpal pain is not to warn of caries, but to warn of atttrition approaching the pulp faster than secondary dentin can be laid down. This causes automatic shift of bolus of food and therefore attrition to other teeth until secondary can overtake the attrition. www.indiandentalacademy.com
  69. 69. INCIDENCE OF CROWDING  Since attrition especially interproximallly causes a continoual reduction in mesiodistal tooth widths, the incidence of tooth crowding is relatively low in primitive man.  The persistence of large teeth and the processes of mesial migration in civilized Man explain the currrent relatively high incidence of tooth crowding. www.indiandentalacademy.com
  70. 70. CONCLUSION  As can be seen from the preceding examples, Man‟s dentition is far healthier and efficient in an attritional environment. However, this does not mean that orthodontist or Dentist must prescribe abrasive diets or begin eliminating cusps from their patients teeth. Rather, it provides the reason for most of the problems seen in the mouth of both dental and orthodontic patients. www.indiandentalacademy.com
  71. 71. BEEG‟S TECHNIQUE www.indiandentalacademy.com
  72. 72.  An orthodontic technique may defined as a systematic sequence of definite procedure to achieve the correction of malocclusion with a specific type of appliance or with a combination of appliances.  The Begg method is a system that demands stringent interdependence of technique and appearance; this technique requires specific bracket design, arch wire size and configurations, molar tube size and molar tube placement as well as specific system of procedure. www.indiandentalacademy.com
  73. 73.  The method consist essentially of tipping movements of the teeth. Two successive tipping movements are required to achieve bodily movement. The first to position the tooth crowns and second to position the tooth roots. As a result of these tipping movements, complemented by intrusion, extrusion and rotation of teeth whenever required, optimal occlusion, axial positioning and alignment of the teeth are secured. www.indiandentalacademy.com
  74. 74. COMPONENTS OF BEGG APPLIANCE  ARCH WIRE MATERIAL Round austenitic stainless steel wire of 0.016 inch diameter, which has been heat treated and cold drawn down to its proper diameter, in order to give it the required properties of resiliency, toughness and tensile strength. – without which this technique could not have been devleloped and cannot be employed. www.indiandentalacademy.com
  75. 75. PRECAUTION TAKEN WHILE BENDING THE WIRE  When the wire is bent around the round beak of the pliers, the stress on the crystalline structure is confined to a small area, which may cause the wire to break. When bending the wire around the square beak the points of stressare offset, providing more area for crystalline adjustment and there fore less chance fracture. www.indiandentalacademy.com
  76. 76. MODIFIED RIBBON ARCH BRACKET ( TP -256500) By changing the lock pins, the size of the arch wire slot can be changed to accept properly either a 0.016 inch or a 0.020 inch arch wire www.indiandentalacademy.com
  77. 77. Requirements for a light wire brackets       Ease of arch wire engagement A means to guide both the tail and head of lock pin during locking Positive retention of arch wire in all 3 stages Free tipping and sliding on arch wire Ability to effect and hold rotation Ability to prevent accidental tipping in stage III. These brackets are fabricated from stainless steel strips, hence it is economical. www.indiandentalacademy.com
  78. 78. TYPES A. B. c. d. 1. Full flange 2.Half flange 1. Bondable 2. Weldable 1.Flat 2. Curved Full flange brackets will have more friction with arch wire and hence hindrance to smooth tipping movement of anteriors. in half flange brackets, contact of the flange with arch wire is minimal , thus friction is also minimal. www.indiandentalacademy.com
  79. 79. AUSTRALIAN ARCHWIRES  In 1952 Dr Begg in collaboration with an Australian Metallurgist Mr. A.J Wilcock, developed a high tensile S.S wire that is heat treated and cold drawn to yield its now familiar and excellent clinical properties.  It was made thin enough, to distribute force at an optimal level for tooth movement over a considerable period of time, over long distance and with minimal loss of force intensity while doing so. www.indiandentalacademy.com
  80. 80. SIX TYPES OF AUSTRALIAN WIRE 1. REGULAR GRADE: - Lowest grade – easy to bend - Used for practice bending and forming auxillaries. 2. REGULAR PLUS: - Easy to form, more resilient than regular grade - Used for auxiliaries and arch wires when more pressure and resistance to deformation as desired. 3. SPECIAL GRADE: - Highly resilient yet can be formed into shape. www.indiandentalacademy.com
  81. 81.  SPECIAL PLUS GRADE: - Hardness and resiliency of 0.016” wire, is excellent for supporting anchorage, and reducing deep overbites. - Must be bent with care.  EXTRA SP ECIAL PLUS GRADE : - Also called premium plus - This grade is unequalled in resiliency and hardness. - More difficult to bend and more subjected to fracture. www.indiandentalacademy.com
  82. 82.  SUPREME GRADE: - It is ultra light tensile fine round stainless steel wire. - It was initially introduce in 0.010” diameter and then further reduced to 0.009 diameter. -It is primarily used in the early treatment for rotation. Alignment and leveling. - Although supreme exceeds the yield strength of E.S.P, it is intended for use in either short section or full arches where sharp bends are not required. www.indiandentalacademy.com
  83. 83. BAND MATERIAL  These bands made of stainless steel strips of different size and thickness are recommended for different teeth. These available on 8 feet rolls or cut of 2 inches to 2.5 inches. 1. For incisors - 0.125 x 0.003 inch 2. For canines, premolars – 0.150 x 0.004 inch 3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch www.indiandentalacademy.com
  84. 84. LOCK PINS  Second stage safety lock pin: Shoulder on head ensures free mesiodistal tipping. Labiolingual width of tail dimension is reduced to fit properly into TP – 256 – 500 bracket in conjunction with inch arch wire.  One point safety lock pin : Used in stage I and II. The pin has a shoulder that keeps the head of the pin outside the bracket slot and prevents the impingement of pin on arch wire. The beveled undersurface of head permits free mesiodistal tipping. Thickness of pin is 0.019 length 0.200‟‟ x 0.220” www.indiandentalacademy.com
  85. 85.  Hook lock pins : Used during III stage. Since there is no safety shoulder, they hold the arch wire firmly against the base of the arch wire slot. Thickness – 0.014” to 0.018” , length – 0.220 to 0.293  High hat safety lock pins: They have a gingival extension on head which provides a positive point for engagement of vertical or cross elastics. www.indiandentalacademy.com
  86. 86. BUCCAL TUBES  Round molar tubes with 0.036 internal diameter and 0.250 length are routinely used.  Flat oval molar tubes and doubled back wires are used when second permanent molars are the anchor teeth and also used in mandibular dental arch when second premolar is absent. www.indiandentalacademy.com
  87. 87. AUXILLARY ATTACHMENTS  In addition to the foregoing parts, the light round arch wire technique requires the following adjustments .  LINGUAL BUTTONS: The name clearly indicates the side of the teeth where it is to be welded. Used for correction of premolar and molar rotation. www.indiandentalacademy.com
  88. 88. www.indiandentalacademy.com
  89. 89. EYELETS: Are made from thin stainless steel stiff wires. They are very useful in tying the ligature wire on anterior teeth for purpose of rotation. www.indiandentalacademy.com
  90. 90. CLEAT LUG - - - Are made from heavier metal. Welded in the centre of lingual surfaces and gingival 1/3 of the band. Facilitate proper pushing of bands to its proper place on the tooth. www.indiandentalacademy.com
  91. 91. SEATING LUG - HOOK  Flat or contoured bases designed for the use on lingual surface of all teeth.  Uses: - for placement of elastics - easy insertion and removal of band. www.indiandentalacademy.com
  92. 92. BALL END HOOKS: They are attached to buccal or lingual of molar bands. Positioned as far gingivally and near the mesiodistal centre of the tooth. Make the placing of elastic simple for patient. www.indiandentalacademy.com
  93. 93. Bypass clamp  Pinning of the arch wire in the premolar brackets can cause hinderence to free tipping. So in stage I and stage II Bypass clamps are used on the premolar brackets. www.indiandentalacademy.com
  94. 94. Ligature wires These are very thin (0.007 to 0.009) stainless steel soft wires. - They are very useful in tying of the span of looped arch wire, which are far away from its ideal position, thus porgressive increase In force and also avoiding plastic deformation of the arch wire. - Also used as extra holding devices. When one wants to feel secure about arch wire not getting disengaged from the bracket slot by slipping out www.indiandentalacademy.com
  95. 95. ELASTICS  Elastics are made of synthetic latex and of uniform sizes and applying uniform forces when stretched to required length. These elastics come in different sizes of internal diameter and different thickness of their wall. Thinner walled elastics are called “light elastics” and thick walled elastics are called “Heavy elastics”  These elastics will exert a force equal to between 60 and 70 gms when they are new and first placed. www.indiandentalacademy.com
  96. 96. Strength of the elastics varied according to the clinical requirement. - LIGHT( yellow) class I or class II used for anterior retraction. -STRONGER ( green) class I are used for posterior protraction. - BLUE OR RED used only when green elastics are ineffective. www.indiandentalacademy.com
  97. 97. USES OF ELASTICS          Anterior retraction Posterior protraction Correction of deep bite Correction of class II or class III occlusion Closure of extraction spaces Correction of cross bite Correction of rotation Anterior open bite (box elastics ) Correction of midline. www.indiandentalacademy.com
  98. 98. CLASS I ELASTICS www.indiandentalacademy.com
  99. 99. Class 2 Elastics www.indiandentalacademy.com
  100. 100. EFFECTS OF CLASS II ELASTIC  In lower molar region one vector taking posteriors mesially and other vector extruding force on molar.  On upper anteriors horizontal vector will tipp and retract anteriors distally and vertical counteract vector the will intrusive effect of upper arch wire on anteriors. www.indiandentalacademy.com
  101. 101. CLASS III ELASTICS www.indiandentalacademy.com
  102. 102. SEPARATING SPRING www.indiandentalacademy.com
  103. 103. BRACKET PLACEMENT www.indiandentalacademy.com
  104. 104. BUCCAL TUBE PLACEMENT www.indiandentalacademy.com
  105. 105. STAGES OF THE BEGG TECHNIQUE  STAGE I – OBJECTIVES 1. Open the anterior overbite 2. Overcorrect the mesiodistal relationship of the buccal segment as necessary. 3. Close any anterior space. 4. Eliminate any anterior crowding. 5. Overrotate all teeth that require rotating. 6.Correct posterior crossbites. www.indiandentalacademy.com
  106. 106. HOW TO ACHIEVE THE OBJECTIVES   1.Open the anterior over bite - use 0.016 inch hard Australian wire. - Proper amount of anchor bends at proper locations. -Continual wearing of class II or Class III elastics. 2. Overcorrect the mesiodistal relationship of the buccal segments as necessary. - Continoual wearing of class II or class III elastics as required. - Proper anchorage or bite – opening bends in both upper and lower arch wires. www.indiandentalacademy.com
  107. 107. 3. Close any anterior space: Plain arch wire with elastic from cuspid pin tail to cuspid pin tail. 4.Eliminate any anterior crowding: - Vertical loops between crowded anterior teeth, with bracket areas modified for desired overcorrections. - Arch length designed so that intermaxillary circles rest against mesial surfaces of cuspid brackets. 5.Overrotate all teeth that require rotating - Overcorrection of bracket areas between anterior vertical loops. www.indiandentalacademy.com
  108. 108. - Use of elastic thread from buttons or brackets to rotate cuspids and bicuspids. - Use of rotating springs 6. Correct posterior crossbites: - Modify arch width of one or both arch wires -wearing cross elastics - Rapid maxillary overexpansion, folloed by aperiod of stabilization prior to the placement of complete appliances and the beginning of stage I. www.indiandentalacademy.com
  109. 109. PRIORITIES IN THE STAGE I  1. It is generally agree that reduction of overbite must precede reduction of overjet.  2. While treating cases with anterior crowding, alignment of teeth becomes an important consideration.  3. when the upper incisors are very much proclined they should be subjected to a light intrusive force and a normal retractive class II elastic force till their proclination reduces. www.indiandentalacademy.com
  110. 110.  Stage I arch wire : - Made from 0.016 heat treated high tensile stainless steel wire. - incorporate anchor bends, intermaxillary hooks,toe- in, toe – out bends, vertical loop. www.indiandentalacademy.com
  111. 111. VERTICAL LOOP www.indiandentalacademy.com
  112. 112. ANCHOR BENDS www.indiandentalacademy.com
  113. 113. INTER MAXILLARY HOOK   It helps in placement of elastics It prevent slippage of plain arch wires www.indiandentalacademy.com
  114. 114. CANINE CONDOUR www.indiandentalacademy.com
  115. 115. www.indiandentalacademy.com
  116. 116. TOE - IN BENDS: Incorporated in the arch wire as anti – rotational bends. The toe in bends should never exceed more than 5 degree. TOE – OUT BENDS To correct the disto – buccal molar rotation. www.indiandentalacademy.com
  117. 117. ELASTICS      To open the bite To correct the mesiodistal relationship of buccal segments To close the anterior spacing Corection of rotation Posterior crossbite corection www.indiandentalacademy.com
  118. 118. www.indiandentalacademy.com
  119. 119. www.indiandentalacademy.com
  120. 120. PROBLEMS ARISING IN STAGE I  BITE NOT OPENING: A. Patient not wearing elastics: - educate the patient -do not give enough elastics - make it impossible to hook elastics and see if problem is reported B. Patient biting out bite opening bends. - Remove the arch wire : restore bite opening bends www.indiandentalacademy.com
  121. 121. - Check the level of mandibular molar tubes, lower thm, if necessary. - Check position of anchor bends, if too far mesially, move them closer to molar tube. - Failure to place proper amount of bite opening bends when arches were placed. - Loose molar band - Improper angulations of buccal tube or entire molar bend. MOLAR WIDTH NARROWING: A. Verticl component of classs II elastic force - Form mandibular arch wire wider in posterior www.indiandentalacademy.com segment
  122. 122. B. Prolonged wearing of posterior cross elastics to widen opposing molars - discontinue cross elastics and correct cross bite by others means. C. Disto – lingually rotated cuspids 1. Do not engage the arch wire in the cuspid brackets until these teeth have been rotated by elastic thread or other means. 3. ADVERSE TIPPING OF ANCHOR MOLARS - If tipped mesially : there is no anchor bends. If tipped distaly too much anchor bends. - Improper placement of molar band or tube www.indiandentalacademy.com
  123. 123. - Excessive elastic force - Improper placement of elastics - Oversize arch wire – molar tipped distally. 4. NO APPRECIABLE CHANGE - Patient not wearing elastics - Arch wire bend out of shape - patient seen too soon 5. VERTICALLOOPS BURIED IN THE GINGIVA a. Original, looped arch wire left in the mouth too long - replace it with plain arch wire with bayonet bends www.indiandentalacademy.com
  124. 124. b. Misjudgment in the proper direction of vertical loops when the arch wire was plced - remove and modify the direction of the loops and replace. 6. ELASTICS WHICH BREAK OR DO NOT STAY ON: a. may just be an excuse for not wearing elastics b. elastic will not stay on the intermaxillary circle. 7.LOCK PINS LOST; a. occluso incisal force -use steel pin - Chek anchor bends to facilitate opening the bite www.indiandentalacademy.com
  125. 125. 8. EXTREMELY MOBILE MOLARS: A. clenching of the teeth b. intermittent wearing of elastics c. pathology d. excessive force applied to molar - Reduce arch wire size to 0.016 inch - Reduce elastic force to 2 ½ ounces - Reduce degree of anchor bends 9. LOWER ANTERIOR TEETH TIPPING LABIALLY: A. May be an optical illusion with roots actually moving lingually. b. Binding of the arch wire in bicuspid brackets www.indiandentalacademy.com
  126. 126.  Binding of ends of the arch wire inside distal ends of buccal tube. 10. ANTERIOR OPEN BITE NOT CLOSING: A. patient not wearing anterior vertical elastics B. Persistent tongue thrust or other adverse habits c. Too much anchor bend. www.indiandentalacademy.com
  127. 127. STAGE II  OBJECTIVES: 1. Maintain all corrections achieved during first stage. 2. Close any remaining posterior space. www.indiandentalacademy.com
  128. 128.  Mesiodistal molar relationship maintained through the wearing of clasII or ClassIII elastics as required.  Spaces between the anterior teeth are prevented by tying intermaxillary circles to the cuspid brackets.  Overrotations of central and lateral incisors are maintained through the continued use of bayonet bends in the arch wires. www.indiandentalacademy.com
  129. 129.  Mesiodistal molar relationship maintained through the wearing of clasII or ClassIII elastics as required.  Spaces between the anterior teeth are prevented by tying intermaxillary circles to the cuspid brackets.  Overrotations of central and lateral incisors are maintained through the continued use of bayonet bends in the arch wires. www.indiandentalacademy.com
  130. 130.  Overrotations of bicuspids are held by replacing elastic threads with steel ligature tie.  Opening of deep anterior overbite is maintained through the continued use of bite opening bends and class II or class III elastics.  Closing of extraction space by wearing of horizontal elastics. www.indiandentalacademy.com
  131. 131. ARCH WIRE ( 0.020 SS) - To maintain the corrections already achieved. - To stabilize the teeth against any adverse reciprocal forces may occur as a result of the application of elastics or auxiliaries. ANCHOR BEND: - Less compared to stage I PREMOLAR OFFSET BEND LOCK PIN: www.indiandentalacademy.com - “Stage 2” safety lock pins.
  132. 132. ELASTIC  Horizontal intra-maxillary space closing elastics with class 2 elastics to maintain to maintain the edge to edge.  creates rotational tendency on molar (distobuccal). www.indiandentalacademy.com
  133. 133.  1. Horizontal elastic is engaged on the lingual of the molar instead on the buccal.  2. Elastic thread tie on the lingual, from the canine to molar. www.indiandentalacademy.com
  134. 134. AUXILIARIES USED IN STAGE II  Passive uprighting springs on mandibular canine.  It establish two point contact between the teeth and arch wire to prevent further free tipping.  The strength of horizontal elastics increased from 21/2 ounces to 8 ounces. www.indiandentalacademy.com is
  135. 135. CORRECTION OF MIDLINE  Class II intermaxillary elastics on one side and class three on other side.  Elastic from intermaxillary hook mesial to upper canine to intermaxillary hook mesial of the lower canine on opposite side www.indiandentalacademy.com
  136. 136.  Ligature wire or by – pass clamps are used on second premolars in order to avoid overclosure of extraction space and pushing of II premolar lingually. www.indiandentalacademy.com
  137. 137. END OF STAGE II www.indiandentalacademy.com
  138. 138. PROBLEM ENCOUNTERED DURING SECOND STAGE  Anterior bite closing: a. Not enough anchor bend b. Bite – opening bends bitten out - Educate patient , correct the archwire c. Patient not wearing the classII elastics d. Anchor molars out of occlusion - Discontinue class II or class III elastics. Use horizontal elastics to get molars in occlusion. www.indiandentalacademy.com
  139. 139.  Anterior teeth assuming class III relation a. Excessive wearing of class II elastics  Spaces Developing Between The Anterior teeth: a. Failure to give cuspid tie b. Intermaxillary circles formed too far apart.  Anchor molar rotating distobucally a. Toe – out on arch wire www.indiandentalacademy.com
  140. 140. Anchor molars rotating distobuccally a. Too much force from horizontal elastics - Use lighter horizontal elastics - Elastic thread from cuspid lingual buttons to the lingual hooks on the molars.   Posterior spaces not closing: a. Patient not wearing elastics. b.Arch wire not free to slide distally through buccal tube. c. Arch wire pinned or caught in bicuspid bracket slot. www.indiandentalacademy.com
  141. 141. d. Anterior teeth or tooth not free to tip distally: - Use proper brackets that allow free mesiodistal tipping. - use safety lock pins  Second bicuspids tipping mesially in first bicuspid: - Slight, expected mesial movement of anchor molar - Abnormal loss of anchorage, if second bicuspids are tipping excessively. www.indiandentalacademy.com
  142. 142. STAGE III  OBJECTIVES: 1. Maintain all corrections achieved during first and second stages. 2. Achieve desired axial inclinations of all teeth. www.indiandentalacademy.com
  143. 143. - Posterior spaces kept closed by bending the distal ends of the arch wires around the buccal tubes. - Arch form and overbite corrections maintained by using heavier (0.018 to 0.025) main arch wires. - Changes in the mesiodistal inclinations of teeth are accomplished by the use of individual root – tipping springs. - Lingual or labial root torque is applied to anterior teeth through the application www.indiandentalacademy.comauxiliaries. of torqueing
  144. 144. STAGE THREE UPPER ARCH WIRE  Made by 0.20 s.s  Constricted in distal ends.  Gingival bend distal to cuspid bracket. www.indiandentalacademy.com
  145. 145. STAGE III LOWER ARCH WIRE  Made by 0.20 round s.s.  Expansion in distal ends.  Molar offset bend  Mild anchor bend distal to canine.  Slight vertical step in the anchor bend area. www.indiandentalacademy.com
  146. 146. AUXILIARIES USED IN STAGE III UPRIGHTING SPRING:   Used to correct the axial angulation of teeth in mesio – distal direction. Made by 0.014” round S.S for canine and premolars, 0.012 for laterals. Helix of spring face towards tooth surface and lie on the gingival aspect of arch wire. www.indiandentalacademy.com
  147. 147.  The degree of activation of spring depends on 1. The size of wire from which spring is made 2. The diameter of the helix 3. The number of turns in helix 4. The length of the arms of spring 5. The size of the root of the tooth being uprighted www.indiandentalacademy.com
  148. 148.  Arch wire ligation prior to placement of uprighting spring www.indiandentalacademy.com
  149. 149. TYPES OF UPRIGHTING SPRING  A combination safety lock pin and uprighting spring that eliminates the need for ligating the arch wire to the bracket. Locked in place by bending the tail of the spring around the body of bracket.  Available as two coil and three coil from .014 www.indiandentalacademy.com
  150. 150. PLAIN UPRIGHTING SPRING  Made of 0.014 for uprighting canine and premolars, 0.012 for incisors.  The angulation of the active arm and retentive arm is 135 degree.  The helix with retentive arm should face the tooth surface.  The base arch wire is ligated, otherwise the action of uprighting spring will extrude the tooth . www.indiandentalacademy.com
  151. 151. -The length of hook is made greater than the diameter of the helix to keep the arm of the spring parallel to the arch wire in the vertical plane. -- To avoid a rotating force on the tooth, the arm of the spring is offset buccally to make it parallel to the arch wire in the horizontal plane. www.indiandentalacademy.com
  152. 152. The degree of activation of the uprighting springs depends on: 1. The size of wire 2. Diameter of helix 3. Number of turns in the helix 4. Length of the arm of the spring 5. The size of the root being uprighted. www.indiandentalacademy.com
  153. 153. MINISPRING  Made of thinner diameter (0.009) high resilient supreme grade wire.  The coil of springs is only twice the size of the wire.  The activation is 100%, the stem and active arm are in one line. www.indiandentalacademy.com
  154. 154.  The hooks of short – arm uprighting springs will slide along the arch wire and approach each other as teeth upright.  If long arm uprighting springs are used, the arms of premolar and canine cross each other. www.indiandentalacademy.com
  155. 155.  The rotational component of the tooth displacement, caused by a single force application, is generally unfavorable. Hence it is resisted by applying a counter moment as by uprighting sping www.indiandentalacademy.com
  156. 156. TORQUING AUXILLARY www.indiandentalacademy.com
  158. 158. FOUR SPUR TORQUEING AUXILLARY  Used for torqueing the upper anterior teeth palataly  Preformed from .016” wire www.indiandentalacademy.com
  159. 159. TWO SPUR TORQUEING AUXILLARY  Used when lateral incisors do not require palatal root torque , as in extraction cases when upper laterals were displaced slightly palataly. www.indiandentalacademy.com
  160. 160. FABRICATION OF TORQUEING AUXILIARY www.indiandentalacademy.com
  161. 161. RECIPROCAL TORQUEING AUXILIARY - Indicated when the upper lateral incisors were blocked out palatally before treatment. Their root apices must be torqued labially to reduce the tendency for the crowns to relapse lingually. - Lever arms on laterals pass incisaly for labial root torque. www.indiandentalacademy.com
  162. 162. SHORT FOUR – SPUR TORQUEING AUXILIARY  Indicated for torqueing of upper anterios.  Does not engage cuspid bracket  Easy to fabricate. www.indiandentalacademy.com
  163. 163. INDIVIDUAL TORQUEING AUXILIARY  Used for selected upper or lower teeth  Auxiliary should extend at least one tooth pass tooth being torqued, and around curve of arch, for maximum activation.  If placed gingivally, torque the root of the lateral lingually. www.indiandentalacademy.com
  164. 164. REVERSE TORQUEING AUXILIARY  Indicated if lower anterior teeth are becoming too proclined.  Acts as a source of intra oral mandibular anchorage to inhibit forward movement of mandibular dental arch. www.indiandentalacademy.com
  165. 165. ONE TO ONE TORQUEING AUXILIARY  Indicated when two adjacent teeth require root torque in opposite directions.  Tends to deliver excessive force therefore degree of activation between lever arms should be low www.indiandentalacademy.com
  166. 166. RAT - TRAP TORQUEING AUXILIARY    Main arch wire is formed from 0.020 inch round wire. The auxiliary is wound from either 0.014 or 0.016 inch highly resilient round wire. The torqueing “bars” do not extend to the gingiva. www.indiandentalacademy.com
  167. 167. ASYMMETRICAL TORQUING AUXILIARY Auxiliary used to produce palatal root torque of the maxillary right central and lateral incisors.  The ends of the auxiliary are terminated distal to the canine brackets.  As the central incisor loop is formed mesial to the bracket and the lateral incisor loop is formed distal to the bracket mesodistal movement of the auxiliary is prevented.  www.indiandentalacademy.com
  168. 168. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Two spur arch Four spur arch Modified four spur Art four – spur Modified Kitchon 2 – spurs Kitchon two finger spur F and J two spur arch Von der heydt two – spur arch Modified reverse torque arch Sain reverse torque arch www.indiandentalacademy.com
  169. 169. The lingual torquing effect is on account of two factors: 1. Vertical plane changes to horizontal. 2. Smaller circle opens to large. Both these effects force the tips of the spurs to press in a lingual direction against the gingival portion of the crown. Reciprocally, the inter – spur spans of the auxiliary tend to lift away in a labial direction. Thus a force couple is created. The labial forces are resisted by the bracket slots and the base archwire to which auxiliary is tied this accentuates the action of root www.indiandentalacademy.com lingual moving force.
  170. 170. PROBLEMS ENCOUNTERED DURING STAGE III  Maxillary Molars Widening: A. Anchor bends present in maxillary arch wire. b.Too much bite – opening bend between cuspid and bicuspid c. maxillary arch wire too small in diameter. d. Maxillary arch wire too wide. e. Torqueing auxillary not constricted adequately. www.indiandentalacademy.com
  171. 171.  Mandibular molars narrowing a. Lower arch wire not wide enough b. class II elastics exerting too much force c presence of steel ligature tie from the lingual of the mandibular cuspid to the lingual of the mandibular molar  Anterior bite deepening: a. Too much power in the torqueing auxillary b. Maxillary arch wire too thin. c. Patient not wearing class II elastic www.indiandentalacademy.com
  172. 172.  Teeth not uprighting mesiodistally: A. springs not active B. Arch wire caught on the edge of the bracket - Tighten spring – pin to draw arch wire in bracket - Draw arch wire into bracket with a steel ligature tie C. Occlusal interference caused by an elevated tooth. D. Springs placed in backwards www.indiandentalacademy.com
  173. 173.  Teeth not uprighting mesiodistally: A. springs not active B. Arch wire caught on the edge of the bracket - Tighten spring – pin to draw arch wire in bracket - Draw arch wire into bracket with a steel ligature tie C. Occlusal interference caused by an elevated tooth. D. Springs placed in backwards www.indiandentalacademy.com
  174. 174.  1. 2. Maxillary anterior teeth not torqueing palatally Not enough force from maxillary torqueing auxiliary Maxillary incisal edges caught lingual to lower anterior teeth  Lower anterior teeth labially inclined Normal mesial migration of teeth during third stage  Rotation of teeth other than molars Lack of complete bracket engagement Arch wire slot too large. 1. 2. www.indiandentalacademy.com
  175. 175. It was partly through studying Stone age man’s attrition that light tooth moving forces were found to make higher standards of orthodontic treatment possible. Furthermore, the light wire technique is unique in that the tooth moving forces it exerts are so appropriate that extra – oral forces are never required neither to enhance nor to combat the force values exerted by it. The advent of this technique provides common ground for agreement between the school of thought advocating movement of tooth roots to their correct relations and the school advocating light forces. www.indiandentalacademy.com
  176. 176. www.indiandentalacademy.com