Beddtiot seminar 5

BEDDTIOTBEDDTIOT
www.indiandentalacademy.comwww.indiandentalacademy.com

INTRODUCTIONINTRODUCTION
 The appliance system known as the Begg-The appliance system known as the Begg-
Edgewise Diagnosis-Determined TotallyEdgewise Diagnosis-Determined Totally
Individualized Orthodontic TechniqueIndividualized Orthodontic Technique
[BEDDTIOT] designed by RICHARD A.[BEDDTIOT] designed by RICHARD A.
HOCEVAR in 1981 and modified it in 1985HOCEVAR in 1981 and modified it in 1985
offers the capacity to employ selectedoffers the capacity to employ selected
principles and features of Begg andprinciples and features of Begg and
edgewise mechanisms in specific situationsedgewise mechanisms in specific situations
in which they are most advantageous.in which they are most advantageous.

 The appliance was developed to meetThe appliance was developed to meet
specific criteria , characteristics deemedspecific criteria , characteristics deemed
to be most desirable in an orthodonticto be most desirable in an orthodontic
appliance.appliance.
 The primary goal was the facility to treatThe primary goal was the facility to treat
each patient’s needs in the manner mosteach patient’s needs in the manner most
efficient for that individual.efficient for that individual.

 The intent was to incorporate theThe intent was to incorporate the
important advantages, features, andimportant advantages, features, and
capabilities of many fixed appliances andcapabilities of many fixed appliances and
minimize deficiencies, making the most ofminimize deficiencies, making the most of
current understanding of orthodonticcurrent understanding of orthodontic
biomechanics and technology.biomechanics and technology.

ADVANTAGES OF EDGEWISEADVANTAGES OF EDGEWISE
AND BEGG TECHNIQUEAND BEGG TECHNIQUE
 The edgewise appliances have full torqueThe edgewise appliances have full torque
and angulation built in which accounts forand angulation built in which accounts for
its control and precision.its control and precision.
 The Begg technique has an advantage ofThe Begg technique has an advantage of
proficiency in bite opening which isproficiency in bite opening which is
enhanced when check elastics areenhanced when check elastics are
employed.employed.

 The other advantage of this technique isThe other advantage of this technique is
the utilization of the principles ofthe utilization of the principles of
differential response to force i.e., limiteddifferential response to force i.e., limited
tipping against translation, using large-tipping against translation, using large-
rooted posterior teeth as anchorage forrooted posterior teeth as anchorage for
the movement of small rooted anteriors,the movement of small rooted anteriors,
and using light forces which produceand using light forces which produce
optimal movement of anteriors andoptimal movement of anteriors and
minimal movement of posteriorsminimal movement of posteriors
(anchorage conservation).(anchorage conservation).

PRINCIPLES OF BEDDTIOTPRINCIPLES OF BEDDTIOT
 The inherent versatility of the systemThe inherent versatility of the system
allows the principles and approaches ofallows the principles and approaches of
the various schools of thought to bethe various schools of thought to be
applied to the situations in which theyapplied to the situations in which they
seem most appropriate.seem most appropriate.
 The demands of each case determine theThe demands of each case determine the
treatment modality.treatment modality.

 Gentle, long-range force systems may beGentle, long-range force systems may be
employed for fast, efficacious alignmentemployed for fast, efficacious alignment
and major movements of crowns and/orand major movements of crowns and/or
roots.roots.
 Minimal bracket size yield maximum interMinimal bracket size yield maximum inter
bracket arch wire spans. Light, undersizedbracket arch wire spans. Light, undersized
wires have ample free play in thewires have ample free play in the
brackets.brackets.

 These factors together with extensive useThese factors together with extensive use
of elastomeric ligatures and elastics,of elastomeric ligatures and elastics,
combine to produce an appliance that cancombine to produce an appliance that can
provide low force levels over great elasticprovide low force levels over great elastic
ranges.ranges.
 Although loops in arch wires can increaseAlthough loops in arch wires can increase
range and decrease force in specific areas,range and decrease force in specific areas,
they are rarely used because they arethey are rarely used because they are
time-consuming, unhygienic, unattractive,time-consuming, unhygienic, unattractive,
and may cause irritation or injury to theand may cause irritation or injury to the
patient’s soft tissues.patient’s soft tissues.

 Alignment may be achieved instead withAlignment may be achieved instead with
extremely light auxillary wires.extremely light auxillary wires.
 The best approach for each patient mustThe best approach for each patient must
be determined by diagnosis. It should notbe determined by diagnosis. It should not
be dictated by the appliance limitation.be dictated by the appliance limitation.
 The appliance system should be versatileThe appliance system should be versatile
enough to facilitate attainment of anyenough to facilitate attainment of any
reasonable goal.reasonable goal.

 HOCEVAR presents an applianceHOCEVAR presents an appliance
system designed to facilitate efficientsystem designed to facilitate efficient
treatment by the use of thetreatment by the use of the
biomechanical approach consideredbiomechanical approach considered
more suitable by the orthodontist formore suitable by the orthodontist for
the individual patient.the individual patient.

HOCEVAR had designed the appliance by theHOCEVAR had designed the appliance by the
modification ofmodification of
 Bracket designBracket design
 Arch wire dimensionArch wire dimension
 Buccal tubeBuccal tube
 Tube positioningTube positioning
 Utilization of light forcesUtilization of light forces
 Check elastics and uprighting springsCheck elastics and uprighting springs
 Torquing archesTorquing arches
 Anchor bendsAnchor bends
 Use of elastomeric ligatures and elasticsUse of elastomeric ligatures and elastics
 Elimination of loops in arch wires.Elimination of loops in arch wires.

BEDDTIOT BRACKETSBEDDTIOT BRACKETS
 The Beddtiot bracketsThe Beddtiot brackets
are narrow, single-are narrow, single-
width (0.050 inch orwidth (0.050 inch or
1.3 mm) edgewise1.3 mm) edgewise
brackets with 0.022brackets with 0.022
inch (height) X 0.028inch (height) X 0.028
inch (faciolingualinch (faciolingual
depth) horizontal archdepth) horizontal arch
wires slots.wires slots.
 On the lingual side ofOn the lingual side of
the bracket ( i.e.the bracket ( i.e.
against the band oragainst the band or
bonding pad) is abonding pad) is a
0.020 X 0.020 inch0.020 X 0.020 inch
vertical slot.vertical slot. www.indiandentalacademy.comwww.indiandentalacademy.com

 The vertical slot has many potential uses.The vertical slot has many potential uses.
1.1. It can accommodate ligatures, elasticIt can accommodate ligatures, elastic
hooks , rotation devices, and varioushooks , rotation devices, and various
others auxiliaries.others auxiliaries.
2.2. Turned 90 degrees (so it is horizontal), itTurned 90 degrees (so it is horizontal), it
can serve as a miniature buccal tube.can serve as a miniature buccal tube.
3.3. Its function as a buccal tube would be toIts function as a buccal tube would be to
gain control of partially erupted orgain control of partially erupted or
impacted second molars that require upimpacted second molars that require up
righting or cross bite correction.righting or cross bite correction.

 The arch wire slot are “torqued” (cut atThe arch wire slot are “torqued” (cut at
such angles to the brackets that they willsuch angles to the brackets that they will
be oriented parallel to the plane of thebe oriented parallel to the plane of the
arch when the teeth are positionedarch when the teeth are positioned
properly).properly).
 In average cases the appropriateIn average cases the appropriate
brackets to be assigned to the variousbrackets to be assigned to the various
teeth will be determined by the slopes ofteeth will be determined by the slopes of
the surface of the tooth, Since the slopesthe surface of the tooth, Since the slopes
of any particular tooth varies amongof any particular tooth varies among
patients.patients.

 The operator should exercise judgementThe operator should exercise judgement
in the selection of appropriate brackets.in the selection of appropriate brackets.
Except for torque, the brackets are allExcept for torque, the brackets are all
identical.identical.
 Therefore, they are interchangeable, anyTherefore, they are interchangeable, any
brackets may be used on any tooth.brackets may be used on any tooth.
 Placed with its torque indicator groovePlaced with its torque indicator groove
gingival, a bracket provides lingual rootgingival, a bracket provides lingual root
torque; with the groove occlusal, ittorque; with the groove occlusal, it
provides lingual crown torque.provides lingual crown torque.

 The standard torque values areThe standard torque values are
 maxilla -10, -5 , 0 , 5 , 5 ,10maxilla -10, -5 , 0 , 5 , 5 ,10
 Tooth 1 , 2 , 3 , 4 , 5 , 6Tooth 1 , 2 , 3 , 4 , 5 , 6
 mandible 0 , 0 ,10,15, 20, 25mandible 0 , 0 ,10,15, 20, 25
 thus , an appropriate bracket is availablethus , an appropriate bracket is available
for most situations.for most situations.
 The brackets and bonding pads are smallThe brackets and bonding pads are small
in all dimensions to ensure optimalin all dimensions to ensure optimal
appearance and inter bracket arch wireappearance and inter bracket arch wire
spans and minimal lip and cheek irritation.spans and minimal lip and cheek irritation.
 This also lessens occlusal interference,This also lessens occlusal interference,
enamel surface involved in bonding, andenamel surface involved in bonding, and
problems with gingival proximity and oralproblems with gingival proximity and oral
hygienehygiene

 A wire in narrowA wire in narrow
single brackets hassingle brackets has
approximately twiceapproximately twice
the elastic range ofthe elastic range of
the same wire in twinthe same wire in twin
brackets and is onlybrackets and is only
about one half as stiff,about one half as stiff,
that is, produces onlythat is, produces only
one half as much forceone half as much force
in a given deflection.in a given deflection.
 A wire is distorted lessA wire is distorted less
in the engagement ofin the engagement of
narrow bracketsnarrow brackets
magnifies theirmagnifies their
advantage; less elasticadvantage; less elastic
range is required andrange is required and
less force is produced.less force is produced.

BUCCAL TUBESBUCCAL TUBES
The basic buccalThe basic buccal
tubes aretubes are
conventionalconventional
4.5mm long, 0.0224.5mm long, 0.022
x 0.028 inch “edgex 0.028 inch “edge
wise” tubes with 25wise” tubes with 25
degrees lingualdegrees lingual
crown torque forcrown torque for
lower molar and 10lower molar and 10
degree for upper 1degree for upper 1stst
molar.molar.

 The distal end of the maxillary tube isThe distal end of the maxillary tube is
angulated outward 10 degrees from theangulated outward 10 degrees from the
welding flanges to maintain properwelding flanges to maintain proper
rotation [“toe - in”].rotation [“toe - in”].
 In cases that require head gear toIn cases that require head gear to
maxillary molars, 0.051 inch additionalmaxillary molars, 0.051 inch additional
round tube is used..round tube is used..
 The head gear tube is located occlusal andThe head gear tube is located occlusal and
slightly buccal to the main tube and it isslightly buccal to the main tube and it is
not angulated.not angulated.

 Most important special feature of theMost important special feature of the
beddtiot technique is buccal tube assemblybeddtiot technique is buccal tube assembly
used for 1used for 1stst
molars in cases with deep overmolars in cases with deep over
bites or moderate to severe anchoragebites or moderate to severe anchorage
requirements.requirements.
 An additional rectangular tube is carriedAn additional rectangular tube is carried
diagonally across the buccal surface of thediagonally across the buccal surface of the
basic tube, its mesial end pointingbasic tube, its mesial end pointing
gingivally.gingivally.
 The additional tube is 4.5mm long and theThe additional tube is 4.5mm long and the
inside dimensions are 0.022 x 0.028 inch.inside dimensions are 0.022 x 0.028 inch.
 So, the additional tube is referred to asSo, the additional tube is referred to as
the outer tube and the basic tube as thethe outer tube and the basic tube as the
inner tube.inner tube.

 The outer tube crosses the inner tube atThe outer tube crosses the inner tube at
an angle of approximately 15 degrees andan angle of approximately 15 degrees and
is gingival to the inner tube.is gingival to the inner tube.
 It carries the main (working) arch wiresIt carries the main (working) arch wires
during the bite- opening and retractionduring the bite- opening and retraction
phases of treatment, rectangular sectionalphases of treatment, rectangular sectional
wires in the inner tubes and secondwires in the inner tubes and second
premolar brackets lock molar andpremolar brackets lock molar and
premolar teeth together so neither can tippremolar teeth together so neither can tip
independently.independently.
 As a unit they provide tremendousAs a unit they provide tremendous
anchorage for bite opening and retraction.anchorage for bite opening and retraction.

 The gingivally positioned and angulatedThe gingivally positioned and angulated
outer tubes direct the arch wires awayouter tubes direct the arch wires away
from the danger of distortion fromfrom the danger of distortion from
mastication.mastication.
 They provide effective built-in “anchorThey provide effective built-in “anchor
bend”, while the actual bends can be slightbend”, while the actual bends can be slight
(usually about 25 degrees) and still(usually about 25 degrees) and still
provide sufficient force to intrude theprovide sufficient force to intrude the
anterior teeth and hold the posterior teethanterior teeth and hold the posterior teeth
upright.upright.

 Considerable force for the incisor intrusionConsiderable force for the incisor intrusion
can be derived from the arch wirescan be derived from the arch wires
because the molars cannot tip distallybecause the molars cannot tip distally
without extruding the premolars.without extruding the premolars.
 Occlusion may help minimize this. WhenOcclusion may help minimize this. When
check elastics are used, bite opening ischeck elastics are used, bite opening is
even more potent.even more potent.

TORQUE CONTROL WITHTORQUE CONTROL WITH
BRACKETS AND ARCH WIRESBRACKETS AND ARCH WIRES
 According to HOCEVAR, one of the reasonsAccording to HOCEVAR, one of the reasons
the smaller (0.018 X 0.025) edgewisethe smaller (0.018 X 0.025) edgewise
bracket slot gained some favor a fewbracket slot gained some favor a few
years ago was the fact that the edgewiseyears ago was the fact that the edgewise
wires required for precise control in thewires required for precise control in the
larger (0.022 X 0.028 inch) brackets werelarger (0.022 X 0.028 inch) brackets were
too rigid.too rigid.

 In fact, there is no need for theIn fact, there is no need for the
heavy edge wise wires ever to be usedheavy edge wise wires ever to be used
in the large brackets. Similarly precisein the large brackets. Similarly precise
control can be attained with lightercontrol can be attained with lighter
forces by using more resilientforces by using more resilient
rectangular wires bent as ribbon arches -rectangular wires bent as ribbon arches -
0.020 X 0.016 inch, 0.021 X 0.016 inch,0.020 X 0.016 inch, 0.021 X 0.016 inch,
0.022 X 0.016 inch, or square 0.019 X0.022 X 0.016 inch, or square 0.019 X
0.019 inch, 0.020 X 0.020 inch, 0.021 x0.019 inch, 0.020 X 0.020 inch, 0.021 x
0.021 inch, 0.022 X 0.022 inch wires.0.021 inch, 0.022 X 0.022 inch wires.

• These wires are easier for the operatorThese wires are easier for the operator
to work with than the heavier edge wiseto work with than the heavier edge wise
wires.wires.
• An 0.022 X 0.016 inch ribbon arch hasAn 0.022 X 0.016 inch ribbon arch has
just over half the cross-sectional areajust over half the cross-sectional area
of an 0.022 X 0.028 inch edge wiseof an 0.022 X 0.028 inch edge wise
arch and is only one third as stiff, yet itarch and is only one third as stiff, yet it
fits the bracket just as precisely.fits the bracket just as precisely.
• In most instances the lighter ribbon wiresIn most instances the lighter ribbon wires
are preferable to square ones.are preferable to square ones.

 Heavy rectangular arch wires should notHeavy rectangular arch wires should not
be used to deliver active torquing forcesbe used to deliver active torquing forces
because force levels would be too highbecause force levels would be too high
and the range too limited.and the range too limited.
 However, when arch wires of new nonHowever, when arch wires of new non
steel alloys become available insteel alloys become available in
appropriate sizes for precise bracketappropriate sizes for precise bracket
engagement, these extremely resilientengagement, these extremely resilient
gentle wires could effect all torquing andgentle wires could effect all torquing and
up righting ; the need for any auxiliariesup righting ; the need for any auxiliaries
would then be virtually eliminated.would then be virtually eliminated.

 Such wires would have esthetic and hygienicSuch wires would have esthetic and hygienic
advantages and in at least some ways, would beadvantages and in at least some ways, would be
easier to use.easier to use.
 As a general rule, it is better to use wiresAs a general rule, it is better to use wires
selected for the specific purposes for which theyselected for the specific purposes for which they
are most suitable than to expect a single wire toare most suitable than to expect a single wire to
serve all needs.serve all needs.
 It is very difficult, and in many situationsIt is very difficult, and in many situations
impossible to accomplish much torquing or upimpossible to accomplish much torquing or up
righting of a tooth by the precise fit of arighting of a tooth by the precise fit of a
rectangular wire in its bracket without causingrectangular wire in its bracket without causing
unwanted reciprocal effects and round tipping ofunwanted reciprocal effects and round tipping of
adjacent teeth.adjacent teeth.

 Combinations like the heavy round baseCombinations like the heavy round base
arch wire and light resilient auxiliariesarch wire and light resilient auxiliaries
used in the Begg technique are often moreused in the Begg technique are often more
efficient.efficient.
 Brackets with the desired degree of facialBrackets with the desired degree of facial
root torque could be used so that theroot torque could be used so that the
wires would provide the desired effectwires would provide the desired effect
without needing to have torque bent intowithout needing to have torque bent into
them. If full sized 0.022 x 0.016 ribbonthem. If full sized 0.022 x 0.016 ribbon
arches were to be used, 5 degrees ofarches were to be used, 5 degrees of
torque would usually be adequate.torque would usually be adequate.

 If the use of slightly under sized wires,If the use of slightly under sized wires,
such as 0.020 x 0.016 inch or 0.021 xsuch as 0.020 x 0.016 inch or 0.021 x
0.016 inch was anticipated, brackets with0.016 inch was anticipated, brackets with
a greater degree of torque (10 degrees ora greater degree of torque (10 degrees or
even 15 degrees) could be used toeven 15 degrees) could be used to
compensate for the play.compensate for the play.
 The force level decreases to zero when aThe force level decreases to zero when a
wire returns to it passive state; either thewire returns to it passive state; either the
bracket or the arch wires must carry somebracket or the arch wires must carry some
what more torque than is actually desiredwhat more torque than is actually desired
in the teeth .in the teeth .

DIFFERENTIAL RESPONSEDIFFERENTIAL RESPONSE
TO FORCETO FORCE
 When a force is applied theWhen a force is applied the
alveolar crestal bone may bealveolar crestal bone may be
more readily strained thanmore readily strained than
apical bone and that theapical bone and that the
supporting structures aroundsupporting structures around
the cervical portion of thethe cervical portion of the
root may experience moreroot may experience more
stress than those around thestress than those around the
apex.apex.
 There should be a level ofThere should be a level of
force that causes significantforce that causes significant
crown movement butcrown movement but
remains insufficient to triggerremains insufficient to trigger
any opposite movement ofany opposite movement of
the apex.the apex.

 The minimum forceThe minimum force
required to producerequired to produce
movement of themovement of the
cervical portion of thecervical portion of the
root at its maximumroot at its maximum
rate might or mightrate might or might
not be sufficient tonot be sufficient to
effect some movementeffect some movement
of the apex in theof the apex in the
opposite direction butopposite direction but
should not causeshould not cause
movement of the apexmovement of the apex
at maximum rate.at maximum rate.www.indiandentalacademy.comwww.indiandentalacademy.com

 Any force which isAny force which is
greater than thegreater than the
previous forceprevious force
could not move thecould not move the
cervical portion ofcervical portion of
the root any fasterthe root any faster
but could result inbut could result in
a greater rate ofa greater rate of
apex – up to itsapex – up to its
maximum.maximum.

 Very heavy forcesVery heavy forces
can reduce toothcan reduce tooth
movement bymovement by
producing excessiveproducing excessive
tissue damage, suchtissue damage, such
a heavy force mighta heavy force might
result in lessresult in less
cervical portion ofcervical portion of
the root whilethe root while
moving the apex atmoving the apex at
maximum rate.maximum rate.

ROTATIONSROTATIONS
 HOCEVAR stated that one reason for the lack ofHOCEVAR stated that one reason for the lack of
popularity of edgewise brackets has been thepopularity of edgewise brackets has been the
belief that control of rotations is difficult . In factbelief that control of rotations is difficult . In fact
, control is simple and can be managed in a, control is simple and can be managed in a
variety of ways. (especially with vertically slottedvariety of ways. (especially with vertically slotted
brackets).brackets).
 It is preferable on a round tooth (premolar orIt is preferable on a round tooth (premolar or
canine) to offset the bracket slightly towards thecanine) to offset the bracket slightly towards the
side of the tooth that is displaced lingually.side of the tooth that is displaced lingually.
 Frequently, simple engagement of the bracket onFrequently, simple engagement of the bracket on
the arch wire with a small elastomeric ligaturethe arch wire with a small elastomeric ligature
will correct the rotation.will correct the rotation.www.indiandentalacademy.comwww.indiandentalacademy.com

 If the bracket is so far from the arch wireIf the bracket is so far from the arch wire
that this would be too forceful, a large,that this would be too forceful, a large,
more gentle ligature may be used and themore gentle ligature may be used and the
bracket may be tied to the arch wire withbracket may be tied to the arch wire with
elastomeric thread.elastomeric thread.
 If further correction or overcorrection isIf further correction or overcorrection is
desired, a thick-walled elastomeric ligaturedesired, a thick-walled elastomeric ligature
may be placed on the wire before the wiremay be placed on the wire before the wire
is placed in the mouth.is placed in the mouth.
 Bayonet bends in arch wires are alsoBayonet bends in arch wires are also
effective; they have less tendency to rolleffective; they have less tendency to roll
when used with edge wise brackets andwhen used with edge wise brackets and
resilient ligatures than they do in beggresilient ligatures than they do in begg
brackets.brackets.

UPRIGHTING SPRINGS ANDUPRIGHTING SPRINGS AND
CHECK ELASTICSCHECK ELASTICS
 They may beThey may be
inserted in the 0.020inserted in the 0.020
x 0.020 inch verticalx 0.020 inch vertical
slot. The originalslot. The original
springs are onlysprings are only
slightly different fromslightly different from
those used in thethose used in the
begg technique;begg technique;
 The helix is fartherThe helix is farther
from the arch wire,from the arch wire,
 The hook arm isThe hook arm is
slightly longer ,slightly longer , www.indiandentalacademy.comwww.indiandentalacademy.com

 The helix winds out awayThe helix winds out away
from the tooth from thefrom the tooth from the
pin legpin leg
 The hook arm does notThe hook arm does not
require the extra offsetrequire the extra offset
bend used in beggbend used in begg
springs.springs.
 Demands placed on theDemands placed on the
springs are much lowersprings are much lower
because they move teethbecause they move teeth
through a more limitedthrough a more limited
range than in the beggrange than in the begg
technique.technique.

 Check elastics and arch wires modifiedCheck elastics and arch wires modified
with bite opening bends help improve thewith bite opening bends help improve the
control and efficiency without increasingcontrol and efficiency without increasing
anchorage taxation.anchorage taxation.
 The arch wires guide the canines andThe arch wires guide the canines and
incisors directly to desirableincisors directly to desirable
interrelationships, making the best use ofinterrelationships, making the best use of
the vertical anchorage available from thethe vertical anchorage available from the
molars; this vertical anchorage ismolars; this vertical anchorage is
bolstered by the elastics.bolstered by the elastics.

TORQUING ARCHESTORQUING ARCHES
 Torquing arches, along with uprightingTorquing arches, along with uprighting
springs can be used wheneversprings can be used whenever
appropriate to regulate tipping, to assist inappropriate to regulate tipping, to assist in
effecting translation, or to effect activeeffecting translation, or to effect active
root movement.root movement.
 Passive torquing arches can be used inPassive torquing arches can be used in
combination with check elastics and bitecombination with check elastics and bite
opening arch wires to translate upperopening arch wires to translate upper
incisors.incisors.

RIBBON ARCH WIRESRIBBON ARCH WIRES
 Like torquing or up righting auxiliaries,Like torquing or up righting auxiliaries,
such arch wires can provide control of typesuch arch wires can provide control of type
and direction of tooth movement.and direction of tooth movement.
 They are not suitable for applying muchThey are not suitable for applying much
active torque because of the delicateactive torque because of the delicate
construction of the brackets and the heavyconstruction of the brackets and the heavy
short range forces that would be involved.short range forces that would be involved.
 These arch wires are eminently suitableThese arch wires are eminently suitable
for relatively precise passive torquefor relatively precise passive torque
control.control.

 With passive lingual root torque bent intoWith passive lingual root torque bent into
the incisor portion, a ribbon arch canthe incisor portion, a ribbon arch can
prevent incisor tipping, acting as aprevent incisor tipping, acting as a
breaking arch to reduce incisor retractionbreaking arch to reduce incisor retraction
while posterior teeth are protracted.while posterior teeth are protracted.
 But a mandibular ribbon arch with slightBut a mandibular ribbon arch with slight
facial root torque in the incisor segmentfacial root torque in the incisor segment
can support lower arch anchorage bycan support lower arch anchorage by
preventing incisor proclination.preventing incisor proclination.
 Ribbon arches can also be helpful inRibbon arches can also be helpful in
1. controlling individual teeth1. controlling individual teeth
2.accomplishing minor torquing2.accomplishing minor torquing
movements.movements.

ELASTOMERIC LIGATURESELASTOMERIC LIGATURES
 They are individual or in chains, and areThey are individual or in chains, and are
routinely used.routinely used.
 They are faster and easier to use thanThey are faster and easier to use than
either steel ligatures or brass pins,either steel ligatures or brass pins,
 Are less expensive than pins,Are less expensive than pins,
 And are actively useful in alignment,And are actively useful in alignment,
adding their resilience to that of the archadding their resilience to that of the arch
wire.wire.
 Elastomeric ligatures (usually chains) areElastomeric ligatures (usually chains) are
even used through out stage III witheven used through out stage III with
torquing arches and up righting springs.torquing arches and up righting springs.

EXTRAORAL TRACTIONEXTRAORAL TRACTION
 Extra oral force can be advantageous inExtra oral force can be advantageous in
many cases.many cases.
 It can reduce both the percentage ofIt can reduce both the percentage of
patients requiring extractions and thepatients requiring extractions and the
number of teeth that must be extracted innumber of teeth that must be extracted in
those patients who do require extractions.those patients who do require extractions.
 It can yield simpler, shorter treatment byIt can yield simpler, shorter treatment by
providing an increment of anchorage toproviding an increment of anchorage to
prevent unnecessary extractions or toprevent unnecessary extractions or to
allow retraction of anterior teeth byallow retraction of anterior teeth by
translation rather than circuitous tippingtranslation rather than circuitous tipping
and up righting.and up righting.

 The use of appropriate types of headgearThe use of appropriate types of headgear
can provide control of the direction ofcan provide control of the direction of
movement of the dentition within the facemovement of the dentition within the face
that is not possible with pure beggthat is not possible with pure begg
technique.technique.
 In a patient who has a class IIIn a patient who has a class II
malocclusion with anterior open-bite themalocclusion with anterior open-bite the
maxillary incisors should be retracted withmaxillary incisors should be retracted with
anchorage provided by an appropriateanchorage provided by an appropriate
headgear rather than intermaxilllaryheadgear rather than intermaxilllary
elastics, if sufficient anchorage is notelastics, if sufficient anchorage is not
available with in the maxillary dentitionavailable with in the maxillary dentition
itself, or a highpull chin cup could be useditself, or a highpull chin cup could be used
to keep molars intruded in conjunctionto keep molars intruded in conjunction
with class II elastics.with class II elastics.

 One of the most important advantages ofOne of the most important advantages of
the Beddtiot appliance is its facility forthe Beddtiot appliance is its facility for
both three dimensional control.both three dimensional control.
 and limited tipping with light forces usingand limited tipping with light forces using
a simple bracket.a simple bracket.
ADVANTAGES OF BEDDTIOTADVANTAGES OF BEDDTIOT

DISADVANTAGES OF BEDDTIOTDISADVANTAGES OF BEDDTIOT
 There is no precise and complete analysisThere is no precise and complete analysis
of mathematical and physicalof mathematical and physical
considerations involved in biomechanics.considerations involved in biomechanics.
 Precise regulation of forces is not feasible.Precise regulation of forces is not feasible.
 Neither magnitude nor direction of forceNeither magnitude nor direction of force
can be determined or controlledcan be determined or controlled
accurately.accurately.
 Actual response will be modified by manyActual response will be modified by many
factors like anatomic and physiologicfactors like anatomic and physiologic
aspects of bones, roots, soft connectiveaspects of bones, roots, soft connective
tissue, and muscles.tissue, and muscles.

CONCLUSIONCONCLUSION
 Treatment of each individual patientTreatment of each individual patient
involves a complex inter action of manyinvolves a complex inter action of many
factors.factors.
 However, application of the basicHowever, application of the basic
principles delineated in this series shouldprinciples delineated in this series should
facilitate determination of definite goalsfacilitate determination of definite goals
and the force systems required to attainand the force systems required to attain
them and maintenance of that delicatethem and maintenance of that delicate
balance that is essential to successfulbalance that is essential to successful
treatment.treatment.

Beddtiot seminar 5

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Beddtiot seminar 5