The stage iii of begg technique /certified fixed orthodontic courses by Indian dental academy

The stage III of Begg
Technique Including
Problem Management
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

Introduction
 Objectives of stage II achieved  Stage III.

Stage III unlike Stages I & II – root tipping
phase.
 Correction of axial inclination of teeth
Achieved with torquing and root paralleling
auxiliary.
 Base arch wire ( Stiffer ) –
Retainer

Objectives
 Maintaining corrections achieved during

Stages 1 & 2.
 Edge to edge bite
 Anterior and posterior spaces closed.
 Aligned anterior teeth.


 Overrotated cuspids/ or bicuspids.
 Normal or overcorrected

buccolingual relation.
 Normal or overcorrected

mesiodistal molar reln.
 Upright anchor molars.


 Achieving desired axial inclination of all teeth.
 Labiolingual
 Mesiodistal

inclination of incisors.

inclination of lateral incisors,

cuspids & bicuspids.

All objectives are achieved simultaneously.


Need for 3rd stage
In Begg technique movement of a tooth from one
position to another ,
Achieved in two phases –
Crown tipping.
Root torquing or uprighting.
VS
Bodily movement in Edgewise technique.


In root torquing or uprighting
root is moved while crown is more or less
stationary
Achieved by increasing M:F ratio 12 : 1
so that centre of rotation is incisal or occlusal
third.
Therefore tooth movements carried out by
auxiliaries &
archwires are a passive component.

Stage III Appliance.
 Base archwires
 Torquing auxiliary.
 Uprighting spring.
 Elastics.


Preparation for Stage III.
 Prestage III-

for premolar alignment.
 Stage models
to ensure all stage II objectives
are achieved.
To demonstrate progress to patient.
 Radiographs


Archwire functions.
Functions:
 Base

for deriving forces for the
auxiliaries.
 Maintain corrections achieved in Stages I
& II.
 Withstand the reactioary forces
generated by the auxiliaries.


Archwire requirements.
Sufficient rigidity - to counter reactionary
forces.
Simple to fabricate – prevents auxiliaries
from binding.
Easy workability in the mouth.

Archwire material & dimension.
0.020 round special AJW wire.
Diameter varies with
Upper wires
Extn cases – 0.020”
If reciprocal torquing is needed for incisors –
0.018”
 Non – extn. Cases – 0.018”/ 0.020”
 If U/V bend in the midline – 0.020 / 0.022”.


Lower wires –
Non extn & some Extn. – 0.018”
 If lingual root torquing is needed – 0.020 “



Archwire shape and form.
 Maxillary archwire
Similar to stage wire. Has few modifications –
 Anchorage

bends reduced or removed

- to prevent distal tipping of max. molars.
- bite has already opened.
 Elimination

of premolar offset and placement of

molar offset, 1 – 2 mm mesial to the molar
tube.

 Ant.

segment of archwire will lie much more
gingivally than posterior segment , correct it
with no. 442 pliers.

 Placement

of a ‘V’ bend distal to canine

to counteract –
extrusive component of torquing on central incisors.
intrusive component of uprighting springs , torquing
aux. on premolars & cuspids.
Anterior segment should lie against the gingival margin
of the central incisors.

 Constricted post. segment with toe in bend

To counteract buccal flaring of & distobucal
rotation of molars due to cinching of archwires.


Amount of constriction –




size of the base arch.
Degree & duration. of incisor torque needed.

Archwire lie on buccal cusp tips in molar area.

Mandibular Archwire.
Similar to stage I
Modifications –


Replacements of premolar offsets with molar
offsets.



‘V’bend distal to cuspid but resulting gingival
bow flattened out in the incisor area.



Anchor bends reduced.



Expansion in post. segment



IMH – 0.5 mm mesial to the cuspid bracket.



Vertical step up bends mesial to the molar
tube.


to 3 mm / side.

Torquing auxiliaries.
Mainly used to torque roots of max. incisors
lingually.
Indicated in :

Mild discrepancy cases.

Severe discrepancy cases – in lower arch
also.

some non – extn. cases.


Types

Torquing archwire.



4 spur torquing auxiliary.



Pre wound / Rat trap



2 spur.



Reciprocal



John Kitchton.



Reverse.

Torquing archwire.
Original form
spurs bent into main archwire of 0.016 SS.
buccal rotation of anchor molars.
Separation of torq. Aux. from archwire
enables use of stiffer base wires.

4 spur torquing auxiliary.
most popular and simplest.
torque palatally roots of four max. central
incisors.
Made in 0.014 or 0.016 SS.
4 spurs angulated at 45° to the centre of the
crown.
Adequate length

reactionary forces

Arms terminate b/w cuspid and bicuspid and
ends curled in opp. direction.

Activated by –
constricting the aux.
keeping the loops 80°
to 90°
from the vertical.
curving the arm in a vertical
plane.
If curved in a horizontal plane Buccal tipping of the molars
& bicuspids.


Intrusion of molars and

Action – palatal movement of roots of
incisors.
Adv. Reactions :
Labial
Bite

movement of crowns of ant. teeth

deepening

Expanding

effect.

Labial movement of antr. Teeth.
Some pivotal movement of crown in labial
direction unavoidable.
Minimized by –
cuspid ties.
cinching the ends of the archwire.

Bite deepening in the central incisor region.
Reciprocal action of torquing aux. distorts
archwire occlusally.

Expansile effect on posterior segment.


Prewound or Rat trap Aux.
0.014” or 0.016” around – 0.020” base wire.
Incisal offset – reciprocating stop for aux.
Activation –
by meeting the resistance of the stop.
Modify to apply reciprocal torque in LI

Advantages:
Removal

of torque bars form LI doesn’t

reduce force on CI.
Easier

to approach gingival regiomn.

Larger

contact area with tooth.

Easier

to engage & no whiplash injury

Greater

force.

Disadvantages.
 Difficulty

in fabrication.

 Unilateral

torquing not

possible
 Torquing

LI without CI &

torquing cuspids without LI
– not possible.


Two spur torquing Aux.
Used when only CI require torquing.

Reciprocal torquing Aux.
For palatal movement of CI roots &
labial movement of LI roots.

John Kitchton torquing Aux.
Heavy forces exerted
Used for 2 or for 4 incisors.

Reverse torquing aux.
End of stage III –
to reinforce mandibular anchorage.
to upright mandibular incisors.
2 types.
Udder type –
vertical spurs & horizontal segment.
bracket engagement only for canine.
Individual tooth activation &
oral hygiene maintenance – difficult.

Brandt type.
buccal arm
passes through molar tube
distal to canine.
Good activation control &
easy to maintain hygiene


Factors affecting force exerted by
torquing auxiliary.
- according to R.L. Neuger
 Proportional
 Inversely

proportional to the size of the circle.

 Angulation
 Position

to the D4 of the wire.

of the spurs.

of the roots.

 Inversely

proportional to the intercanine dist.

Uprighting springs
Introduced by Dr. Begg in 1961.
Consists of
stem,
helix,
lever /active arm &
hook.

Principle.
Energy expended in flexing lever arm stored as
potential energy in the coil. During unloading,
force produces mechanical couple & root moves
because crown is ligated.

Force exerted –


Gauge of the wire.

 Angulation
 Length
 Size
 No.

of the lever arm.

of the lever arm.

of the helix.

of turns in the helix

 Size

of the root.

Begg recommended.
Gauge

Coils.

Max. & Mand.
Cuspids

0.014 /0.016

2

Max. & Mand. 2nd
P.M.

0.014

2

Max. Laterals

0.014

2

Mand. Laterals

0.014

3


Short arm

Length of lever arm
Long arm

Normally used short arm.
Short enough –
2 mm gap b/w canine & p.m hooks.
M-D widths small – long arm
uprighting spring.


Thank you
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