CENTRAL DIASTEMA CLOSURE WITHCONTRACTION LOOPS IN BEGG TECHNIQUE

(Case Report)

Bayu Ananda*, Wayan Ardhana**, Christnawati***Orthodontic Resident, **Lecturer, Department of Orthodontics,

Faculty of Dentistry GadjahMada University

Rationale

• Central diastema cause aesthetic problem in some people. Correction of this malocclusion may increase self confidence. Central distema is a space between incisuvus centralis, space formed by more than 0,5 mm. Orthodontist will be challenged to correct this malocclusion. Central distema can be corrected with removable appliance or fixed appliance, include Begg technique.

• Patient, 26 years old.• Class II div 1 Angle malocclusion.• Abnormal attachement frenulum labialis anterior.• Bad habit: lower lip sucking, opening mouth when

sleeping.• Want to close central diastema.• Want to correct malocclusion and malposition.

- Class II molar and caninus relation in the right region.- Class I molar and caninus relation in the left region.- Interincisivus shifting to the right.- Third molar impaction had been extracted.- SNA: 83,50

- SNB: 760

- ANB: 7,50

Treatment planing

• Motivate to eliminate bad habit.

• Frenectomy.

• Extracting tooth 14 and 24.

• Begg technique treatment:

- central diastema closure.

- overjet and overbite correction.

- molar relation correction.

Stage of Begg Technique

• First stage : - central diastema closure

- retracting anterior tooth.

- deepbite correction.

- molar relationship correction.

• Second stage : space closing.

• Third stage : root paralelling.

After one year of treatment:

• Central distema has been corrected.

• Overjet has been reduced, 10,5 mm to 5,5 mm.

before treatment in the middle of treatment after one year of treatment

before treament in the middle of treatment after one year of treatment

before treatment OPG after one year of treatment OPG

before treatment sefalometri after one year of treatment sefalometri

RADIOGRAPHIC BEFORE AND AFTER ONE YEAR OF TREATMENT

TABLE BEFORE AND AFTER ONE YEAR OF TREATMENT

Metode Sebelum Perawatan Dalam Progres Perawatan

Steiner ∠ SNA 83,5° 83,50

∠ SNB 76° 760

∠ ANB 7,5° 7,50

I ke NA 10.5 mm 5,5 mm

∠ I ke NA 35° 250

I ke NB 7 mm 3 mm

∠ I ke NB 27° 210

Pg ke NB 1,5 mm 1,5 mm

∠ I ke I 107,5° 1240

Downs ∠Facial 84.5° 84,50

∠Conv 12,5° 12,50

Bidang A-B -11° -50

FMPA 33° 210

Y axis 67° 600

Inklinasi Bidang Oklusal 10° 90

I ke I 107,50 1240

I ke bidang Oklusal 27° 160

IMPA 99° 910

Derajat protrusi 10.5 mm 5 mm

Wits AO – BO 10 mm 5 mm

CONCLUSION

• This pastient was treated with fixed orthodontic appliance Begg technique. extraction teeth 14 and 24 decided because of the retrusion of mandible. Differential force caused by Beeg technique may correct the central diastema, overjet, overbite, molar relationship.

• Begg technique consists of three stages: First stage : levelling , unravelling, overjet, overbite,

molar relationship correction. Second stage : space closing. Third stage : root paralelling.• This patient still in the first stage of the treatment.