Components of begg appliance /certified fixed orthodontic courses by Indian dental academy

COMPONENTS OF BEGG
APPLIANCE

www.indiandentalacadmey.com

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


MODIFIED RIBBON ARCH BRACKET ( TP -256500)


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.


TYPES
A. 1. Full flange
2.Half flange
B. 1. Bondable
2. Weldable
Full flange brackets will have more
friction with arch wire and hence hindrance to
smooth tipping movement of anterior.
in half flange brackets, contact of the
flange with arch wire is minimal , thus friction is
also minimal.

ARCH WIRE


AUSTRALIAN ARCHWIRES
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

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.

SIX TYPES OF AUSTRALIAN WIRE
1. REGULAR GRADE:
- Lowest grade – easy to bend

- Used for practice bending and forming auxiliaries.
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.


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.


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.

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


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.


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.


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.


Objectives
►Correction of Deep Anterior Over Bite
►Correction of Proclination of the Anteriors
►Correction Of Crowding and irregularities
►Correction of Rotations


►Corrrection of Buccolingual and
Labiolingual Crossbites
►Axial Relations of the Anchor molars
corrected
►Correction of Anteriorposterior Occlusal
Relationship of the Buccal Segments
►Closure of spaces between Anterior teeth

Stage I arch wire


:

- Made from 0.016 heat treated
high tensile stainless steel wire.
incorporate -: anchor bends,
intermaxillary hooks,
vertical loop.
Canine contours


VERTICAL LOOP


Functions -:
Correction of Crowding
,spacing,Rotations of Central and Lateral
Incisors, Stops

1)
2)
3)

Cautions
Not given distal to Canines
Should not impede on tissues
Removed as soon as Function has been
served

ANCHOR BENDS


Initially called Tip back Bends
Functions :- 1)to activate the archwires
so that they can depress the upper and
lower anterior in their sockets thus helping
in opening the bite
2) To bestow upon the anchor molars the
power to resist forward pull of class II
elatics

Factors that effect Anchor bends
1) Degree of Deep –Bite
2) Diameter of the wire
3) Meio-Distal inclination of the anchor
molars
4) Position of the anchor bends
Checking For Degree of Anchor bend…


Adverse effects of excessive anchor
bends
1) Greater tipping forces exerted on anchor
molars  cause them to tip-back and
elevate their MMR pseudo bite
opening
2) Causes rotation of arch wire in molar
tube


Intermaxillary Hooks


CANINE CONDOUR


Application of the appliance
The arch wire is engaged into the bracket slots
and secured in position with stage i lock pins
The segment of the arch wire between hooks
made to lie gingival to distal segment  more
effective intrusive force on Incisors
Arch wire should assume the 6 o’clock – 12
o’clock positions in molar tubes when arch wire
is contracted for placement .


2-3 mm through distal aspect of molar
tubes if not  ends lie in MT 
frictional binding hindrance to free distal
tipping of canines.


Lingually Locked out Teeth


Lingually Locked out Teeth
It may be difficult to engage the wire in the
brackets at times if the space between
proximating teeth is less than the length of
the bracket area for a blocked out tooth
The ligate the arch wire to the bracket of
blocked out tooth….


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.


Tying Intermaxillary hook to cuspid
bracket


If there is no restraining ties between
intermaxillary hooks and cuspid brackets
cuspid teeth will continue to tip distally
and slide along the arch wire resulting in
spacing
Ligation done in figure of eight and
always pass ligature through circle and not
through crevice….


Achieving objectives
Correction of deep bite
- Intrusion of the upper and lower anteriors
via anchor bends
Correction of overjet
- Class II elastics which bring about tipping
of the six upper and lower anteriors
- Force used 60-70 gms. each side

Importance of simultaneous using of class II
elastics and anchor bends
Correction of Molar relation
Alignment of teeth
Elimination of crowding -: by way of using Vertical
loops
Correction of crowding

Rotations
Need to eliminate rotations
Methods which may be employed to
eliminate rotations
1)using section of wire
between vertical loops
2)using elastic ligature,
thread or coil spring
3)using spring auxillary

Correction of rotations of labial segment…
achieved by way of adjusting the
horizontal section of the arch wire
between two vertical loops….
Corrections may be maintained by way of
bayonet bends.


Rotations of Cuspid and Bicuspid
1)Elastic ties
2)Rotating springs


Rotation of molars
Slightly rotated -: incorporate toe-in or toeout bends
Moderately rotated -: elastic ligature ties
Severely rotated -: Bayonet /Toe-in bend


Closure of anterior
spaces -:
1) Contraction Loops
Dig 107 pg111


2) Plain Arch wire in
conjunction with
elastics….adv…
eliminates need for
loops
dig 108 pg 111and 109
pg 112


Correction of crossbite
 Resulting from local tooth displacements
or angulationscorrected with the use of
cross-elastics between the buccal hooks
on the lower molar and buttons/cleats on
lingual surface of the uppers


Problems
Failure to correct deep overbite
Patient not wearing elastics
Arch wire getting distorted
Insufficient anchorage bends
Anchor bends positioned too far mesial
from MT
Bends displaced in MT
Use of Torquing and uprighting springs

8) Arch wire in premolar bracket, By pass
clamp …
9) Incorrect bracket placement
Insufficient retraction of maxillary
anterior teeth
Patients not wearing class II elastics
Binding of arch wire

3) Hinderance to free tipping of teeth :- loops, pins,
wedging of class II elastics
4) Occlusal interferences :- bite, arch form,bracket
placement
5) Flaring of incisors caused by excessive
expansion of loops in initial arch wire
Mandibular molars tipping lingually
1) Insufficient expansion in arch wire
2) Excessive and improperly placed anchor
bends
3) Prolonged use of loops
4) Excessive traction from class II elastics


Rotation of Mandibular molars
1) Incorrectly formed anchor bends
2) Distortion of arch wire
3) Incorrectly placed molar tubes
4) Excessive elastic traction
Anterior Spacing
1)Intermaxillary hooks not tied back to
canines
2)Excessive expansion of loops initially


Maxillary Molar Rotation or Tipping
1)Incorrectly formed anchorage bends
2)Anchorage bends formed too far mesially
3)Arch wire distortion
4)Incorrect Buccolingaul angulation of molar
tube


Objectives
Maintainence of corrections achieved thus
far
Closure of extraction spaces :-partially by
retraction of anteriors and partially by
movement of posteriors
Correction of midline discrepancies


Arch wire
0.020 inch wire is used
Usually plain arch wire with intermaxillary hooks
anchor bends
premolar offsets
Arch wire kept expanded
wire not engaged in premolar bracket
but important to ligate to the wire
Use Stge II lock pins

MD molar relation is maintained.
Spaces between anterior teeth
prevented form opening
Maintaining the bite opening achieved
Maintainence of corrected rotations …
incisors by use of bayonet bends
bicuspids …replacing elastics with
ligature threads

Closure of extraction spaces
Achieved partially by retraction opf
anteriors and partially by mesial
movement of posteriors…best judge of
this would be lateral ceph.
Need for over retraction of labial segment
while closing of extraction spaces.


How is this space closure
achieved
Space closure achieved by wearing class I
or horizontal elastics.
Worn from intermaxillary hook to molar
tube of same arch on same side
caution….tend to cause molar rotation


Intermaxillary elastics also worn…reasons


Braking Auxillaries


Arch Symmetry


END OF STAGE II


Problems in Stage II
Anterior bite closing
Insufficent /distortion of anchor bends
Patient not wearing class II elastics
Anchor molars out of occlusion
Anterior teeth assuming class III relation
Excessive wearing of class II elastics

Opening of anterior spaces
Intermaxillary hook not ligated to cuspid
Hooks formed too far apart
Distobuccal rotation of Anchor molars
Insufficient molar toe-in bends
Too much force from horizontal elastics
Elastics pulling on distal of molar tubes


Posterior spaces not closing
Binding of arch wire…thus not free to
slidde distally through buccal tube
Lack of wearing of class I elastics
Anterior teeth not free to tip distally
Occlusal interferences


STAGE III

OBJECTIVES:
1. Maintain all corrections achieved
during first and second stages.
2. Achieve desired axial inclinations of
all teeth.


Arch Wire
0.020 arch wire is used
Functions -: maintenance
transmitting forces
stabilizing against adverse
reciprocal forces


Form -: upper …constricted
Lower …expanded
Anchor bends-: decreased in magnitude
Molar offsets
Bends in vertical plane in premolar-molar
area to compensate for vertical
discrepancy in bracket – tube position

Auxillaries
1) Uprighting springs
2) Anterior root torqueing auxillaries-:upper
lower
3) Reverse torqueing auxillary
4) Pre-Wound torqueing auxillary
5)


Uprighting springs


Uprighting springs
Function -:serve to correct the mesiodistal
inclination of the teeth …i.e for paralleling
of the roots
Springs to be made from the most resilient
wires
Diameter of wire used will depend on the
tooth being uprighted…differential force
concept

Upper and lower canines-0.016inchor
0.018inch,2- coil
Upper and lower second premolars- 0.016
inch , 2- coil
Upper lateral incisors – 0.014 inch,2- coils
Lower lateral incisors – 0,014 inch ,3- coils


Important to take into account reciprocal
action of springs.
Arch length held by either -:lingual ligature
cinching arch
wire round MT
Use spring – pin combination


Consists of a leg to fit through the vertical
slot in the attachment,a helical loop and
an arm into which a hook is incorporated
running parallel to the main arch
When hook end latched to base wire make
sure lever arm lies parallel with the wire


Function -:to torque the roots of
maxillary anterior teeth.
0.014 inch or 0.016 inch arch wire is
used
vertical spurs 3-4 mm in height are bent
into the the arch wire to conform to
points just distal to the central and
lateral incisor brackets.
Force generated from horizontal section
of the auxillary when spurs are
appplied to the labial surface ….and
transmitted via the spurs

The spurs must be angled to the labial
surfaces of the incisors
the ends should terminate 2-3mm distal
to the cuspid brackets
Activation is done by forming it into an
arc smaller than that of the anterior
portion of the patients dental arch.
Reason for constricted arch form
thus inclination of teeth govern-: degree
of

Reverse Torqueing Auxillary

Uses -: to upright labially inclined
mandibular incisors
-: to retard further forward shift of
the mandible

Lower Lingual Torqueing
Auxillary


Bite deepens-:
1 ) class II elastics not worn
1 excessive torque force on maxillary
incisors
1 excessive force of caninie and premolar
uprighting springs
1 insufficient gingival bow in base arch wire

Reappearance of overjet -:
class II elatics not worn
excessive torquing force
Maxillary molars tip bucally
1) not adequate constriction of base
arch wire,torquing auxillary
2)excessive or prolonged torquing force


Base arch wire cinched back without
the required compensation in arch wire
form
Molars rotate mesiolingually
Incorrect placement of molar bucal tube
Distortion of arch wire in area of molar
Chinching back of arch wire without
required compensation

Anterior spaces opening
Intermaxillary hooks contacting the
canine brackets
Intermaxillary hooks not ligated to the
canine brackets
Labial force of lowers against upper
Incisors if bite has deepened
ClassIII incisor relation…prolonged
wearing of or excessive traction from
classII elastics

Extrusion of teeth being uprighted
Failure to ligate base arch wire
too mesial positioning of anchor bends
Failure of teeth to upright
Related to springs….incorrectly
formed,placed,distortion,interference in
their free sliding
ligature tied on wrong side
overclosure of extraction spaces…
causing bands of neighbouring teeth to
get caught on one another

Failure to achieve incisor torque
Insufficient force from torquing auxillary
Binding of arch wire
Maxillary incisors locked behind
mandibular incisors
Rotaion of canine/premolar
Incorrect bracket placement
Distortion or improper placement of
uprighting spring
arm of spring not parallel to wire.

www.indiandentalacademy.com
Leader in continuing dental education


Components of begg appliance /certified fixed orthodontic courses by Indian dental academy

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