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Anchorage in beggs technique /certified fixed orthodontic courses by Indian dental academy
1. Anchorage
&
Its Management In
Stage I Of Begg
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Anchorage
Webster “a secure hold sufficient to
resist a heavy pull”
In orthodontics “nature and degree of
resistance to unwanted displacement
offered by an anatomic unit, when used
for
purpose
of
effective
tooth
movement”
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3. Anchorage management
Involves restricting movement of one
group of teeth while facilitating
movement of other teeth.
Successful anchorage management is
key to successful orthodontic
treatment.
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4. “Anchorage preparation is most
important step in clinical orthodontics”
(Tweed)
Begg light wire appliance develops its
total anchorage potential from with in
the mouth.
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5. Relationship of tooth movement to
force
Conc. the force needed to produce
tooth movement, where it is desired
Dissipate the reaction force over as
many other teeth as possible keeping
the pressure in PDL of anchor teeth
as low as possible
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6. A threshold, below which pressure
would produce no reaction perfect
anchorage control
since it would only be necessary to be
certain that the threshold for tooth
movement was not reached for teeth
in anchorage unit.
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7. Amount of tooth movement α mag. Of
pressure ,up to a point.
After this, AOTM is indep. Of
magnitude of pressure
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8. Optimum orthodontic force level for
movement is the lightest force &
resulting pressure that produces a
near maximum response
Force > that ,equally effective but
would be unness. traumatic &
stressful to anchorage
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9. Anchorage situations
Reciprocal anchorage force applied
to teeth & to arch segments are
equal ,so the force distribution in
PDL
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10. Anchorage value
Anchorage value of any tooth
roughly eq. to its root surface area
5 & 6 in each arch is appro. eq. in
surface area to 1,2 & 3
Freeman’s
anchorage value
diagram
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11. Reinforced anchorage
By adding more resistance units.
It is effective because with more
teeth (extraoral structures) in the
anchorage, reaction force distributed
over a larger PDL area.
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13. Anchorage bend
In begg’s technique anchorage is
used
For retraction and intrusion
Derived from single bend (anchorage
bend)
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14. Anchorage bend
Formerly called the tip-back bend.
Bend whose vertex faces occlusally
Placed in buccal segment at some point
mesial to the tube.
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15. The manner in which anchorage is
obtained for vertical movements When initial arch wire is inserted the
AB ant. Portion should rest in
mucobuccal fold
Engaged in brackets
wire will exert force on molar,
occlusal pressure on mesial end of tube and
gingival pressure on distal end
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16. This will tend to cause
Extrusion of mesial cusp & root
Intrusion of distal cusp & root
Distal tipping of crown
Mesial tipping of root
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17. These tendencies encounter certain
resistance
Ex. Of mesial cusp opp. Occl. Force
Int. of distal cusp bone
Distal tipping of crown 2nd & 3rd molars
Mesial tipping of root bone on mesial
surface
Resistance not equal magnitude prevent
effect of anchorage bend
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18. If arch wire viewed from side, mildly
gingival curve
reflect force for overbite correction
resistance to movement exhibited by molar
The amount of constant light force,
optimal for intruding the anterior
at a minimal level to produce movement
of molars.
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19. The manner in which anchorage is
obtained for retraction
After arch wire attached
class II elastic between I.M.H of upper arch
wire & hook on mesial end of lower molar
tube.
Tend to pull molar forward & retract
anteriors
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20. AB counteract mesial pull
If appro. Ab and elastics are used
(proper m/f) tooth lean upright,& if
move, bodily
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21. At the same time e retract ant. Ling.
by tipping
The amount of force exerted by elastic
Optimal for tip the anterior backwards
At a minimal level to move of molars
forward bodily.
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22. Amount of force exerted by wire &
elastics is important if desired
movements are to be attained with
minimal anchorage loss, throughout
the Rx.
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23. Orthodontic Judo
Based on using the opponent’s greater
strength and weight to his disadvantage
Enable a weak & small man to overcome
a large & strong man, based on scientific
principles of leverage and balance
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24. The crown tipping tendency can be used to
advantage
↓
by simply eliminating the stabilizing
resistance supplied by wires and
elastics attached to other teeth
↓
crown takes the path of least resistance and
net result crown movement.
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25. Attainment of beneficial crown tipping
movement resulting from root tipping
force or prevention of detrimental
crown movements by these forces is
called orthodontic judo
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26. Three elements
Lever arm( arch wire)
Area of High resistance (bone around
roots)
Area of low resistance (area around
crown)
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28. Operation boot strap: net distal movement
of anchor molars with judo mechanics
Under certain conditions, and relatively
early in Rx
light forces can induce a backward
movement of anchor molar crown,
which in themselves are being used to
move ant. teeth backward
Contravention to Newton’s 3rd law
Like lifting yourself off the floor with your
own bootstrap
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29. AB force in first stage & net distal
movement of upper molars
AB tends to tip the molar roots
forward and crown backward
Net effect of widespread difference
between the high resistance root
tipping and the low resistance crown
tipping
More crown movement
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30. If molar mesially inclined at comm. of
Rx , net distal movement of crown to
upright position can be sig. for
class II correction
incr. arch length in nonext. Cases.
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31. For net distal movement
molar crown should freely move back
No binding of arch wire in tube
Do not bend the end of arch wire
Do not use tie back ligature to molar
tube
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32. AB force in first stage with or without
net distal movement of lower molars
Lower molar crown also have tendency
to tip back
Controlled by varying the force of class
II elastics
11/2 – 21/2 ounce (nonext.) crown may
tip back more & root tip forward less
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33. 21/2 – 31/2 ounce (ext.)
both crown & root may tip, uprighting
the tooth but imparting little or no
distal tipping
Net distal movement is proportional
to amount of elastic force
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34. The location and degree of
angulations of A.B, depends upon
Types of arch wires
Location of extraction space, if any
Depth of overbite
Hazard of occlusal impingement and
distortion aids
Inclination of anchor molars
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35. Variations in the angulations of AB
Stage of treatment
In stage 1- usually greater than
stage 2 except for open bites
Little if required in stage 3.
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36. Depth of overbite
In avg. deep bite cases –
anterior segment of wire rest
passively at the depth of mucolabial fold
In open bite caseto keep the anchor molar of both
jaws upright against the mesial pull of
elastic and wire. After OB correction
↓ to prevent dev. excessive OB or distal
tipping of molars.
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37. Rate of progress of case
If progress is unsatisfactory, ↑ bend or
relocate bend closer to molar tube.
Inclination of anchor molar at the
commencement of the treatment
If molars are inclined mesially ↓ AB, so
that wire rests passively in mucolabial
fold.
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38. On severe mesial inclinationNo AB initially
Later for uprighting molar
unilaterally mesial inclined molar
the increased intrusive force on that
side can be prevented by using vertical
elastics and arch wires.
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39. Variation in location of AB
Stage 1 of treatment
placed forward to the molar tooth to
permit it to slide back to tube during
space closer
but not to enter the tube
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40. At the commencement of treatment
distal to premolar or tip of buccal cusp
Mild overbite/open bite cases
formed as gentle curve located at the
head of bicuspid bracket
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41. Nearer to molar tube
Occlusal impingement
Difficulty and delay in overbite
correction
non extraction case
In first molar extraction cases
In second bicuspid extraction cases
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42. The rate of progress and amount of
space remaining
When progress rapid
placed farther forward
If little space remains
placed far enough forward to
assure that old teeth will come into
proximal contact before AB reach the
molar tube.
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43. Location of AB in loop arch
wires
used for 2-3 appointments
placed far enough forward to
assure that it will not slide back and
reach the molar tube.
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44. Causes of loss
of Anchorage in stage I
and
its prevention
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45. Vertical loop touching the labial
surface of the teeth
A loop resting but not touching labial
surface of ant. teeth
As the crown tip lingually loop is moved
towards the teeth inhibit further free
tipping of ant. Teeth in same arch, may
affect opp. Arch also.
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46. Prevention
Proper arch wire fabrication
Proper location of loops &
limitation of the number of loops
Slightly labial inclination of loops
in severe crowding cases
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47. Vertical loop impinging on the
gingival tissue
Prevent free tipping but less than if
touching the tooth
If impinge on gingiva become imbedded
by next visit
Prolong first stage I
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48. Prevention
Care modification of loops
Slightly labial inclination of loops when arch
first applied
Do not modify the loop without removing
from mouth
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49. Intermaxillary hooks not cranked
out
Vertical portion of I.M.H resting snugly
against the canine +ve braking
mechanism
Prevention
I.M.H should be cranked out before arch
wire is applied
Use horizontal circle
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50. Distal leg of I.M.H sliding against the
lock pin & becoming engaged in canine
bracket
Prevents free and simple tipping of canine
crown
Usually happen when loop arch wire are used
to unravel ant. Crowding
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51. Prevention
I.M.H should be cranked far enough
labillay, engage against the mesial
surface of bracket
Use horizontal circle
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52. Elastic over the I.M.H engaging the
labial surface of canine
Not major cause
Due to using thick elastics or two
elastics
Prevention
Modify I.M.H so that elastic not
produce undesirable pressure
Use horizontal circle
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53. Lock pin binding the arch wire
in the bracket
If one or more ant. teeth are bind
Prevention
Use special safety lock pins
If conv. Pins, tails should be bend
before head strike the arch wire
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54. Cuspid forced out into buccal plate
Improper arch wire form
Causes drag teeth can not tip freely
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55. Prevention
Place the distal ends of arch wire in
molar tubes, see if wire lies so far
labially in canine region
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56. Too strong elastic force
Use proper intermaxillary elastic
force
2-21/2 ounce
Molar will come forward
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57. Wearing more than one elastic
Pt. must be properly educated in
function of elastics
Danger of wearing more elastics
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58. Elastics not worn continuously
Intermittent wearing causes anchor tooth
to become loose
Ant. Teeth hardly move
Prolong Rx anchorage loss
Prevention
Proper patient education
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59. Arch wire accidentally engaged in
the slot of second premolar
Increases friction
In mes.ling molar rotation wire may
acci. engage
Prevention
Use of bypass clamp
Remove the premolar band for first 6
weeks
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60. Arch wire binding in buccal tube
If arch wire too short to protrude through the
distal end of molar tube
When cut to proper length, cause internal
burring (not removed by ordinary polishing)
Prevention
Make always slightly longer than necessary
Do not cut the end of wire until all
modifications and bends, 1/8”should
protrude
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61. End of arch wires striking the
second permanent molar
Retards and sometimes stops the
distal sliding of arch wire (usually in
upper molar)
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62. Prevention
Extend the arch wire farther distally
through the 1 molar tube not only to
prevent striking but also to move 2nd
molar lingually
If impossible, cut it short enough to
allow it to slide freely until next visit
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63. End of arch wire penetrating the
gingival tissue
Usually distal end of lower arch
Gingival tissue (bone) prevent free
sliding
Prevention
Patients should be instructed to visit
orthodontist if they feel discomfort or
Can not engage elastics
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64. Anchorage bends engaging buccal
tube
Once entered in molar tube free
sliding is prevented due to three point
contact
Prevention
Check the situation every visit
If necessary remove the
arch wire, st. it and, make
new anchor bend mesially
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65. Ligating premolar too tightly to
arch wire
Arch wire can not slide distally
Prevention
Ligate the arch wire lightly so that arch
is free to slide
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66. Insufficient anchorage bend in first
arch wire when first applied
Good rule to follow to incorporate
enough AB to cause the ant. section to
lie against the floor of mucobuccal fold
when distal ends of arch wire is
threaded into molar tubes.
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67. Prevention
Not to estimate the amount of bend in
number of degrees, because
Inclination of molar and buccal tube
Length of arch wire
must be taken into account
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68. Distorted anchorage bend
Seen in negligent pt. mesial to lower
molar tube, esp. when lower 2nd
premolars are not present
Prevention
Examine the arch wire closely
If distorted ,remove from mouth,
eliminate the distortion
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69. Too much anchorage bend
May cause distortion of arch wire
May cause arch wire to rotate in molar
tubes rotate the molars failing to
depress molars
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70. Improper toe in
Results in loss of control of anchor teeth &
failure to reduce ant. Deep bite.
Proper amount of toe in or toe out is
determined by placing the arch wire in molar
tubes & in anterior brackets
The wire should pass st. forward and occlusally
as it leaves the tube from the action of
anchorage bend.
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71. Arch wire too soft
Arch wire material must have higher
resiliency that is compatible with
freedom from likelihood of # of arch
wire while they are being worn
Other wise Rx time will increase
more anchorage loss
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72. Overactivated expansion loops or
improperly bent arch wires
Cause rapid initial labial tipping and
spacing of ant. Teeth
More force time spend to recover
original lab.ling.
inclination of ant. Teeth
Loss of anchorage
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73. Bend – over free end of lock pin
impinging on arch wire
A lock pin tail striking the wire distal to
caninedoes more harm than the same
in C.I
Prevention
Use short lock pin or cut the lock pin
tail off flush with the side of bracket
Bend all pins tail to mesial.
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74. Wrong type of bracket
Do not edge wise bracket
May allow ample tipping labiolingually
but it restricts mesiodistal tipping and
causes loss of anchorage
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75. Arch wire rolling in buccal tube
Avoid too much anchorage bend
and/or too much toe in bend
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76. Improper arch wire form
Arch wire should keep all teeth in the
cancellous through of alveolar bone
Arch wire must be bilaterally similar
in form or should be so shaped as to
eliminate any asymmetry of arch
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77. Upper and lower arch wire forms
not coordinated
Teeth will assume faulty relationship
Ant. or pos. cross bite cuspal
interference prolonged Rx time
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78. Internal diameter of buccal tube
too small or large
Best internal diameter 0.036” for 0.016”
wire
if less free sliding will reduced
if more molar control lessen,
depression force on ant. Lessen
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79. length
Length 0.20” – 0.25” ,
shorter tube lessens molar control &
force of anchor bend,
longer tube more control, reduces the
distance of arch wire between mesial
end of molar tube and premolar bracket
operational difficulties during stage 3.
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80. Retaining looped arch wire longer
than necessary
Danger of loops moving into such
positions that they press against
labial surface of ant. teeth
Not transmit tooth depressing force
as accurately as an arch wire without
loop
Cuspid will depress more than
incisors
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81. Binding of doubled-back arch wire
in flat oval tube
Binding will occur by having the legs too
far apart
May be due to too large a radius where
the arch wire returned on itself, or too
long a vertical section extending from the
hook that is wound around the arch.
Legs of double back are not ll.
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82. Curving arch wires between
expansion loops
Make the arch wire st. between the loops
If need to modify the form make bends in
the loops
When engaged, loops become distorted
rotations of the sections of archwire
If curved three point contact inhibit free
lab.ling. tipping
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83. Thumb or finger sucking, lip sucking,tongue
thrusting and abnormal sleeping habits
Retard or prevent treatment progress
Cause loss of anchorage
Prevention
Habit breaking measures
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84. Improper ligature tie at canine
do not pass ligature ties on canines
over the incisal of brackets
prevents free tipping
It should pass directly
distally across the labial
surface of canine
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85. Anchorage bend too far mesially
Ideal location at the mesial of anchor molar
It may become restricted by ligature tie on
bicuspid, preventing free distal sliding
Arch wire will be projected
towards the occlusal plane
and be deformed by occlusal
forces.
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86. prevention
Anchorage curves instead of bends
Gently curved anchor bend can be
initially placed so far mesially in the arch
wire that it is unnecessary to remove the
arch wire from mouth in order to make a
new bend farther.
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87. Using 0.014” instead of0.016” wire
0.014” exerts insufficient force from
its anchorage bend to prevent the
anchor molars from being tipped
mesially.
Ant. Deep bite will also not open
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88. Loosening of anchor molar bend
Pull the affected molar forward
Anterior teeth are not depressed
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89. Conclusion
Place adequate anchorage bends in
both arch mesial to molar tubes
Use of arch wires, rubber elastics
which exert tooth moving forces of
low value.
Not to move any teeth bodily other
than anchor molars in stage I
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