BEGG’S AND TIP

EDGE
PHILOSOPHY
PERCEPTOR: DR. ANIL MIGLANI
P R E S E N T E D B Y : D R . D E VA N S H
A,, J. Orthodontics January 19 6 4
Volume 50 Number 1
NORMAL OCCLUSION
• Begg has proposed a concept of normal occlusion defined as
"anatomically correct occlusion" based on Stone Age man's
dentition as exemplified in the Australian aborigine.
• This theory is certainly a radical departure from, and at variance
with, previous orthodontic considerations.
• Yet it provides a basis of explanation for certain factors affecting the
etiology of malocclusion and a biologic rationale supporting
extraction in orthodontic procedures.
• The two major factors to be considered in producing anatomically
correct occlusion in the aborigine are tooth migration and attritional
tooth wear.
• Begg contends that attritional occlusion with wearing away of tooth
cusps, reduction in arch length, and establishment of an edge-to-
edge incisor bite together with an Angle Class III occlusal
relationship results in the only anatomically correct occlusion and
has the constant quality that it is continually changing throughout
life.
Normal occlusion in young adult of
present day

Normal occlusion in
primitive times.
• On the other hand, he states that so-called textbook normal
occlusion, with the teeth almost unworn throughout life, both
occlusally and interproximally, and with high interlocking cusps and
incisor overbite, is anatomically abnormal.

• The teeth are prevented by these high cusps from altering their
occlusal relations as they should and are kept from migrating
mesially in the proper manner in the jaws.
A BIOLOGIC RATIONALE FOR EXTRACTION
IN ORTHODONTIC TREATMENT
• We must also take into account the evolutionary reduction in jaw
size which has particularly affected the alveolar portion of the
maxilla and mandible.
• Such a deficiency of bone is most obvious in the mandibular incisal
area when emphasized by the presence of so-called good pogonion
development.
• This is a complicating factor in addition to that of attritional lack.
• Any attempt to move the dentition further forward off alveolar bone,
in conformity with our consideration of mesial migration as applied
to the buccal segments, can only lead to instability in orthodontic
treatment.
• For the following reasons, therefore, tooth extraction where
necessary,

l. It simulates to some degree the natural loss of tooth substance

which should take place by attrition.
2. It balances discrepancies between tooth size and evolutionary
alveolar bone reduction.
3. It affords a means of masking severe anteroposterior jaw
malrelationships.
• When extraction is confined to either the premolar or first molar
regions, it enables us to harness the naturally occurring anterior
force component, mesial migration, and move the most distal
segment forward in the direction of naturally occurring migration
and thus position these teeth in a more anatomically correct mesial
relationship within the jaws. Furthermore, the third molars are
therefore given the opportunity to erupt mesially into functional
occlusion.
DIFFERENTIAL FORCES
• Storey and Smith using an edgewise
mechanism, moved cuspids distally, with the
first molar and the second premolar serving as
the anchor unit. Their results showed that a
light optimum force of 200 grams moved only
the cuspid; a heavy force of 500 grams moved
only the molar-premolar segment (with the
cuspid therefore acting as an anchor), while a
medium force of 350 grams simultaneously
moved both cuspid and molar segments.
• With the use of the Begg appliance in clinical practice, the force
values advocated by Storey and Smith are much higher than the
ideal required to move cuspids distally. For example, Class II
intermaxillary elastics, each delivering no more than 60 grams of
tractive force, are quite sufficient for the simultaneous retraction of
six maxillary anterior teeth when the first permanent molar is used
as the source of anchorage.
WHEN LIGHTER FORCES ARE USED
WHEN HEAVY FORCES ARE USED
• Even more difficult for clinicians to appreciate is the fact that, with
four first permanent molars extracted, second molars can provide all
the anchorage required for the distal movement of the anterior
maxillary segment of ten teeth, from second premolar to second
premolar, when light Class II elastics are used. This correction is
obtained without loss of anchorage, production of a bimaxillary
protrusion, or incorporation of any supplementary anchorage aids.

• Begg has offered a far simpler means of obtaining adequate intraoral

anchorage than hitherto appreciated or believed possible. This is
accomplished through the medium of differential force application.
A DISCUSSION OF ELASTICS AND THEIR
APPLICATION IN THE LIGHT WIRE TECHNIQUE

• Differential forces give greater control of movements and high

standards of results, even in difficult cases. There is a considerable
reduction in treatment time and simplification of treatment
procedures. This is because the various groups of tooth movements
are carried out simultaneously, each group movement reciprocally
assisting all other groups and producing a balanced flow of
correctional movements.
• Schwarz stated: "Most favourable treatment is that which works
with forces not greater than the pressure in the blood capillaries (i.e.
25 grams per sq. ram.), moving a tooth less than I mm. distance."
But Goldman ~1 considers that bone response to orthodontic stimuli
is produced by fluid displacement within the marrow spaces of the
alveolar bone. This effect is inactive unless slightly in excess of
normal capillary blood pressure.
• At the opposite end of the spectrum we have the investigations of
Halderson, Johns, and Moyers, who found that the forces being
applied by certain rectangular arch appliances exceeded 900 grams
or 32 ounces. They stated: "The edgewise mechanism operates,
more than any other appliance, in the realm of controlled pathology.
• When four first permanent molars are removed in the treatment of a
severe malocclusion with the Begg light-wire technique, light Class
II elastics, each delivering no more than 60 grams of tension, will
effectively retract ~ maxillary anterior segment of ten teeth from the
left second premolar to the right second premolar.
• This means that a total of 120 grams is more than adequate for
effectively moving ten teeth distally, without loss of anchorage, to
obtain the desired maximum orthodontic correction.
• From the arithmetic (though not precise biologic) point of view, a
mere 12 grams of tension is applied to each anterior tooth.
A RESUME OF THE BEGG APPLIANCE

• The use of differential orthodontic forces makes it possible to

carry out simultaneously, and with maximum efficiency, various
groups of tooth movements, such as aligning crowded teeth,
opening up deep overbites, and correcting anteroposterior tooth
relationships. Differential forces are also used to the same
advantages in nonextraction cases.
• The bracket attachments used on the stainless steel band material are
modified ribbon arch brackets which must permit application of
the principles of single point attachment to allow simple tipping
of the teeth without any binding or friction whatsoever between
arch wire and bracket.

• Any binding action will produce bodily tooth movement and loss of
anchorage control. Bands with ribbon arch brackets are placed on
the six anterior teeth in each arch.

• The four first molars are banded, and round buccal tubes are
attached with their long axes parallel to the occlusal surface.
• All arch wires
are fabricated at the chair, from the left buccal tube
to the right buecal tube, the intermaxillary hooks being positioned
just mesial to the cuspid brackets.

• In the preparation of arch wires, one outstanding difference between

the edgewise technique and the Begg light-wire technique is that
edgewise arch wires are shaped to the ideal form and the teeth
are then moved out to the arch wires, whereas the arches for the
light-wire technique are initially shape s, that they will tend to
overmove the teeth and, as a result, the teeth are brought into
correct alignment as arch wire resiliency is exhausted.
• The Tweed and Begg philosophies are extraordinarily similar in
their final treatment objectives. The fundamental differences lie in
the approach to treatment planning, the sequence of treatment
stages, and the utilization of the principle of overtreament before
cases are placed in retention.
 Begg Synergistic arch
Seperation of
Simultaneous Diagnosis and treatment plan root moving
movement of Forces from
all teeth Archwire
forces

Light
Intermaxillary
Elastics
Round
continuous
archwire

Molar
attachments
Brackets permitting
tipping
BEGG’S ARMAMENTARIUM
First stage Second stage Third stage
DIMENSIONS OF FLAT OVAL MOLAR TUBES

.072”x.024”ID x .200’’ long

DIMENSIONS OF ROUND MOLAR TUBES

.036’’I.D x .25’’ Long

 .045
.020

DIMENSIONS OF A BEGG BRACKET

 Bracket placement Molar tube placement

4 mm
4 mm
LIGHT-WIRE APPLIANCES AND THE THREE STAGES
OF TREATMENT IN" THE BEGG TECHNIQUE

• Stage I involves the simultaneous alignment of all upper and

lower anterior teeth, elimination of overbite, correction of
rotated teeth, elimination of crossbites, and production of a
slight Class III relationship in the buccal segments. This first
stage of treatment is essentially the simple tipping of maxillary
anterior teeth. The lower molars must always remain controlled in
an upright position.
ANCHOR BENDS Or Tip Back Bends.
Placed Even With The Mesial Surface Of Anchor Molar.
.

33
• Racheting effect-
 End
Of
stage I
CORRECTION

OF

ROTATIONS
ELASTOMERIC CHAIN TO CLOSE SPACES
• Stage II involves the closing of all remaining extraction spaces
with horizontal elastics. This is achieved by the controlled
application of differential forces.

• Light elastic forces close spaces by moving the incisal segment

distally, while increased elastic forces can be utilized to move the
buccal segments forward. Throughout this stage, tile use of Class
II elastics is continued. In some instances of treatment, this can be
a rather startling phase of progress because of the manner in which
the crowns of the maxillary incisors are tipped back.
Braking auxiliaries
 End
of
stage II
• Stage III involves the final positioning of all tooth roots in their
correct axial relationships by means of auxiliary attachments.
The roots of the cuspids and premolars are orientated by the use
of uprighting springs. Correct axial inclinations of the incisors are
obtained by means of an auxiliary torquing arch.
CONCLUSION
• As an aid to understanding Begg light-wire procedures, the
following facts should t)e appreciated:
1. This is not a loop appliance, as many have been led to believe and
encouraged to use.
2. Mesial tipping of molar teeth is always a positive indication of
excessive force application through the medium of intermaxillary
elastics.
3. A fundamental aspect of successful and stable treatment is
overcorrection of all tooth relations
4. This is a simplified technique which will prove disastrous when
innovations and improvization are attempted.
5. Anchorage principles are utilized, although there is no separate
stage of anchorage preparation.
6. The Begg light-wire appliance does not require more extractions
than other techniques.
DISADVANTAGES OF BEGG
TECHNIQUE
• Ribbon arch-type brackets presently used in the Begg technique
permit mesiodistal tipping but demands high level of skills from the
operator.

• Gingivally facing slots complicate arch wire placement, and

• The range of mesiodistal tipping is so great that it must be

continually monitored.
47
BEDDTIOT

• Hocevar in 1985 gave the appliance system known as the Begg-

Edgewise Diagnosis-Determined Totally Individualized
Orthodontic Technique.

• The control and precision of edgewise appliances (having full

torque and angulation built in) is combined with the capabilities
of rapid tooth movement (of the ''light-wire differential force"
approach). 48
TIP EDGE

• In 1986, Dr. Peter C Kesling, son of H.

D. Kesling, introduced a modified
version of the Edgewise bracket by
removing two diagonally opposite
sections from the mesial and distal
ends of the bracket.
• Tip-Edge appliance is meant to be used
by those who want the ease of Begg
mechanics and style of Edgewise
appliance. 49
• Tip-Edge bracket was invented by Dr Peter Kesling to introduce
differential tooth movement within an Edgewise based bracket
system.
• As the name suggests, Tip-Edge combines an initial degree of tooth
tipping which greatly facilitates tooth movement, prior to the
‘Edgewise’ precision finishing.

50
• The appliance is "Tip-Edge," but can credibly be referred to as "The
Kesling Slot".
• Dr. Kesling called it DSAT for ‘Differential Straight-Arch
Technique’.

51
• Kesling thought that rather than attempting to limit the
range of tipping possible from a ribbon arch-type bracket,
it is better to develop an edgewise bracket that could
provide a variable degree of mesiodistal angular tooth
control.

52
• The diagonally opposed surfaces of the slot permit initial crown
tipping, which is controlled in both direction and degree.
• This in effect changes the face of the edgewise bracket and expands
the horizons (functions) of the edgewise slot.

53
• Each bracket is aimed to tip in a predetermined direction,
whereas with a full thickness archwire in place, it will resist
tipping in the reverse direction.

CROWN TIPPING CONTROL ROOT UPRIGHTING CONTROL

(TIP LIMITING) SURFACE (FINISHING) SURFACE

ROTATIONAL CONTROL
SURFACE

VERTICAL AND TORQUE CONTROL (CENTRAL)

RIDGES OR PIVOTS 54
 0.022” 0.028”
The central ridges of Tip-Edge bracket slots are not directly opposite. As the
retraction occurs, the Tip-Edge arch wire slot provides an operational
increase in size from 0.022 inch to as much as 0.028 inch depending on the
degree of lateral tipping of the tooth.
55
SIDE-WINDER
• It is called so because The
power coils rest over the labial
surface for optimum esthetics
and hygiene. This location
over the bracket face, near the
center of rotation is also more
efficient.
• It generates mesio-distal root
movement and when used
with rectangular wires will
produce torque correction as
56
well.
 Arc of Arc of
activation activation
500 800

• Side winders have been modified from the original

ones in order to increase the arc of activation.
• They should always be inserted from the occlusal side
and never from the gingival side.
57
DIFFERENTIAL TOOTH MOVEMENT

• In contrast bracket designed

for differential tooth
movement allows free crown
tipping which requires far less
force and anchorage than
moving the teeth bodily.

58
Control of vertical dimension by:
1. Light and progressive action of auxiliary spring.
2. Stability by a relatively heavy but passive archwire.
59
LIGHT FORCES:

– Different tooth movement naturally implies a differential

periodontal response.
– It is fundamental to differential tooth movement that all forces
should be light.
– In Tip-edge, forces are less evenly dissipated along the root and
this will not be a problem because of light forces.

60
 ><

• VARIABLE ANCHORAGE:
– In Tip-Edge, there is a choice of which root to control and when. Variable
anchorage provides invaluable mechanism towards the control of profile.

><

61
SEQUENCE OF DIFFERENTIAL TOOTH MOVEMENT.
62
TREATMENT STAGES

• Differential tooth movement involves repositioning of

the crowns of the teeth first, followed by root
uprighting to the new crown position.

• STAGE-1: is all about the anterior segments, aligning

and levelling. Duration: 6-9 months.
• STAGE-2: closure of residual extraction spaces.
Duration: 3-4 months.
• STAGE-3: is a root uprighting phase. Duration: based
on the severity upto 9 months. 63
STAGE 1
• OBJECTIVES:
1. Alignment of upper and lower anterior segments.
2. Closure of anterior spaces.
3. Correction of increased overjet or reverse overjet.
4. Correction of increased overbite or anterior open
bite.
5. Work toward buccal segment crossbite correction.

64
Class II elastics are engaged to the wire distal to the molar tube and not to
molar hooks, not only to get a more horizontal vector of force, but also to
resist distal crown tip and encourages a fuller expression of the anchor
bend.
POWER TIPPING

• There is a danger of proclining lower incisors during overbite

reduction particularly in crowded situation.
• With Tip-Edge technique, flaring is less likely than with straight
wire technique because lower canines are free to tip distally.

66
• However, by the law of physics, in a situation when
the lower incisors are already proclined, force as it is
applied labial to the centre of rotation definitely
causes further flaring.

X
67
• If further proclination is to be avoided, a lingual component
of force must be introduced to counteract the proclination.
– In conventional edgewise bracket, lingual crown torque might be
induced by means of a torqued rectangular archwire.
– In case of Tip-Edge brackets this cannot be achieved because of
the very characteristic dynamics of the bracket.

68
Power Tipping utilizes ‘reverse Side-Winder
springs’ to induce distal crown movement of
the lower canines, which inturn uprights the
lower anterior segment lingually.
69
End of stage I, where Same arch wires which align the premolars
premolars are not included. to the rectangular molar tubes.

70
STAGE 2

• OBJECTIVES OF STAGE II:

1. Closure of residual spacing.
2. Derotation of first molars.
3. Levelling of first molars.
4. Continuing cross bite correction.
5. Maintenance of Stage I corrections.

71
• In addition, orthodontist is given a choice between
retraction of the anteriors or protraction of the
posteriors using side-winder brakes.

72
STAGE 3

• Objectives of stage III:

1. Correction of torque and tip angles for each tooth individually.
2. Attainment of optimum facial profile compatible with stability.
3. Maintenance of class I occlusion and
4. Final detailing.

73
• A Side-Winder spring can recover 140 of torque from either
direction, without the archwire deflection or archwire
adjustment.
• Inverting the brackets or using high torqued brackets are
not necessary in Tip-Edge.
140 140

74
THANK YOU