Beggs Stage 2-OrTHO / Orthodontic Courses by Indian Dental Academy

Beggs Second Phase of
Treatment
www.indiandentalacademy.com
Contents
Objectives of second stage
Construction of appliance
Treatment procedure
Problem encountered

Reason for second stage
To prevent the posterior teeth from being
moved too far mesially.
Insufficient space left in buccal segment
to move the anterior teeth far enough
back on to basal bone.
Objectives of second stage
Maintain all the correction achieved during
first stage
Close any remaining extraction space
Correction of premolar rotation is
completed.
To correct the Midline discrepancies.
Characteristic tooth movement of
second stage
Retracting of anterior teeth
Maintaining the anchor molars upright & in
Class I
Correction of crossbite relationship and
rotating bicuspid.
Characteristic wires and Elastics
Plain round wires
Horizontal Elastics
Class II elastics
Arch Wire
Heavier 0.018 or 0.020 inch arch wire.
Anchor bend -1mm mesial to molar tube
Toe in bend in molar areas
Intermaxillary hook are ligated to canine
bracket.
Arch wire should be held loosely against
the buccal aspect of the premolar brackets
to prevent buccal or lingual crowding after
the extraction space closure


Cement the premolar .

Slight horizontal offset bents are form
distal to the canine to maintain the correct
buccolingual position of premolars and
canines.

Stage 2 safety lock pins are used
Elastics
Space closing elastics are called horizontal
elastics or intramaxillaryelastics.
Six elastics are worn simultaneously
Twist together the two ends of the
ligature wire that holds the arch wire to
the buccal surface of the second premolar
bracket.
Wearing of horizontal elastics from the
buccal surface of molar creates a
rotational force on molars.
Methods of correcting an anchor molar
that has rotated distobuccally.
Control of Bicuspid Height
Use of bypass clamp and reversing them- to
bring the bicuspid to the occlusal plane and hold
them there ,ready for the arch wire to be
placed in the bracket slot.
Bicuspid can be rotated with elastic thread &
held overrotated with a steel ligature tie.

Correction of midline discrepancies
Anterior intermaxillary cross elastics are
used.
Diagonal Elastic Light intra-maxillary Elastics
Midline discrepancies disappear during the
first stage of treatment as a result of the
arch wires being contoured in such a ways
as to eliminate a difference in form of one
side of the dental arch, compared that of
other side.
Shaping arch wires for correcting
asymmetrical dental arch form
Eliminated by shaping the arch wire to
produce bilateral symmetry of dental arch.
Breaking mechanics
If anterior teeth exhibit a tendency for excessive
lingual tipping during stage II use braking
mechanics.
Passive mesiodistal root uprighting spring on
canine & lower anterior braking arches establish
anterior anchorage mechanics.
To further encourage the mesial
movement of lower posterior teeth, the
strength of the mandibular horizontal
elastics is increased from 2 ounces to
6 or 8 ounces.
This brings into play the principles of
differential force.
Shortening length of double-back
Arch wires
Timely placement of small vertical takeup loops
in the buccal section of arch wire
Loops are first made distal to the cuspid
brackets.
If necessary to shorten the doubled-back arch
wire again, similar tekeup loops are made just
mesial to the anchor bend.
Teeth Position at the end of second
stage of treatment
Tipping back or Dishing inof the six upper
and lower anterior teeth is most favorable state
of affair as far as the success of the final result
of treatment is concerned.

1.Ant. Bite closing:

Cause Remedy
A.Not enough bite-
opening bends
placed in the
archwires.
B.Bite opening
bend bitten
out or arch
wire
distorted

A. Remove arch wires and place
proper bite opening bends.

A. Educate patient in the
importance of proper diet to prevent
further distortion.
B. Remove , correct and replace
archwire.
Problems that may be encountered during
the Second stage and their remedies
1. Ant. Bite closing:

Cause Remedy
C. Patient not wearing
intermaxillary elastics
properly

D. Anchor molars out of
occlusion
A.Educate the patient

A. Discontinue class II or Cl III.
Use horizontal elastic from
molar to inter max hook or
inter max elastics from molar
to molars to move the
molars towards one another.
Cause Remedy
A. Excessive wearing of
CL II elastics
A.Discontinue Cl II elastics

2. Ant teeth assuming CL III relationship:

Cause Remedy
A. Failure to tie with steel
ligature wires from the inter
max hook distal to cuspid
brackets.
A.Make necessary tie with
steel ligature wires.
B. Intermaxillary circles
formed too far apart
A.Remove arch wire and roll
one or both circles
mesially, Replace and tie
with steel ligature wire
3. Space developing between ant teeth
4. Anchor Molars rotating distobuccally

Cause: Remedy:
A. Toe-out on arch
wire

B. Too much force
from hz elastics
A. Place toe in at the
distal end of the arch
wire
A. Use lighter hz elastics
B. Tie elastic thread from
cuspid lingual button to
the lingual hooks on the
molars
5. Posterior spaces not closing
Cause: Remedy:
A.Pt not wearing elastics.

B.Arch wire not free to
slide distally through
the buccal tube
A.Educate the patient

A. Remove source of
resistance like end of arch
wire striking second
molar and anchor bend in
to molar tube.

6. Second bicuspid tipping mesially in 1
st

bicuspid extraction case

Cause: Remedy:
A. Slight expected
mesial movement of
anchor molar
B. Abnormal loss of
anchorage
A. Continue to guard
anchorage

A. Increase anchor bends
B. Decrease elastic force
C. Check for loose molar
bands or loose molar
tubes.
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Beggs Stage 2-OrTHO / Orthodontic Courses by Indian Dental Academy

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Beggs Second Phase of

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