Presented by :- Dr.

Pinaki Roy

Guide:- Prof. Anuranjan Das

Dr.R.Ahmed Dental College and Hospital

1
 CONTENTS
 Introduction
 About Dr.P.R.Begg
 Sequence of event in the development of Begg Technique.
 Philosophies governing the Begg Technique.
 Components of the Begg Technique.
 Diagnosis and treatment planning.
 Begg Technique :Acc. To Thompson
 Stages I,II,III AND IV.
 Conclusion
 References

2
•Dr. Percival Raymond
Begg was born on
Oct.13,1898 in a gold
mining camp outside
Coolgardie, Australia.
•In 1923 he passed B.D.S.
from Melbourne
University and L.D.S.
from Victoria.
•In 1924,he was accepted
at the Angle School in
Pasadena, California.

3
Appliances developed by Dr.E.H.Angle

4
 The expansion arch was introduced in late 1800’s
 It used bands on molars with an E-arch threaded to
buccal aspect of molars.

5
 In 1912 he introduced a pin and tube appliance.
 It consisted of bands with a vertical tube placed on all
teeth.
 Archwire had soldered pins which inserted into the
buccal tubes.
 Tooth movement was achieved by changing placement
of these pins

6
 Angle’s initial ribbon
arch appliance
developed in 1925, before
Dr.Begg arrived.

7
Dr.Begg was with
Dr.Angle from March
1924 to November 1925.
At that time Angle was
working on a new
mechanism in which he
turned the ribbon arch
90 degree and inserted it
into the tie brackets
with slots in their faces.

8
 When Dr.P.C.Kesling asked Dr.Begg that why
Dr.Angle felt the need of turning the ribbon arch on
edge……he replied that he changed the orientation of
the bracket slots to make it easier for the “not so clever
dentist”
 And to achive better control of the mesiodistal and
axial inclinations of teeth

9
 Begg and Fred Ishii of Japan were the first to treat
patients with this technique and also introduced it to
others.

10
 The anterior component of forces

 Term given by Dr. Begg

 Dr. Atkins demonstrations made Dr. Begg observe
that mesial migration and attrition of teeth play a role
in:
 development of dentition.
 dental arches,
 and also determines the ever changing relationships of
the jaws.

11
 During Dr.Beggs stay Dr.Angle wrote his paper,
 “The latest and best in orthodontic mechanism”
 It disclosed the use of the edgewise mechanism.
 Dr Begg helped him to teach his new technique to his
former students also.

12
 In Nov.1925 Dr.Begg sailed back to Australia .

 Here he started practising Edge wise mechanism---

non extraction as advocated byDr.Angle.

13
 After 2 years of practice he started facing serious
relapses and dissatisfying facial profiles.
 In Feb 1928, he routinely started removing teeth and
mesiodistal stripping.
 Faced fanatical opposition from other dentists.
 Criticism relented after his superior treatment results
were seen to stand the test of time .
 He even retreated his patients with relapses due to
excess tooth material.

14
 Changing the mechanics

He realised that the rectangular cross sections of wires

were initially chosen by Angle to take advantage of the
physical properties of gold platinum wire.

Similar dimensions were unsuitable for the more

powerful and round stainless steel wires.

15
 Initially in 1929, he used .020 inch round platinised
gold wires.

 In 1931-32, he started using .018inch round stainless

steel wires bending the vertical loops and
intermaxillary hooks right into the arch wires.

16
Begg soon discovered that edgewise mechanism did not:

 Rapidly closed extraction spaces,

 Reduce deep overbites.

17
 He also found that edjewise brackets even if used with
round arch wires caused:

 Undesired root movements.

 Unavoidable uprighting of mesiodistally tipped teeth.

 Created a strain on intra oral anchorage that resulted in

anterior teeth being bodily repositioned across the
midline.
 Prolonged treatment time.

18
 To avoid these problems he discarded edgewise
brackets .
 He started using ribbon arch brackets with slots
facing gingivally.

19
 Begg now started using a
ribbon arch bracket with
round archwire as it:
 Permits tipping in all
directions.
 Root torque and
uprighting cannot occur
accidentally due to
auxillaries separated
from main archwire.

20
 Teeth can move independently of one another.
 Also permits the teeth to follow the paths of least
resistance as they are depressed or tipped through the
cancellous bone.
 Roots are not forced against the cortical plates thereby
preventing:
 Tissue damage
 Retard tooth movement.
 Additional stress on anchorage

21
 A new wire

 Dr Begg met ArthurJ.Wilcock in 1940s who was a

metallurgist in Melbourne.

22
 After many years of research Wilcock finally produced
a cold drawn, heat treated wire.
 It had the balance between hardness and resilience.
 Had a unique property of zero stress relaxation.

23
 He also produced:
1. Modified ribbon arch brackets.
2. Lock pins.
3. Buccal tubes.

24
 In 1952 Dr. Begg started using .016 round stainless steel
arch wires.
 It opened deep anterior overbites quickly.
 In 1953 he began experimenting with root tipping
springs to upright teeth mesio distally,rather than
horizontal band spurs.

25
 After returning to Australia,Begg also began studying
natural wearing of teeth as evidensed in skulls of
Australian aborigines who died before being
influenced by civilization.

26
Skull of an Australian aboriginal

27
 In his dissertation
 “The evolutionary reduction and degeneration of
men’s jaws and teeth” he related attrition or lack of it
to the increased incidence of malocclusion and other
dental problems in modern humans.

28
 In 1954 he summarised his work on attritional
occlusion in a classic paper titled:
 “Stone age man’s dentition”.
 In this he also described his new “round wire”
technique, by using .018 inch (0.46mm) ss wire and
modified ribbon arch brackets.

29
 Acc.to G.G.T. Fletcher: the philosophies governing the
Begg technique are as follows:

 The theory of attritional occlusion,

 The theory of differtential forces and,

 Employment of modified ribbon arch bracket and light gauge

round archwires.

30
 Concept of attritional occlusion

 The concept of attritional

occlusion was based on
studies of ancient skulls of
stone age man.
 Their dentitions displayed
attrition,both occlusally and
interproximally.
 The cusps and fissures were
worn out.
Anatomically correct
attritional occlusion.
31
  Incisors had narrow
dimensions and elimination
of overbite.
 Mesial migration of lower
teeth.
 Intermaxillary height
maintained by continued
eruption.
Occlusal view of stone age  Total reduction in arch length
man teeth showing marked was equal to 1 premolar width
attrition on each side at 20 yrs of age.

32
ATTRITIONAL OCCLUSION
IN STONE AGE MAN

33
 Textbook normal occlusion Vs attritional
occlusion.

 It is the physiologically anatomically and functionally

normal occlusion for man.
 Concept was arrived at by studying the occlusion of
teeth of modern civilized man of 19th century.

34
Factors in correct occlusion are:

 Tooth migration.
 Changing anatomy of teeth.

 As it is not a static occlusion rather a changing

functional process undergoing modifications during
deciduous and permanent dentition.

35
Mesial and occlusal
migration Anatomical changes of
teeth 36
 “Textbook normal” occlusion v.s. Attritional
Occlusion.

37
 Characteristics of Attritional Occlusion and evidence
that it rather than textbook occlusion is normal for man.

•EDGE TO EDGE
ANTERIOR OVERBITE.
 Incisal wear :oblique and
then horizontal eliminates
the initial anterior overbite.

38
 Gingival recession and vertical
eruption

 The teeth continually

erupt towards the
occlusion plane as tooth
is worn away.

39
 Caries and Periodontal disease

 Gingival embrasures in
civilized man increase
with age due to lack of
proximal wear as
compared to primitive
man.

40
 Eruption of first permanent molar

Normal eruptive
End to end relationship in
relationship in attritional
civilized man.
mixed dentition.
41
 Eruption of third molars

 Attritional occlusion
illustrates the amount of
space available for early
normal eruption of first
permanent molars.

42
A change in the curve of Wilson ---and a
reason for cusp of carabelli.

 Curve of wilson reverses

direction with attrition
and TUBERCLE OF
CARABELLI serves to
increase overall surface
area.

43
 Low incidence of Malocclusions with tooth
crowding

 Interproximal attrition causes

reduction in mesio distal
tooth widths(about 14mm).
 Hence incidence of tooth
crowding is low.

44
Proximal wear provides space for eruption
of succedaneous teeth

 Attrition brings about

enough reduction in
mesio distal dimensions
of teeth to allow enough
space for erupting
canines.

45
 Anatomy of TMJ
 Attritional occlusion affects the anatomy of TMJ.
 Glenoid fossa and condylar head adapt to the wide
excursive movements possible with flat occlusal
surfaces.
 Begg felt that cusps are only required during
eruption,to guide the the teeth into proper occlusal
relationship.

46
Secondary dentine and pulpal pain.

 Pulpal pain and secondary

dentine formation have
survival value to overcome
attrition ---not dental caries.

47
 “X” OCCLUSION
 Observed by M.J.Barret of Adelaide.

 1/3rd of living Australian aboriginals have lower dental

arches so relatively narrow that when the first
permanent molar of one side occludes than those on
the other side cannot occlude properly.

 In the civilized descendents, it produces a severe and

harmful maloccclusion called lower molar lingual
crossbite.
48
 This is because civilized man’s mandibular
movements are restricted as his soft diet does not
cause tooth attrition.

49
 Introduced in 1956.(AJO)
 Based on the work of Storey and Smith.

 When a relatively light force is applied reciprocally

between small rooted anterior teeth and larger rooted
posterior teeth, the anterior teeth move relatively
rapidly,whereas the larger rooted posterior teeth
remain almost stationary.
.

50
 Conversely,if a relatively heavy force is applied in the
same situation, the posterior teeth tend to migrate
mesially while the anterior teeth resist movement

51
Differential Reactions

52
 Use of modified ribbon arch brackets and
light gauge arch wires.

 Use of .016 inch archwires pramotes:

 Long, continuous tooth movement,
 Low force values,
 Adequate anchorage control.

53
 The ribbon arch bracket
has a vertical slot,which
permits free hinge
attachment for bucco-
lingual tooth movement
and freedom to tilt mesio-
distally.

 Here the arch wire controls

heights of teeth and
prevents rotation.

54
 Hence the combination of round arch wire and
vertically slotted bracket makes it possible to obtain
rapid alignment using light forces with minimal
anchorage expenditure.

 Promotes less friction and locking with the arch wire.

55
 Brackets in same plane
as the arch wire:
 Prevent tilting & cause
bracket binding through
friction.
 Instead ,the ribbon arch
brackets with a vertically
placed slot permits
tilting with minimum of
friction.

56
Begg’s synergistic Arch

57
“The synergism of the various components that make
up the contemporary begg technique makes possible
the satisfactory treatment of most discrepancies
without use of extra oral force”

58
 The begg’s synergistic arch graphically demonstrates
and emphasises the importance of the specific
combination of the 7 components of begg technique
today.

59
 It can be summarised as follows:
 A diagnosis which recognises the primitive forces of
mesial migration and vertical eruption.

 Simultaneous movement of all teeth towards their

final position in the arch.

 Total separation of root moving forces from arch wire

forces during 3rd stage of treatment.

60
 Application of proper elastic forces :
Intermaxillary-20z,
Intramaxillary-2 to 10 oz.

 Use of light,round continous archwires.

 Use of molar attachments that prevent free

mesiodistal tipping but permit free sliding.

61
 Use of attachments on all teeth except anchor molars
that prevents rotations but permits tipping.

 It should allow free sliding along the archwire.

 e.g. modified ribbon arch type bracket.

62
 Diagnosis and treatment planning.
 A thorough examination of the patient for:

 Nature of malocclusion
 Relation of dental arches as a whole to the jaws the
relation of jaws to rest of the head.
 Teeth are already crowded or may develop later
 Nature of patients musculature
 Act of deglutition

63
 Habits
 Anomalies in the anatomy or function of TMJ
 Hereditary causes of malocclusion
 General health
 Oral health

64
 The overall picture of the patients orthodontic
requirements makes easier for the dentist to make an
assessment of the extent of departure of the patients
condition from what is regarded as ideal occlusion and
ideal jaw formation.

65
 Early investigations also make possible the
formulation and institution of better plans for
orthodontic treatment procedures.

66
 Diagnostic set-up

 Praposed by H.D.Kesling
 A practical aid in
treatment planning and
diagnosis
 Provides a glimpse into
the future of each
individual patient

67
 It has the greast value only when the teeth are removed
and replaced in positions they will occuy after
experiencing mesial migration in an orthodontic
environment.

68
 Requirements of the diagnostic set -up
 A set of well trimmed
models
 Lines are drawn through
buccal grooves on
mandibular first molars
onto the soft tissue- used
as a reference for mesial
migration built in the set
up.
 Horizontal cuts are made
3mm. Gingival to the gum
margins,and a spiral
bladed saw is used.

69
 Next a fine 0.004 inch
ribbon saw is used to cut
through contact areas
and teeth are removed
 Hot beeswax is put on
the base of teeth
 Lower 1st molars are
replaced in positions
they will occupy under
influences of mesial
migration

70
A completed diagnostic
set-up

71
 Factors influencing position of first molars
1. Size of teeth
2. Crowding mesial to anchor molars
3. Procumbency of anterior teeth
4. Missing teeth
5. Age of patient
6. Treatment plan
7. Tooth size related to jaw size

72
 Growth of jaws during and after treatment

 According to Begg it is a neglected consideration in

case analysis, diagnosis and treatment planning.

 A very less allowance is made by the present day

methods for amount of natural growth and change of
childrens jaws before and after treatment.

73
 Also, no allowance is made by the current
cephalometric analysis for those continual changes by
reduction in tooth anatomy.
 If sufficient tooth removal is not done before appliance
therapy,it causes relapse after treatment.
 So with knowledge of “attritional occlusion” we can
make allowances by appliance adjustments for changes
taking place after therapy

74
 Components of the Begg appliance

The appliances used in Begg Technique have evolved to

the present state over the period of 50 years.

75
 Arch wire material
 Produced by A.J.Wilcock of Australia.
 Round austinitic stainless steel wires which are heat
treated and cold drawn.
 Has adequate properties of resiliency, toughness and
high tensile strength.

76
Classification of Archwires

77
 Ideal requirements of Archwires
1. Springback
2. Stiffness
3. Formability
4. Resiliency
5. Biocompatibility & Environmental stability
6. Joining
7. Friction

78
 Nowadays, for specific corrections NiTi or braided ss
wires may be used in the initial phase.
 Rectangular arch wires of alpha titanium or ss may be
used in the finishing stage

79
Newer grades of Australian wires

80
 Mechanical properties of newer wires
High yield strength

 Increases the working

range,hence can be deflected
over a large range without a
permanent deformation.

81
 Resiliency

 Higher yield strength results

in high resiliency.
 It means high work
availability to move teeth and
release of more energy when
the wire returns to original
shape.

82
 Zero stress relaxation

 Ability of the wire to deliver ,over long periods a

constant force when subjected to an external load.
 Forces generated by the wires remain unaffected over
long periods.

83
 Formability

 Greater the resiliency, lesser is the formability.

 Hence these are more brittle than low grade wires and
have to be bent in a specific way.

84
 Bauschinger effect

 If the wires are straightened by flexing in the direction

opposite to the original bend, the yield point of the
wire reduces.
 This phenomenon is called as work softning due to
reverse straining or BAUSCHINGER EFFECT.

85
 Pulse straightning

 A special method of straightning the wires which

avoids reverse straining.
 Permits highest tensile strength wires to be
straightened without reducing the high yield point of
wires.
 More costly.

86
 Brackets
 It is a modified ribbon
arch bracket.
 Archwire slot is .020
by.045inch to accept
.020inch archwire and
.016 torquing auxillary.

87
 2 vertical slots on either
side accept lock pins or
auxillaries.

88
Lock pins

89
1. One point safety pin
used in 1st stage with
0.016 archwires for free
tipping and sliding.
2. Double safety pin for
co-axial alignment and
in 2nd stage for
desiredtipping and
sliding with .018 or
0.020 inch wire.

90
 Hook pin is used to retain one or more wires in
archwire slot.

91
 Ceramic bracket hook
pin.
 For all 3 stages of
treatment.

92
 T –pin
 Has a broad head for
mesiodistal inclinations.
 Normally used in stage 3.
 To replace deactivated
springs.
 To limit free tipping in
any stage.

93
 Super high hat safety
pin.
 Used in post surgical
fixation.
 Can also be used in twin
edge brackets.

94
 High hat safety pin.
 For engagement of cross
or vertical elastics.

95
 Lingual lock pin.
 Prrmits use of ordinary
uprighting springs
during stage 3 with no
need for ligation.

96
 Second stage safety pin.
 Double safety pin is now
recommended for use in
stage 2.
 Allows maximum free
mesiodistal tipping of
teeth.

97
 Super safety pin.
 Elongated head places
nose of pin against band
or bracket base for
maximum retention of
archwire.
 Allows tipping and
sliding of teeth.

98
 Curved tail safety pin.
 Safety shoulder prevents
binding on the arch wire
to allow free tipping and
sliding.

99
 Rounded head safety
pin.
 Designed for maximum
comfort.
 Permits tipping and
sliding of teeth on
archwire

100
 Molar tubes

 Round molar tubes with

inside diameter
of.o36inch and length of
.025inch are placed on all
anchor molars.

101
 If increased buccolingual molar control is desired then
a flat oval tube of length .200 inch and inside
diameter of .072 x .024 inch is used with a double back
archwire end.

 Commonly used with 2nd molar as anchor tooth.

102
 Coaxial Auxillaries
 Straight coaxial wire either of.016 or .018 inch can be
used to align anterior teeth.

 Should always be used with more resistant and harder

archwires for molar and anterior vertical control.

 Intermaxillary elastics can be used simultaneously for

bite opening.

103
 Rotating springs

 Vertical leg is inserted through the bracket from the

gingival and bent against tooth in direction of desired
rotation.
 Engagement of the lever arm over archwire activates
the coil to rotate the tooth.

104
 Byepass clamps

 Used to connect the arch wire loosely to the buccal

surface of the bracket body during posterior space
closure or premolar rotation.

105
A. Coaxial auxillary
B. Rotating spring
C. Byepass clamp

106
 Torquing auxillaries

 4-spur torquing auxillary delivers root moving forces

to the anterior teeth with minimal distortion of the
arch wire.

107
A. Upper and lower root
torquing auxillary used
to move roots of
anterior teeth lingually.
B. Individual root tipping
or uprighting springs.

108
 Spring pins

 A combination of uprighting spring and lock pin that

can upright a tipped tooth mesiodistally 30degree
without being reactivated.

109
A. 4 spur torquing
auxillary
B. Spring pin
C. T -pin

110
 Adjuncts to the light wire technique
I. Elastics
II. Elastic tie material
III. Elastomeric rings
IV. Lingual buttons
V. Elastic/Molar hooks with ball ends
VI. Keslings tooth separating springs

111
 Elastics

 Elastics are made of latex or rubber.

 Interarch forces should not exceed 2 to 2.5 oz on each
side.

112
Elastic forces

113
 Applications of elastics

 Class 1,2 &3

 Crossbite and
 Box elastics

114
 Elastic tie material or thread

 It provides force to rotate or

erupt teeth.
 An elastomeric filament or
thread can be used.
 In guided eruption of a tooth
elastic thread is used.
 Elastomeric material is more
esthetic.

115
 Elastic thread

 It has core of latex

surrounded by silk.
 Used to close space or for
derotation

116
 Elastomeric rings
 Made of synthetic
polyurethene.
 Available in different
forms based on distance
between rings.
 Used to close space
between teeth by
stretching the rings
between them

117
 Lingual buttons

 Used as a point of
engagement for:
 Rubber elastics,
 Ligature wire,
 Sections of arch wire
material.

118
 Molar hooks with ball- ends

 These make the

placement of elastics
simple for the patient.
 Can be attached to both
sides of molar bands.
 Placed as far as gingivally
as possible.

119
 Kesling tooth seperating springs

 Used to gain seperation

between teeth for band
placement.

120
 Modern Begg:A combination of Begg and
straightwire appliance and techniques

 It is a 4-stage light wire appliance.

 Uses advantages of both techniques.
 Each stage comprises of unique anchorage
characteristics, appliance design features and varying
force levels

121
Relationship of appliance and biologic forces in
dynamic anchorage.

122
 The combination bracket
system of the four stage light
wire technique has specific
design to provide the
optimum efficiency of both
the Begg and Straight wire
systems.

123
Brackets used in the four stage lightwire
technique
Canine ,Premolars &
Maxillary centrals maxillary laterals

124
Mandibular incisors

125
 The combination bracket
must be able to function
as an excellent edgewise
bracket and as a free
tipping Begg bracket.

126
 The 4 stages of light wire bracket system.
ORGANISATION

 Complete overbite correction

 Correction of class 2 or class 3 relationship
 Correction of crossbite and arch width problems
 overcorrection

127
 Consolidation

 Closure of the remaining spaces

 Retraction of the incisors
 Maintenance of overbite,rotations and anteroposterior
correction.
 Continuation of overcorrection.

128
 Correction of crown and root inclination

 Uprighting and paralleling of roots

 Torquing of anterior teeth
 Maintenance of overbite correction and rotations
 Maintenance of over correction

129
 Final detailing
 Attainment of ideal arch form and coordination of
arch width.
 Attainment of desired torque of teeth
 Precise intercuspation and functional harmony in all
mandibular excursions
 Optimal facial and dental esthetics
 Commencement of retention.

130
 Stages of begg technique

 Treatment in Begg technique is divided in 3 stages

with distinct objectives and to utilize various
attachments, auxillaries and forces in proper sequence
and relationships to one another.

 Objectives of the 3 stages are:

131
 Stage I
 Achieve edge to edge anterior relationship.
 Eliminate anterior crowing.
 Close anterior spaces.
 Overcorrect rotated canines and premolars.
 Correct posterior crossbite.
 Overcorrect mesio-distal relationship of buccal
segment.

132
 Stage II

 Maintain all corrections of stage I.

 Close remaining posterior spaces.

133
 Stage III
 Maintain all corrections achieved in Ist and IInd
stages.
 Achieve desired axial inclinations of all teeth.

134
 Final settling and retention

 As the treatment time by this technique is short, the

fixed appliances do not have the time to act as
retainers.
 The desired settling of teeth can be accelerated by
using a Kesling tooth positioner or a Begg type
retainer.

135
 Conclusion
 This technique can treat all types of malocclusions
without use of extra oral forces and its inherent
efficiency permits orthodontists to treat patients on a
one to one basis, thereby reducing need of assistants.
 As a result more personal doctor-patient relationship
patient rapport and cooperation improves.
 Moreover ,when taught by qualified instructors ,it can
easily be mastered as any contemporary fixed
appliance technique

136
 But as nothing is constant in orthodontics,all of our
present appliances will be shelved in museums,having
being replaced by simpler and more efficient methods
of tooth movements

 However, Begg’s monumental work on evolutionary

development of human teeth and jaws will remain
forever relevant to dentistry in general and
“orthodontics” in particular.
137
 References :
Begg orthodontic theory and technique,3rd edition,

The Begg appliance and technique: G.G.T.Fletcher,

New vistas in orthodontics: Lysle E.Johnston,

Orthodontics:current principles and techniques by Graber

Swain,

Refined Begg: Dr. Vijay P Jayade.

A Manual of advanced course in :The Begg Appliance,

TP Orthodontics: Product Catalogue.

138
139