Stages in beggs technique /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Stages in beggs technique /certified fixed orthodontic courses by Indian dental academy

  1. 1. STAGES IN BEGG’S •STAGE I •STAGE II www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. CONTENTSCONTENTS COMPONENTS OF THE APPLIANCECOMPONENTS OF THE APPLIANCE STAGE ISTAGE I PROBLEMS IN STAGE IPROBLEMS IN STAGE I STAGE IISTAGE II PROBLEMS IN STAGE IIPROBLEMS IN STAGE II REFERENCESREFERENCES www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. COMPONENTS OF BEGGCOMPONENTS OF BEGG APPLIANCEAPPLIANCE www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. MODIFIED RIBBON ARCH BRACKET ( TP -256-MODIFIED RIBBON ARCH BRACKET ( TP -256- 500)500) www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. Requirements for a light wire bracketsRequirements for a light wire brackets Ease of arch wire engagementEase of arch wire engagement A means to guide both the tail and head of lock pinA means to guide both the tail and head of lock pin during lockingduring locking Positive retention of arch wire in all 3 stagesPositive retention of arch wire in all 3 stages Free tipping and sliding on arch wireFree tipping and sliding on arch wire Ability to effect and hold rotationAbility to effect and hold rotation Ability to prevent accidental tipping in stage III.Ability to prevent accidental tipping in stage III. These brackets are fabricated from stainlessThese brackets are fabricated from stainless steel strips, hence it is economical.steel strips, hence it is economical. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. TYPESTYPES A.A. 1. Full flange1. Full flange 2.Half flange2.Half flange B.B. 1. Bondable1. Bondable 2. Weldable2. Weldable Full flange brackets will have moreFull flange brackets will have more friction with arch wire and hence hindrance tofriction with arch wire and hence hindrance to smooth tipping movement of anterior.smooth tipping movement of anterior. in half flange brackets, contact of thein half flange brackets, contact of the flange with arch wire is minimal , thus friction isflange with arch wire is minimal , thus friction is also minimal.also minimal. www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. ARCH WIREARCH WIRE www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. AUSTRALIAN ARCHWIRESAUSTRALIAN ARCHWIRES Round austenitic stainless steel wire of 0.016 inchRound austenitic stainless steel wire of 0.016 inch diameter, which has been heat treated and colddiameter, which has been heat treated and cold drawn down to its proper diameter, in order to givedrawn down to its proper diameter, in order to give it the required properties of resiliency, toughnessit the required properties of resiliency, toughness and tensile strengthand tensile strength It was made thin enough, to distribute force at anIt was made thin enough, to distribute force at an optimal level for tooth movement over aoptimal level for tooth movement over a considerable period of time, over long distance andconsiderable period of time, over long distance and with minimal loss of force intensity while doing so.with minimal loss of force intensity while doing so. www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. SIX TYPES OF AUSTRALIAN WIRESIX TYPES OF AUSTRALIAN WIRE 1.1. REGULAR GRADE:REGULAR GRADE: -- Lowest grade – easy to bendLowest grade – easy to bend - Used for practice bending and forming auxiliaries.- Used for practice bending and forming auxiliaries. 2.2. REGULAR PLUS:REGULAR PLUS: -- Easy to form, more resilient than regular gradeEasy to form, more resilient than regular grade - Used for auxiliaries and arch wires when more- Used for auxiliaries and arch wires when more pressure and resistance to deformation as desired.pressure and resistance to deformation as desired. 3. SPECIAL GRADE:3. SPECIAL GRADE: -- Highly resilient yet can be formed into shape.Highly resilient yet can be formed into shape. www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. SPECIAL PLUS GRADE:SPECIAL PLUS GRADE: -- Hardness and resiliency of 0.016” wire, isHardness and resiliency of 0.016” wire, is excellent for supporting anchorage, and reducingexcellent for supporting anchorage, and reducing deep overbites.deep overbites. - Must be bent with care.- Must be bent with care. EXTRA SP ECIAL PLUS GRADEEXTRA SP ECIAL PLUS GRADE :: -- Also called premium plusAlso called premium plus - This grade is unequalled in resiliency and- This grade is unequalled in resiliency and hardness.hardness. - More difficult to bend and more subjected to- More difficult to bend and more subjected to fracture.fracture. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. SUPREME GRADE:SUPREME GRADE: -- It is ultra light tensile fine round stainless steelIt is ultra light tensile fine round stainless steel wire.wire. - It was initially introduce in 0.010” diameter and- It was initially introduce in 0.010” diameter and then further reduced to 0.009 diameter.then further reduced to 0.009 diameter. -It is primarily used in the early treatment for-It is primarily used in the early treatment for rotation. Alignment and leveling.rotation. Alignment and leveling. - Although supreme exceeds the yield strength of- Although supreme exceeds the yield strength of E.S.P, it is intended for use in either short section orE.S.P, it is intended for use in either short section or full arches where sharp bends are not required.full arches where sharp bends are not required. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. BAND MATERIALBAND MATERIAL These bands made of stainless steel strips of differentThese bands made of stainless steel strips of different size and thickness are recommended for different teeth.size and thickness are recommended for different teeth. These available on 8 feet rolls or cut of 2 inches to 2.5These available on 8 feet rolls or cut of 2 inches to 2.5 inches.inches. 1. For incisors - 0.125 x 0.003 inch1. For incisors - 0.125 x 0.003 inch 2. For canines, premolars – 0.150 x 0.004 inch2. For canines, premolars – 0.150 x 0.004 inch 3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch3. For molars - 0.150 x 0.005 or 0.180 x 0.006 inch www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. AUXILLARY ATTACHMENTSAUXILLARY ATTACHMENTS In addition to theIn addition to the foregoing parts, the lightforegoing parts, the light round arch wire techniqueround arch wire technique requires the followingrequires the following adjustmentsadjustments .. LINGUAL BUTTONS:LINGUAL BUTTONS: The name clearlyThe name clearly indicates the side of theindicates the side of the teeth where it is to beteeth where it is to be welded. Used forwelded. Used for correction of premolarcorrection of premolar and molar rotation.and molar rotation. www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. BALL END HOOKS:BALL END HOOKS: They are attached toThey are attached to buccal or lingual of molarbuccal or lingual of molar bands. Positioned as farbands. Positioned as far gingivally and near thegingivally and near the mesiodistal centre of themesiodistal centre of the tooth. Make the placing oftooth. Make the placing of elastic simple for patient.elastic simple for patient. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. ELASTICSELASTICS Elastics are made of synthetic latex and of uniform sizesElastics are made of synthetic latex and of uniform sizes and applying uniform forces when stretched to requiredand applying uniform forces when stretched to required length. These elastics come in different sizes of internallength. These elastics come in different sizes of internal diameter and different thickness of their wall. Thinnerdiameter and different thickness of their wall. Thinner walled elastics are called “walled elastics are called “light elasticslight elastics” and thick” and thick walled elastics are called “walled elastics are called “Heavy elasticsHeavy elastics”” These elastics will exert a force equal to between 60 andThese elastics will exert a force equal to between 60 and 70 gms when they are new and first placed.70 gms when they are new and first placed. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. USES OF ELASTICSUSES OF ELASTICS Anterior retractionAnterior retraction Posterior protractionPosterior protraction Correction of deep biteCorrection of deep bite Correction of class II or class III occlusionCorrection of class II or class III occlusion Closure of extraction spacesClosure of extraction spaces Correction of cross biteCorrection of cross bite Correction of rotationCorrection of rotation Anterior open bite (box elastics )Anterior open bite (box elastics ) Correction of midline.Correction of midline. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. CLASS I ELASTICSCLASS I ELASTICS www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. Class 2 ElasticsClass 2 Elastics www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. EFFECTS OF CLASS II ELASTICEFFECTS OF CLASS II ELASTIC In lower molar region oneIn lower molar region one vector taking posteriorsvector taking posteriors mesially and other vectormesially and other vector extruding force on molar.extruding force on molar. On upper anteriorsOn upper anteriors horizontal vector will tipphorizontal vector will tipp and retract anteriors distallyand retract anteriors distally and vertical vector willand vertical vector will counteract the intrusivecounteract the intrusive effect of upper arch wire oneffect of upper arch wire on anteriorsanteriors.. www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. CLASS III ELASTICSCLASS III ELASTICS www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. Ligature wiresLigature wires These are very thin (0.007 to 0.009) stainless steel softThese are very thin (0.007 to 0.009) stainless steel soft wires.wires. - They are very useful in tying of the span of looped arch- They are very useful in tying of the span of looped arch wire, which are far away from its ideal position, thuswire, which are far away from its ideal position, thus progressive increase In force and also avoiding plasticprogressive increase In force and also avoiding plastic deformation of the arch wire.deformation of the arch wire. - Also used as extra holding devices. When one wants to- Also used as extra holding devices. When one wants to feel secure about arch wire not getting disengaged fromfeel secure about arch wire not getting disengaged from the bracket slot by slipping outthe bracket slot by slipping out www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. BUCCAL TUBESBUCCAL TUBES Round molar tubes withRound molar tubes with 0.036 internal diameter0.036 internal diameter and 0.250 length areand 0.250 length are routinely used.routinely used. Flat oval molar tubes andFlat oval molar tubes and doubled back wires aredoubled back wires are used when secondused when second permanent molars are thepermanent molars are the anchor teeth and alsoanchor teeth and also used in mandibular dentalused in mandibular dental arch when secondarch when second premolar is absent.premolar is absent. www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. LOCK PINSLOCK PINS Second stage safety lock pin:Second stage safety lock pin: Shoulder on head ensures freeShoulder on head ensures free mesiodistal tipping. Labiolingual width of tail dimension is reduced tomesiodistal tipping. Labiolingual width of tail dimension is reduced to fit properly into TP – 256 – 500 bracket in conjunction with inch archfit properly into TP – 256 – 500 bracket in conjunction with inch arch wire.wire. One point safety lock pinOne point safety lock pin : Used in stage I and II. The pin has a: Used in stage I and II. The pin has a shoulder that keeps the head of the pin outside the bracket slot andshoulder that keeps the head of the pin outside the bracket slot and prevents the impingement of pin on arch wire. The beveledprevents the impingement of pin on arch wire. The beveled undersurface of head permits free mesiodistal tipping. Thickness ofundersurface of head permits free mesiodistal tipping. Thickness of pin is 0.019 length 0.200’’ x 0.220”pin is 0.019 length 0.200’’ x 0.220” www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. Hook lock pinsHook lock pins : Used during III: Used during III stage. Since there is no safetystage. Since there is no safety shoulder, they hold the arch wireshoulder, they hold the arch wire firmly against the base of the archfirmly against the base of the arch wire slot. Thickness – 0.014” towire slot. Thickness – 0.014” to 0.018” , length – 0.220 to 0.2930.018” , length – 0.220 to 0.293 High hat safety lock pins:High hat safety lock pins: They have a gingival extension onThey have a gingival extension on head which provides a positivehead which provides a positive point for engagement of vertical orpoint for engagement of vertical or cross elastics.cross elastics. www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. BRACKET PLACEMENTBRACKET PLACEMENT www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. BUCCAL TUBE PLACEMENTBUCCAL TUBE PLACEMENT www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. SEVEN SYNERGISTIC COMPO NENTSSEVEN SYNERGISTIC COMPO NENTS 1. A diagnosis and treatment plan that recognizes the persistence of1. A diagnosis and treatment plan that recognizes the persistence of hereditary forces of mesial migration and vertical eruption of teeth and hashereditary forces of mesial migration and vertical eruption of teeth and has its objectives the over correction of malrelationships of both teeth and jaws.its objectives the over correction of malrelationships of both teeth and jaws. 2. The simultaneous movement of all teeth. From the beginning of2. The simultaneous movement of all teeth. From the beginning of treatment each tooth is directed towards its final position in the dental arch.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 during3. The total separation of root moving forces from arch wire forces during the final third stage of treatment.the final third stage of treatment. 4. The application of proper elastic forces to create the desired differential4. The application of proper elastic forces to create the desired differential movement of the teeth.movement of the teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. 5. The use of light round continuos arch wires bent from the hardest5. The use of light round continuos arch wires bent from the hardest wire possible – Not only must the wire be of highest quality, but thewire possible – Not only must the wire be of highest quality, but the aech wire have proper form, including bite opening bends, to controlaech wire have proper form, including bite opening bends, to control the vertical dimension.the vertical dimension. 6. The use of molar attachments that prevent free mesiodistal6. The use of molar attachments that prevent free mesiodistal tipping and yet permit the arch wire to slide freely mesio distally.tipping and yet permit the arch wire to slide freely mesio distally. This permits the rapid retraction of the anterior teeth.This permits the rapid retraction of the anterior teeth. 7. The use of attachments on all teth, except anchor molars, that7. The use of attachments on all teth, except anchor molars, that control rotations yet permit free tipping in the desired direction andcontrol rotations yet permit free tipping in the desired direction and free sliding along arch wires.free sliding along arch wires. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. The method consist essentially of tipping movements ofThe method consist essentially of tipping movements of the teeth. Two successive tipping movements arethe teeth. Two successive tipping movements are required to achieve bodily movement.required to achieve bodily movement. Simultaneous movement of the upper four incisors andSimultaneous movement of the upper four incisors and canines in both the upper and lower arches .canines in both the upper and lower arches . Anchorage considerationsAnchorage considerations www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. ObjectivesObjectives ►Correction of Deep Anterior Over BiteCorrection of Deep Anterior Over Bite ►Correction of Proclination of the AnteriorsCorrection of Proclination of the Anteriors ►Correction Of Crowding and irregularitiesCorrection Of Crowding and irregularities including Rotations.including Rotations. ►Correction of Anteriorposterior OcclusalCorrection of Anteriorposterior Occlusal Relationship of the Buccal SegmentsRelationship of the Buccal Segments www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. ►Corrrection of Buccolingual andCorrrection of Buccolingual and Labiolingual CrossbitesLabiolingual Crossbites ►Axial Relations of the Anchor molarsAxial Relations of the Anchor molars correctedcorrected ►Closure of spaces between Anterior teethClosure of spaces between Anterior teeth www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. Stage I arch wireStage I arch wire www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. :: - Made from 0.016 heat treated- Made from 0.016 heat treated high tensile stainless steel wire.high tensile stainless steel wire. incorporate -: anchor bends,incorporate -: anchor bends, intermaxillary hooks,intermaxillary hooks, vertical loop.vertical loop. Canine contoursCanine contours www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. VERTICAL LOOPVERTICAL LOOP www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. FunctionsFunctions -:-: Correction of CrowdingCorrection of Crowding ,spacing,Rotations of Central and Lateral,spacing,Rotations of Central and Lateral Incisors, StopsIncisors, Stops CautionsCautions 1)1) Not given distal to CaninesNot given distal to Canines 2)2) Should not impede on tissuesShould not impede on tissues 3)3) Removed as soon as Function has beenRemoved as soon as Function has been servedserved www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. ANCHOR BENDSANCHOR BENDS www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. Anchor bends placed too farAnchor bends placed too far mesiallymesially www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. FunctionsFunctions Factors affecting the degree of bendsFactors affecting the degree of bends Location of the bendsLocation of the bends Actions of the bendsActions of the bends Checking for degree of bendChecking for degree of bend Adverse effect of excessive bendAdverse effect of excessive bend www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. Initially called Tip back BendsInitially called Tip back Bends Functions :-Functions :- 1)to activate the archwires1)to activate the archwires so that they can depress the upper andso that they can depress the upper and lower anterior in their sockets thuslower anterior in their sockets thus helpinghelping inin opening the biteopening the bite 2) To bestow upon the anchor molars the2) To bestow upon the anchor molars the power to resist forward pull of class IIpower to resist forward pull of class II elaticselatics www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. Factors that effect Anchor bendsFactors that effect Anchor bends 1)1) Degree of Deep –BiteDegree of Deep –Bite 2)2) Diameter of the wireDiameter of the wire 3)3) Meio-Distal inclination of the anchor molarsMeio-Distal inclination of the anchor molars 4) Position of the anchor bends4) Position of the anchor bends  Action of the anchor bendsAction of the anchor bends on anteriorson anteriors on posteriorson posteriors Checking For Degree of Anchor bend…Checking For Degree of Anchor bend… www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. Adverse effects of excessive anchorAdverse effects of excessive anchor bendsbends 1)1) Greater tipping forces exerted on anchorGreater tipping forces exerted on anchor molarsmolars  cause them to tip-back andcause them to tip-back and elevate their MMRelevate their MMR pseudo bitepseudo bite openingopening 2)2) Causes rotation of arch wire in molarCauses rotation of arch wire in molar tubetube www.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. Intermaxillary HooksIntermaxillary Hooks www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. Intermaxillary HooksIntermaxillary Hooks www.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. CANINE CONTOURCANINE CONTOUR www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. The segment of the arch wire between hooksThe segment of the arch wire between hooks made to lie gingival to distal segment .made to lie gingival to distal segment . Arch wire should assume the 6 o’clock – 12Arch wire should assume the 6 o’clock – 12 o’clock positions in molar tubes when arch wireo’clock positions in molar tubes when arch wire is placed.is placed. Check for the anchor bends.Check for the anchor bends. The arch wire is engaged into the bracket slotsThe arch wire is engaged into the bracket slots and secured in position with stage I lock pins.and secured in position with stage I lock pins. www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. The arch wire is secured to all the teethThe arch wire is secured to all the teeth except the :-second bicuspidexcept the :-second bicuspid teeth placed too farteeth placed too far horizontally/vertically/severely rotatedhorizontally/vertically/severely rotated lingually placed lateralslingually placed laterals www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. Lingually Locked out TeethLingually Locked out Teeth www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. Lingually Locked out TeethLingually Locked out Teeth It may be difficult to engage the wire in theIt may be difficult to engage the wire in the brackets at times if the space betweenbrackets at times if the space between proximating teeth is less than the length ofproximating teeth is less than the length of the bracket area for a blocked out tooththe bracket area for a blocked out tooth The ligate the arch wire to the bracket ofThe ligate the arch wire to the bracket of blocked out tooth….blocked out tooth…. www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. Free ends of the lock pins are turnedFree ends of the lock pins are turned mesially around the brackets.mesially around the brackets. The wire should extend 2-3mm past theThe wire should extend 2-3mm past the buccal tubes to prevent binding of thebuccal tubes to prevent binding of the archwire in them.archwire in them. www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. Tying Intermaxillary hook to cuspidTying Intermaxillary hook to cuspid bracketbracket www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. If there is no restraining ties betweenIf there is no restraining ties between intermaxillary hooks and cuspid bracketsintermaxillary hooks and cuspid brackets cuspid teeth will continue to tip distallycuspid teeth will continue to tip distally and slide along the arch wireand slide along the arch wire resulting inresulting in spacingspacing Ligation done in figure of eight andLigation done in figure of eight and always pass ligature through circle and notalways pass ligature through circle and not through crevice….through crevice…. www.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. Achieving objectivesAchieving objectives Correction of deepCorrection of deep bitebite - Intrusion of the upperIntrusion of the upper and lower anteriorsand lower anteriors via anchor bendsvia anchor bends www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. Correction of overjetCorrection of overjet - Class II elastics which bring about tippingClass II elastics which bring about tipping of the six upper and lower anteriorsof the six upper and lower anteriors - Force used 60-70 gms. each sideForce used 60-70 gms. each side - Importance of simultaneous using of classImportance of simultaneous using of class II elastics and anchor bendsII elastics and anchor bends www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59. Correction of Molar relationCorrection of Molar relation is brought about by theis brought about by the following contributing factors acting simultaneouslyfollowing contributing factors acting simultaneously 1)Distal tipping of the maxillary first molars.1)Distal tipping of the maxillary first molars. 2)Mesial movement of the lower first molar.2)Mesial movement of the lower first molar. 3)Extruson of the lower first molar.3)Extruson of the lower first molar. 4)Favourable change in occlusion.4)Favourable change in occlusion. 5)Restriction of normal forward growth of maxilla and5)Restriction of normal forward growth of maxilla and maxillary denture.maxillary denture. www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60. Alignment of teethAlignment of teeth Elimination of crowding -: by way of usingElimination of crowding -: by way of using Vertical loopsVertical loops Correction of crowdingCorrection of crowding www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. RotationsRotations Need to eliminate rotationsNeed to eliminate rotations Methods which may be employed toMethods which may be employed to eliminate rotationseliminate rotations 1)using section of wire1)using section of wire between vertical loopsbetween vertical loops 2)using elastic ligature,2)using elastic ligature, thread or coil springthread or coil spring 3)using spring auxiliary3)using spring auxiliary www.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. Correction of rotations of labial segmentCorrection of rotations of labial segment is achieved by offsetting the bracket areais achieved by offsetting the bracket area between vertical loops.between vertical loops. Corrections may be maintained by way ofCorrections may be maintained by way of bayonet bends.bayonet bends. www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. Rotations of Cuspid and BicuspidRotations of Cuspid and Bicuspid 1)Elastic ties1)Elastic ties www.indiandentalacademy.comwww.indiandentalacademy.com
  65. 65. Correction may be achieved by usingCorrection may be achieved by using either :-elastic threadseither :-elastic threads rotating springsrotating springs main archwire kept clear of the bracket somain archwire kept clear of the bracket so that there is no impedment to the intendedthat there is no impedment to the intended correctioncorrection Toe-in or toe-out bends for molars as anToe-in or toe-out bends for molars as an antirotational control mechanism.antirotational control mechanism. To maintain teeth in overcorrected positionTo maintain teeth in overcorrected position slightly offset the bracket position.slightly offset the bracket position. www.indiandentalacademy.comwww.indiandentalacademy.com
  66. 66. TOE - IN BENDS:TOE - IN BENDS: Incorporated in the arch wire as anti – rotationalIncorporated in the arch wire as anti – rotational bends. The toe in bends should never exceed more thanbends. The toe in bends should never exceed more than 5 degree.5 degree. TOE – OUT BENDSTOE – OUT BENDS To correct the disto – buccal molar rotation.To correct the disto – buccal molar rotation. www.indiandentalacademy.comwww.indiandentalacademy.com
  67. 67. 2)Rotating springs2)Rotating springs www.indiandentalacademy.comwww.indiandentalacademy.com
  68. 68. Rotation of molarsRotation of molars Slightly rotated -: incorporate toe-in or toe-Slightly rotated -: incorporate toe-in or toe- out bendsout bends Moderately rotated -: elastic ligature tiesModerately rotated -: elastic ligature ties Severely rotated -: Bayonet /Toe-in bendSeverely rotated -: Bayonet /Toe-in bend www.indiandentalacademy.comwww.indiandentalacademy.com
  69. 69. www.indiandentalacademy.comwww.indiandentalacademy.com
  70. 70. Closure of anterior spaces -:Closure of anterior spaces -: 1)1) LoopsLoops www.indiandentalacademy.comwww.indiandentalacademy.com
  71. 71. 2) Plain Arch wire in2) Plain Arch wire in conjunction withconjunction with elastics….adv…elastics….adv… eliminates need foreliminates need for loopsloops www.indiandentalacademy.comwww.indiandentalacademy.com
  72. 72. Correction of crossbiteCorrection of crossbite Resulting from local tooth displacementsResulting from local tooth displacements or angulationsor angulationscorrected with the use ofcorrected with the use of cross-elastics between the buccal hookscross-elastics between the buccal hooks on the lower molar and buttons/cleats onon the lower molar and buttons/cleats on lingual surface of the upperslingual surface of the uppers www.indiandentalacademy.comwww.indiandentalacademy.com
  73. 73. Position of teeth at the end ofPosition of teeth at the end of Stage IStage I www.indiandentalacademy.comwww.indiandentalacademy.com
  74. 74. ProblemsProblems Failure to correct the deep-biteFailure to correct the deep-bite Insufficient retraction of the anteriorsInsufficient retraction of the anteriors Mandibular molars tipping linguallyMandibular molars tipping lingually Rotation of the lower molarsRotation of the lower molars Anterior spaces openingAnterior spaces opening Rotation/tipping of upper molarRotation/tipping of upper molar www.indiandentalacademy.comwww.indiandentalacademy.com
  75. 75. ProblemsProblems Failure to correct deep overbiteFailure to correct deep overbite Patient not wearing elasticsPatient not wearing elastics Arch wire getting distortedArch wire getting distorted Insufficient anchorage bendsInsufficient anchorage bends Anchor bends positioned too far mesialAnchor bends positioned too far mesial from MTfrom MT Bends displaced in MTBends displaced in MT Use of Torquing and uprighting springsUse of Torquing and uprighting springs www.indiandentalacademy.comwww.indiandentalacademy.com
  76. 76. 8) Arch wire in premolar bracket, By pass8) Arch wire in premolar bracket, By pass clamp …clamp … 9) Incorrect bracket placement9) Incorrect bracket placement Insufficient retraction of maxillaryInsufficient retraction of maxillary anterior teethanterior teeth Patients not wearing class II elasticsPatients not wearing class II elastics Binding of arch wireBinding of arch wire www.indiandentalacademy.comwww.indiandentalacademy.com
  77. 77. 3) Hinderance to free tipping of teeth :- loops, pins,3) Hinderance to free tipping of teeth :- loops, pins, wedging of class II elasticswedging of class II elastics 4) Occlusal interferences :- bite, arch form,bracket4) Occlusal interferences :- bite, arch form,bracket placementplacement 5) Flaring of incisors caused by excessive5) Flaring of incisors caused by excessive expansion of loops in initial arch wireexpansion of loops in initial arch wire Mandibular molars tipping linguallyMandibular molars tipping lingually 1)1) Insufficient expansion in arch wireInsufficient expansion in arch wire 2)2) Excessive and improperly placed anchorExcessive and improperly placed anchor bendsbends 3)3) Prolonged use of loopsProlonged use of loops 4)4) Excessive traction from class II elasticsExcessive traction from class II elastics www.indiandentalacademy.comwww.indiandentalacademy.com
  78. 78. Rotation of Mandibular molarsRotation of Mandibular molars 1)1) Incorrectly formed anchor bendsIncorrectly formed anchor bends 2)2) Distortion of arch wireDistortion of arch wire 3)3) Incorrectly placed molar tubesIncorrectly placed molar tubes 4)4) Excessive elastic tractionExcessive elastic traction Anterior SpacingAnterior Spacing 1)Intermaxillary hooks not tied back to1)Intermaxillary hooks not tied back to caninescanines 2)Excessive expansion of loops initially2)Excessive expansion of loops initially www.indiandentalacademy.comwww.indiandentalacademy.com
  79. 79. Maxillary Molar Rotation or TippingMaxillary Molar Rotation or Tipping 1)Incorrectly formed anchorage bends1)Incorrectly formed anchorage bends 2)Anchorage bends formed too far mesially2)Anchorage bends formed too far mesially 3)Arch wire distortion3)Arch wire distortion 4)Incorrect Buccolingaul angulation of molar4)Incorrect Buccolingaul angulation of molar tubetube www.indiandentalacademy.comwww.indiandentalacademy.com
  80. 80. www.indiandentalacademy.comwww.indiandentalacademy.com
  81. 81. ObjectivesObjectives Maintainence of corrections achieved thusMaintainence of corrections achieved thus farfar Closure of extraction spacesClosure of extraction spaces  partially by retraction of anteriorspartially by retraction of anteriors  partially by movement of posteriorspartially by movement of posteriors Correction of midline discrepanciesCorrection of midline discrepancies www.indiandentalacademy.comwww.indiandentalacademy.com
  82. 82. Arch wireArch wire 0.020 inch wire is used0.020 inch wire is used Usually plain arch wire with -Usually plain arch wire with - intermaxillary hooksintermaxillary hooks anchor bendsanchor bends premolar offsetspremolar offsets Arch wire kept expandedArch wire kept expanded wire not engaged in premolar bracketwire not engaged in premolar bracket but important to ligate to the wirebut important to ligate to the wire Use Stge II lock pinsUse Stge II lock pins www.indiandentalacademy.comwww.indiandentalacademy.com
  83. 83. Maintain the results achieved inMaintain the results achieved in Stage IStage I MD molar relation is maintained.MD molar relation is maintained. Spaces between anterior teeth preventedSpaces between anterior teeth prevented form openingform opening Maintaining the bite opening achievedMaintaining the bite opening achieved Maintainence of corrected rotations …Maintainence of corrected rotations … incisors by use of bayonet bendsincisors by use of bayonet bends bicuspids …replacing elastics with ligaturebicuspids …replacing elastics with ligature threadsthreads www.indiandentalacademy.comwww.indiandentalacademy.com
  84. 84. Closure of extraction spacesClosure of extraction spaces Achieved partially by retraction of anteriorsAchieved partially by retraction of anteriors and partially by mesial movement ofand partially by mesial movement of posteriors…best judge of this would beposteriors…best judge of this would be lateral ceph.lateral ceph. Need for over retraction of labial segmentNeed for over retraction of labial segment while closing of extraction spaces.while closing of extraction spaces. www.indiandentalacademy.comwww.indiandentalacademy.com
  85. 85. How is this space closureHow is this space closure achievedachieved Space closure achieved by wearing class ISpace closure achieved by wearing class I or horizontal elastics.or horizontal elastics. Worn from intermaxillary hook to molarWorn from intermaxillary hook to molar tube of same arch on same sidetube of same arch on same side Caution….tend to cause molar rotationCaution….tend to cause molar rotation www.indiandentalacademy.comwww.indiandentalacademy.com
  86. 86. Intermaxillary elastics also worn…reasonsIntermaxillary elastics also worn…reasons www.indiandentalacademy.comwww.indiandentalacademy.com
  87. 87. Braking AuxillariesBraking Auxillaries www.indiandentalacademy.comwww.indiandentalacademy.com
  88. 88. Arch SymmetryArch Symmetry www.indiandentalacademy.comwww.indiandentalacademy.com
  89. 89. END OF STAGE IIEND OF STAGE II www.indiandentalacademy.comwww.indiandentalacademy.com
  90. 90. Problems in Stage IIProblems in Stage II Anterior bite closingAnterior bite closing 1)Insufficent /distortion of anchor bends1)Insufficent /distortion of anchor bends 2)Patient not wearing class II elastics2)Patient not wearing class II elastics 3)Anchor molars out of occlusion3)Anchor molars out of occlusion Anterior teeth assuming class IIIAnterior teeth assuming class III relationrelation 1)Excessive wearing of class II elastics1)Excessive wearing of class II elastics www.indiandentalacademy.comwww.indiandentalacademy.com
  91. 91. Opening of anterior spaces 1)Intermaxillary hook not ligated to cuspid1)Intermaxillary hook not ligated to cuspid 2)Hooks formed too far apart2)Hooks formed too far apart Distobuccal rotation of AnchorDistobuccal rotation of Anchor molarsmolars 1)Insufficient molar toe-in bends1)Insufficient molar toe-in bends 2)Too much force from horizontal elastics2)Too much force from horizontal elastics 3)Elastics pulling on distal of molar tubes3)Elastics pulling on distal of molar tubes www.indiandentalacademy.comwww.indiandentalacademy.com
  92. 92. Posterior spaces not closingPosterior spaces not closing 1)Binding of arch wire…thus not free to1)Binding of arch wire…thus not free to slide distally through buccal tubeslide distally through buccal tube 2)Lack of wearing of class I elastics2)Lack of wearing of class I elastics 3)Anterior teeth not free to tip distally3)Anterior teeth not free to tip distally 4)Occlusal interferences4)Occlusal interferences www.indiandentalacademy.comwww.indiandentalacademy.com
  93. 93. ReferencesReferences Begg and Kesling:Begg Orthodontic Theory andBegg and Kesling:Begg Orthodontic Theory and Technique.Technique. Cadman GR. A Vade mecum for the BeggCadman GR. A Vade mecum for the Begg technique: Technical principles. Am J Orthodtechnique: Technical principles. Am J Orthod 1975:67;477-5121975:67;477-512 Cadman GR. A Vade mecum for the BeggCadman GR. A Vade mecum for the Begg technique: Treatment procedures. Am J Orthodtechnique: Treatment procedures. Am J Orthod 1975:67;601-6241975:67;601-624 Huckaba GW. The Begg technique.ClinicalHuckaba GW. The Begg technique.Clinical dentistry :Vol 2:1- 31.dentistry :Vol 2:1- 31. Fletcher GGT. The begg appliance andFletcher GGT. The begg appliance and technique.technique. www.indiandentalacademy.comwww.indiandentalacademy.com
  94. 94. www.indiandentalacademy.comwww.indiandentalacademy.com
  95. 95. www.indiandentalacademy.comwww.indiandentalacademy.com
  96. 96. STAGE IIISTAGE III OBJECTIVES:OBJECTIVES: 1. Maintain all corrections achieved1. Maintain all corrections achieved during first and second stages.during first and second stages. 2. Achieve desired axial inclinations of2. Achieve desired axial inclinations of all teeth.all teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  97. 97. Arch WireArch Wire 0.020 arch wire is used0.020 arch wire is used Functions -: maintenanceFunctions -: maintenance transmitting forcestransmitting forces stabilizing against adversestabilizing against adverse reciprocal forcesreciprocal forces www.indiandentalacademy.comwww.indiandentalacademy.com
  98. 98. Form -: upper …constrictedForm -: upper …constricted Lower …expandedLower …expanded Anchor bends-: decreased in magnitudeAnchor bends-: decreased in magnitude Molar offsetsMolar offsets Bends in vertical plane in premolar-molarBends in vertical plane in premolar-molar area to compensate for verticalarea to compensate for vertical discrepancy in bracket – tube positiondiscrepancy in bracket – tube position www.indiandentalacademy.comwww.indiandentalacademy.com
  99. 99. AuxillariesAuxillaries 1)1) Uprighting springsUprighting springs 2)2) Anterior root torqueing auxillaries-:upperAnterior root torqueing auxillaries-:upper lowerlower 3)3) Reverse torqueing auxillaryReverse torqueing auxillary 4)4) Pre-Wound torqueing auxillaryPre-Wound torqueing auxillary 5)5) www.indiandentalacademy.comwww.indiandentalacademy.com
  100. 100. Uprighting springsUprighting springs www.indiandentalacademy.comwww.indiandentalacademy.com
  101. 101. Uprighting springsUprighting springs Function -:serve to correct the mesiodistalFunction -:serve to correct the mesiodistal inclination of the teeth …i.e for parallelinginclination of the teeth …i.e for paralleling of the rootsof the roots Springs to be made from the most resilientSprings to be made from the most resilient wireswires Diameter of wire used will depend on theDiameter of wire used will depend on the tooth being uprighted…differential forcetooth being uprighted…differential force conceptconcept www.indiandentalacademy.comwww.indiandentalacademy.com
  102. 102. Upper and lower canines-0.016inchorUpper and lower canines-0.016inchor 0.018inch,2- coil0.018inch,2- coil Upper and lower second premolars- 0.016Upper and lower second premolars- 0.016 inch , 2- coilinch , 2- coil Upper lateral incisors – 0.014 inch,2- coilsUpper lateral incisors – 0.014 inch,2- coils Lower lateral incisors – 0,014 inch ,3- coilsLower lateral incisors – 0,014 inch ,3- coils www.indiandentalacademy.comwww.indiandentalacademy.com
  103. 103. Important to take into account reciprocalImportant to take into account reciprocal action of springs.action of springs. Arch length held by either -:lingual ligatureArch length held by either -:lingual ligature cinching archcinching arch wire round MTwire round MT Use spring – pin combinationUse spring – pin combination www.indiandentalacademy.comwww.indiandentalacademy.com
  104. 104. Consists of a leg to fit through the verticalConsists of a leg to fit through the vertical slot in the attachment,a helical loop andslot in the attachment,a helical loop and an arm into which a hook is incorporatedan arm into which a hook is incorporated running parallel to the main archrunning parallel to the main arch When hook end latched to base wire makeWhen hook end latched to base wire make sure lever arm lies parallel with the wiresure lever arm lies parallel with the wire www.indiandentalacademy.comwww.indiandentalacademy.com
  105. 105. www.indiandentalacademy.comwww.indiandentalacademy.com
  106. 106. Function -:to torque the roots ofFunction -:to torque the roots of maxillary anterior teeth.maxillary anterior teeth. 0.014 inch or 0.016 inch arch wire is0.014 inch or 0.016 inch arch wire is usedused vertical spurs 3-4 mm in height are bentvertical spurs 3-4 mm in height are bent into the the arch wire to conform tointo the the arch wire to conform to points just distal to the central andpoints just distal to the central and lateral incisor brackets.lateral incisor brackets. Force generated from horizontal sectionForce generated from horizontal section of the auxillary when spurs areof the auxillary when spurs are appplied to the labial surface ….andappplied to the labial surface ….and transmitted via the spurstransmitted via the spurswww.indiandentalacademy.comwww.indiandentalacademy.com
  107. 107. The spurs must be angled to the labialThe spurs must be angled to the labial surfaces of the incisorssurfaces of the incisors the ends should terminate 2-3mm distalthe ends should terminate 2-3mm distal to the cuspid bracketsto the cuspid brackets Activation is done by forming it into anActivation is done by forming it into an arc smaller than that of the anteriorarc smaller than that of the anterior portion of the patients dental arch.portion of the patients dental arch. Reason for constricted arch formReason for constricted arch form thus inclination of teeth govern-: degreethus inclination of teeth govern-: degree ofof www.indiandentalacademy.comwww.indiandentalacademy.com
  108. 108. Reverse Torqueing AuxillaryReverse Torqueing Auxillary Uses -: to upright labially inclinedUses -: to upright labially inclined mandibular incisorsmandibular incisors -: to retard further forward shift of-: to retard further forward shift of the mandiblethe mandible www.indiandentalacademy.comwww.indiandentalacademy.com
  109. 109. Lower Lingual TorqueingLower Lingual Torqueing AuxillaryAuxillary www.indiandentalacademy.comwww.indiandentalacademy.com
  110. 110. Bite deepens-:Bite deepens-: 1 ) class II elastics not worn) class II elastics not worn 1 excessive torque force on maxillaryexcessive torque force on maxillary incisorsincisors 1 excessive force of caninie and premolarexcessive force of caninie and premolar uprighting springsuprighting springs 1 insufficient gingival bow in base arch wireinsufficient gingival bow in base arch wire www.indiandentalacademy.comwww.indiandentalacademy.com
  111. 111. Reappearance of overjet -:Reappearance of overjet -: class II elatics not wornclass II elatics not worn excessive torquing forceexcessive torquing force Maxillary molars tip bucallyMaxillary molars tip bucally 1) not adequate constriction of base1) not adequate constriction of base arch wire,torquing auxillaryarch wire,torquing auxillary 2)excessive or prolonged torquing force2)excessive or prolonged torquing force www.indiandentalacademy.comwww.indiandentalacademy.com
  112. 112. Base arch wire cinched back withoutBase arch wire cinched back without the required compensation in arch wirethe required compensation in arch wire formform Molars rotate mesiolinguallyMolars rotate mesiolingually Incorrect placement of molar bucal tubeIncorrect placement of molar bucal tube Distortion of arch wire in area of molarDistortion of arch wire in area of molar Chinching back of arch wire withoutChinching back of arch wire without required compensationrequired compensation www.indiandentalacademy.comwww.indiandentalacademy.com
  113. 113. Anterior spaces openingAnterior spaces opening Intermaxillary hooks contacting theIntermaxillary hooks contacting the canine bracketscanine brackets Intermaxillary hooks not ligated to theIntermaxillary hooks not ligated to the canine bracketscanine brackets Labial force of lowers against upperLabial force of lowers against upper Incisors if bite has deepenedIncisors if bite has deepened ClassIII incisor relation…prolongedClassIII incisor relation…prolonged wearing of or excessive traction fromwearing of or excessive traction from classII elasticsclassII elasticswww.indiandentalacademy.comwww.indiandentalacademy.com
  114. 114. Extrusion of teeth being uprightedExtrusion of teeth being uprighted Failure to ligate base arch wireFailure to ligate base arch wire too mesial positioning of anchor bendstoo mesial positioning of anchor bends Failure of teeth to uprightFailure of teeth to upright Related to springs….incorrectlyRelated to springs….incorrectly formed,placed,distortion,interference informed,placed,distortion,interference in their free slidingtheir free sliding ligature tied on wrong sideligature tied on wrong side overclosure of extraction spaces…overclosure of extraction spaces… causing bands of neighbouring teeth tocausing bands of neighbouring teeth to get caught on one anotherget caught on one anotherwww.indiandentalacademy.comwww.indiandentalacademy.com
  115. 115. Failure to achieve incisor torqueFailure to achieve incisor torque Insufficient force from torquing auxillaryInsufficient force from torquing auxillary Binding of arch wireBinding of arch wire Maxillary incisors locked behindMaxillary incisors locked behind mandibular incisorsmandibular incisors Rotaion of canine/premolarRotaion of canine/premolar Incorrect bracket placementIncorrect bracket placement Distortion or improper placement ofDistortion or improper placement of uprighting springuprighting spring arm of spring not parallel to wire.arm of spring not parallel to wire.www.indiandentalacademy.comwww.indiandentalacademy.com
  116. 116. www.indiandentalacademy.comwww.indiandentalacademy.com Thank youThank you For more details please visitFor more details please visit www.indiandentalacademy.comwww.indiandentalacademy.com

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