Kameda technique

KAMEDAKAMEDA
TECHNIQUETECHNIQUE
www.indiandentalacademy.comwww.indiandentalacademy.com

IntroductionIntroduction
This technique was developed by Akira KamedaThis technique was developed by Akira Kameda
He has been carrying out orthodontic treatment with the BeggHe has been carrying out orthodontic treatment with the Begg
technique since 1966 and some cases ended in successful but manytechnique since 1966 and some cases ended in successful but many
cases which had a series of trouble did not go well around that time.cases which had a series of trouble did not go well around that time.
This technique was developed over a period from 1966-1986This technique was developed over a period from 1966-1986
He took beggs weak points and modified it for stable and better finishHe took beggs weak points and modified it for stable and better finish

Empirical diagnosisEmpirical diagnosis
Unnecessary tipping of tooth in all directions (including anchorUnnecessary tipping of tooth in all directions (including anchor
molars)molars)
Collapse of arch formCollapse of arch form
Rotation and mesial tipping of second premolars during stage IIRotation and mesial tipping of second premolars during stage II
Complicated and unstable stage IIIComplicated and unstable stage III
Gummy face with clockwise rotation of occlusal plane]Gummy face with clockwise rotation of occlusal plane]

Most malocclusions are not composed of mesiodistally inclinedMost malocclusions are not composed of mesiodistally inclined
teeth but made up of labiolingually inclined teethteeth but made up of labiolingually inclined teeth
, therefore it was not necessary to carry out orthodontic treatment, therefore it was not necessary to carry out orthodontic treatment
by mesiodistally tipping teeth but necessary to conduct orthodonticby mesiodistally tipping teeth but necessary to conduct orthodontic
treatment by labiolingually moving teeth.treatment by labiolingually moving teeth.
In order to control unnecessary tipping of teeth, especiallyIn order to control unnecessary tipping of teeth, especially
mesiodistally tipping, principle of horizontal bar’s tooth movementmesiodistally tipping, principle of horizontal bar’s tooth movement
was used from Stage I.was used from Stage I.

►CO-AX wire is used in conjunction with main archwires, lockingCO-AX wire is used in conjunction with main archwires, locking
the two wires with Safety – T pins and a single wire with 90º T pinthe two wires with Safety – T pins and a single wire with 90º T pin
►this will prevent teeth from tipping mesiodistally, but allow teeththis will prevent teeth from tipping mesiodistally, but allow teeth
to tip more or less labiolingually by taking advantage of round wire.to tip more or less labiolingually by taking advantage of round wire.
Principle of horizontal bar tooth movenentPrinciple of horizontal bar tooth movenent

Philosophy of revised begg and purePhilosophy of revised begg and pure
begg in tipping tooth movementbegg in tipping tooth movement

Role of Bite opening and Anchor bendsRole of Bite opening and Anchor bends
► The bite opening bends are to be placed distal to canine in additionThe bite opening bends are to be placed distal to canine in addition
to the usual anchorage bends,to the usual anchorage bends,
► The anchorage bends will play a role of anchoring molars and biteThe anchorage bends will play a role of anchoring molars and bite
opening canines, and the bite opening bends will serve biteopening canines, and the bite opening bends will serve bite
opening for incisors.opening for incisors.
www.indiandentalacademy.com

classII elastic forceclassII elastic force
► Depending on the degree ofDepending on the degree of
overjet and overbite,class II elasticoverjet and overbite,class II elastic
force is divided into three steps asforce is divided into three steps as
follows .follows .
► no elastics,no elastics,
► 40-50 gr Class II elastics40-50 gr Class II elastics
► 60-70 gr, elastics60-70 gr, elastics
► very gentle light force is usedvery gentle light force is used
rather than the past light forcerather than the past light force

► very gentle light force is used rather than the past light forcevery gentle light force is used rather than the past light force
► The apex of upper and lower incisor roots will be depressedThe apex of upper and lower incisor roots will be depressed
toward wide sites of trough of cancellous alveolar bonetoward wide sites of trough of cancellous alveolar bone
► if the upper and lower incisors are sufficiently depressed toif the upper and lower incisors are sufficiently depressed to
decrease overbite and then, by lingual inclination of the upper anddecrease overbite and then, by lingual inclination of the upper and
lower incisors including the alveolar process, gummy face will belower incisors including the alveolar process, gummy face will be
prevented and the risk of developing root resorptions will beprevented and the risk of developing root resorptions will be
minimized.minimized.

KB new type buccal tubesKB new type buccal tubes
► Round buccal tubes employed in the Begg techniques are used with aRound buccal tubes employed in the Begg techniques are used with a
round wire, frictions will be free andround wire, frictions will be free and
► Free tooth movement is possible, but anchor molars tend to roll in.Free tooth movement is possible, but anchor molars tend to roll in.
► Correcting lingually inclined anchor molars is difficult.Correcting lingually inclined anchor molars is difficult.
► Directing the force of anchorage bends and of bite opening bends isDirecting the force of anchorage bends and of bite opening bends is
difficult, and their bite opening efficiency will be decreased.difficult, and their bite opening efficiency will be decreased.

► In order to solve these side effects, buccal tubes do not have to beIn order to solve these side effects, buccal tubes do not have to be
round, and ribbon arch type which is easy to direct force and whichround, and ribbon arch type which is easy to direct force and which
brings little loss of distribution of force is preferable.brings little loss of distribution of force is preferable.
► A new type of buccal tubes was designed after getting a hint from dr.A new type of buccal tubes was designed after getting a hint from dr.
White’s lecture on the occasion of the NABSO meeting in 1986.White’s lecture on the occasion of the NABSO meeting in 1986.
► The inside margin of this new buccal tube is rounded to decreaseThe inside margin of this new buccal tube is rounded to decrease
friction.friction.
In addition to vertical slot, a 6-degree distal offset is incorporated toIn addition to vertical slot, a 6-degree distal offset is incorporated to
prevent molars from distobuccally rotating in the mesial movement ofprevent molars from distobuccally rotating in the mesial movement of
molars .molars .

KB new type buccal tube RoundKB new type buccal tube Round
tube vs KB tubetube vs KB tube

Advantages of KB buccal tubeAdvantages of KB buccal tube
1. This buccal tube can be used for the revised1. This buccal tube can be used for the revised
Begg technique as well as for Tip Edge system,Begg technique as well as for Tip Edge system,
2. The buccolingual inclination of molars can be2. The buccolingual inclination of molars can be
corrected or prevented,corrected or prevented,
3. Extraction spaces are not prevented from3. Extraction spaces are not prevented from
closing because of low friction between buccalclosing because of low friction between buccal
tubes and archwires, andtubes and archwires, and
4. It becomes possible to efficiently direct the4. It becomes possible to efficiently direct the
force of anchorage bends and bite openingforce of anchorage bends and bite opening
bends.bends.

► With regard to the way of distalizing canines it is not tip caninesWith regard to the way of distalizing canines it is not tip canines
distally during Stage I, but it is to move canines naturally in thedistally during Stage I, but it is to move canines naturally in the
distal direction while overbite is being decreased by bite openingdistal direction while overbite is being decreased by bite opening
bends.bends.
► That is, the bite opening of incisors is conducted with the fulcrumThat is, the bite opening of incisors is conducted with the fulcrum
of canines, and canines are not allowed to distally tip.of canines, and canines are not allowed to distally tip.
► Also as regards the treatment goals of Stage I, it is not only goodAlso as regards the treatment goals of Stage I, it is not only good
enough to established an edge-to-edge occlusion but also to bringenough to established an edge-to-edge occlusion but also to bring
about L 1 to Md at an angle at 85º.about L 1 to Md at an angle at 85º.

► It is important to conduct Stage I longer than usual by adding theIt is important to conduct Stage I longer than usual by adding the
correction of midline discrepancy and the establishment of Class Icorrection of midline discrepancy and the establishment of Class I
relation of canines to the treatment goals of Stage I.relation of canines to the treatment goals of Stage I.
► It is also important to consider correcting whatever possible to beIt is also important to consider correcting whatever possible to be
corrected before a patient gets tired of orthodontic treatment and tocorrected before a patient gets tired of orthodontic treatment and to
do that, it is necessary to prolong the duration of Stage I, and godo that, it is necessary to prolong the duration of Stage I, and go
ahead with the enclosure of extraction spaces and so on at theahead with the enclosure of extraction spaces and so on at the
same time.same time.

Stage IIStage II
The major goals of Stage II, areThe major goals of Stage II, are
1. The torquing of upper and lower incisor roots and1. The torquing of upper and lower incisor roots and
2. The closure of extractions spaces.2. The closure of extractions spaces.
The characteristics of Stage II on the revised Begg is to carry outThe characteristics of Stage II on the revised Begg is to carry out
necessary torquing or reverse torquing by using the torquing and ornecessary torquing or reverse torquing by using the torquing and or
reverse torquing brackets in combination with ribbon arch wires , andreverse torquing brackets in combination with ribbon arch wires , and
totally simplify stage II in the long run.totally simplify stage II in the long run.

TorquingTorquing
At first, torque is given to upperAt first, torque is given to upper
and lower incisorsand lower incisors
20 degree torquing brackets for use of20 degree torquing brackets for use of
upper incisorsupper incisors
10 degree reverse torquing brackets for10 degree reverse torquing brackets for
use of lower incisorsuse of lower incisors
in conjunction with control bars,in conjunction with control bars,
or in combination with ribbon archwiresor in combination with ribbon archwires
as main archwires.as main archwires.
20 degree torquing brackets on the upper20 degree torquing brackets on the upper
caninescanines
10 degree reverse torquing brackets on10 degree reverse torquing brackets on
the lower canines.the lower canines.

STAGE IISTAGE II

There are a few things to be solved before ribbonThere are a few things to be solved before ribbon
archwires are used in place of main archwires from Stage II and thearchwires are used in place of main archwires from Stage II and the
most important thing in closing extraction spaces is three dimensionalmost important thing in closing extraction spaces is three dimensional
control of second premolars.control of second premolars.
That is to prevent second premolars from subsiding fromThat is to prevent second premolars from subsiding from
rotating and also from mesially inclining on the occasion of closingrotating and also from mesially inclining on the occasion of closing
extraction spaces.extraction spaces.
Therefore, By-Pas Loos,was designed and used instead ofTherefore, By-Pas Loos,was designed and used instead of
conventional By Pass Clamp.conventional By Pass Clamp.
This By Pass Loop is the combination of By Pass Loop and T pin, andThis By Pass Loop is the combination of By Pass Loop and T pin, and
second pre molars are safely bypassed when By Pass Loops aresecond pre molars are safely bypassed when By Pass Loops are
locked into the second premolar brackets.locked into the second premolar brackets.
In this away, second premolars can be easily controlled in allIn this away, second premolars can be easily controlled in all
directions when extraction spaces are closed.directions when extraction spaces are closed.www.indiandentalacademy.comwww.indiandentalacademy.com

Control of second premolars usingControl of second premolars using
KB By-Pass loopsKB By-Pass loops

E –Links & Power pinsE –Links & Power pins
► E –Links were designed toE –Links were designed to
substitute for circle hooks tosubstitute for circle hooks to
effectively carry out an masse tootheffectively carry out an masse tooth
movement.movement.
► By use of E links to be hooked onBy use of E links to be hooked on
the brackets from canine to caninethe brackets from canine to canine
and by use ofand by use of power pinspower pins to beto be
slipped lingual to the ribbonslipped lingual to the ribbon
archwire with T pins, elastics can bearchwire with T pins, elastics can be
hooked without circle hooks.hooked without circle hooks.

Stage IIIStage III
► What to be handled in Stage III is quite simple since torquing hasWhat to be handled in Stage III is quite simple since torquing has
been already completed during Stage II.been already completed during Stage II.
► Uprighting by means of uprighting springs is the only thing to beUprighting by means of uprighting springs is the only thing to be
left and if uprighting is completed, then active treatment will beleft and if uprighting is completed, then active treatment will be
ended, with 10º T pins holding the over upright teeth.ended, with 10º T pins holding the over upright teeth.

► Accordingly, only angulation of 5º, 9ºAccordingly, only angulation of 5º, 9º
and 11º for upper teeth and angulationand 11º for upper teeth and angulation
of 2º, 2º and 5º for lower teeth areof 2º, 2º and 5º for lower teeth are
incorporated into the brackets, and notincorporated into the brackets, and not
torque is added to the brackets.torque is added to the brackets.
► Ribbon arch types of 0.028 x 0.022Ribbon arch types of 0.028 x 0.022
buccal tubes designed for the revisedbuccal tubes designed for the revised
Begg technique are to be used.Begg technique are to be used.
► The wire to be used during Stage II andThe wire to be used during Stage II and
III is 0.022 x 0.16 ribbon archwire.III is 0.022 x 0.16 ribbon archwire.

► outline of our Tip Edge system with reference to Stage I, II and IIIoutline of our Tip Edge system with reference to Stage I, II and III
First of all, By-Pass Loop which is designed for the use of Tip Edge is to beFirst of all, By-Pass Loop which is designed for the use of Tip Edge is to be
tied with elastics or locked on the upper and lower second premolarstied with elastics or locked on the upper and lower second premolars
brackets during Stage Ibrackets during Stage I

► Then 0.16 ESP plain archwireThen 0.16 ESP plain archwire
with bite opening bends of 30ºwith bite opening bends of 30º
for upper and 20º for lower andfor upper and 20º for lower and
with anchorage bends of 40º forwith anchorage bends of 40º for
lower and with anchoaragelower and with anchoarage
bends of 40º for upper andbends of 40º for upper and
lower is used to conjunction withlower is used to conjunction with
CO-AX wire.CO-AX wire.

► the removal of crowding and rotation, either E-Links or 0.014the removal of crowding and rotation, either E-Links or 0.014
sectional archwire can be used from canine to canine, power pin issectional archwire can be used from canine to canine, power pin is
inserted into vertical slots for easy placement of Class II elasticsinserted into vertical slots for easy placement of Class II elastics
on canines, and then en masse tooth movement is to beon canines, and then en masse tooth movement is to be
conducted.conducted.
► As the treatment goals of Stage I are attained after theAs the treatment goals of Stage I are attained after the
completion of bite opening. 0.018 archwire is used and teeth up tocompletion of bite opening. 0.018 archwire is used and teeth up to
the second molars are to be controlledthe second molars are to be controlled

► When the upper and lower incisors especially IMPA become ideal.When the upper and lower incisors especially IMPA become ideal.
0.018 main archwire is switched to ribbon archwires as in the0.018 main archwire is switched to ribbon archwires as in the
revised Begg technique, and torquing of incisor roots and spacerevised Begg technique, and torquing of incisor roots and space
closing of extraction sites are conducted in Stage II.closing of extraction sites are conducted in Stage II.
► Teeth are uprighted with uprighting springs during Stage III andTeeth are uprighted with uprighting springs during Stage III and
active treatment is finished. In any event, the force system in itself ofactive treatment is finished. In any event, the force system in itself of
the revised Begg technique can be applied to the Tip Edgethe revised Begg technique can be applied to the Tip Edge
brackets.brackets.
► That is, this idea of the revised Begg technique can be utilized byThat is, this idea of the revised Begg technique can be utilized by
decreasing friction between archwires and brackets, regardless ofdecreasing friction between archwires and brackets, regardless of
vertically long or horizontally long brackets.vertically long or horizontally long brackets.

► the treatment goals of maxillary protrusion in 1981 based on thethe treatment goals of maxillary protrusion in 1981 based on the
average mean of 400 treated maxillary protrusion cases, andaverage mean of 400 treated maxillary protrusion cases, and
also the treatment goals of mandibular protrusion werealso the treatment goals of mandibular protrusion were
computed from the average mean of 900 treated mandibularcomputed from the average mean of 900 treated mandibular
protrusion cases.protrusion cases.

Diagnosis and treatment planning can be done and extraction siteDiagnosis and treatment planning can be done and extraction site
can be determined almost automatically. However, on the occasioncan be determined almost automatically. However, on the occasion
of ALD 6mm, where either the first pre-molars or the secondof ALD 6mm, where either the first pre-molars or the second
premolars are possible to be extracted.premolars are possible to be extracted.
In that event, judging criteria on the whole are :In that event, judging criteria on the whole are :
The size of arch length discrepancyThe size of arch length discrepancy
Anchorage valueAnchorage value
Growth tendencyGrowth tendency
Soft tissue analysisSoft tissue analysis
Organized occlusionsOrganized occlusions

► Reducing the number of teeth as a means of harmonizing the size of the jawReducing the number of teeth as a means of harmonizing the size of the jaw
with the size of teeth is a kind of compromise approach by reducing toothwith the size of teeth is a kind of compromise approach by reducing tooth
substance at one section of dental arches.substance at one section of dental arches.
► Therefore, it is a matter of course that special attention should be paid to theTherefore, it is a matter of course that special attention should be paid to the
occlusion organized by orthodontic treatment with the extraction of teeth.occlusion organized by orthodontic treatment with the extraction of teeth.
► To be more specific, in the event of first premolar extraction cases, theTo be more specific, in the event of first premolar extraction cases, the
height of the contact points between canines and second premolarsheight of the contact points between canines and second premolars
becomes different, or the contact relations of the proximal surfaces betweenbecomes different, or the contact relations of the proximal surfaces between
canines and second premolars proves inferior, whereas the contact andcanines and second premolars proves inferior, whereas the contact and
occlusal relation between second premolars and first molars are favourable.occlusal relation between second premolars and first molars are favourable.

► Also with regard to second premolars extraction cases, thoughAlso with regard to second premolars extraction cases, though
the contact and occlusal relations between canines and firstthe contact and occlusal relations between canines and first
premolars are favourable, the height of the contact pointspremolars are favourable, the height of the contact points
between first premolars and first molars comes to be different,between first premolars and first molars comes to be different,
the contact relations of proximal surfaces between firstthe contact relations of proximal surfaces between first
premolars and first molars turn out to be inferior, and firstpremolars and first molars turn out to be inferior, and first
premolars trigger off a distobuccal rotation after orthodonticpremolars trigger off a distobuccal rotation after orthodontic
treatment.treatment.
► The distal surfaces of canines and the mesial surfaces of secondThe distal surfaces of canines and the mesial surfaces of second
premolars will be reduced if first premolars are extracted, andpremolars will be reduced if first premolars are extracted, and
also arrange that the distal surfaces of first premolars and thealso arrange that the distal surfaces of first premolars and the
mesial surfaces of first premolar and the mesial surfaces of firstmesial surfaces of first premolar and the mesial surfaces of first
molars will be stripped off if second premolars are extracted.molars will be stripped off if second premolars are extracted.

References.References.
1.1. Outline of the revised Begg technique and Tip Edge system ( KBOutline of the revised Begg technique and Tip Edge system ( KB
Technique). Journal of Japanese Orthodontic Society, Jan., 1989.Technique). Journal of Japanese Orthodontic Society, Jan., 1989.
2.2. The Begg technique in Japan. Amer. J. Orthodont., 81 (3), 209-The Begg technique in Japan. Amer. J. Orthodont., 81 (3), 209-
228.1982.228.1982.
3.3. Refined Begg – Jayade.Refined Begg – Jayade.

Kameda technique

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Kameda technique

Similar to Kameda technique (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Kameda technique