ortho the international C.E. magazine of orthodontics

06 I I C.E. article_ Combination Technique Introduction _During the 1960s, when the Begg lightwire and the Tweed edgewise were the mainstream tech- niques of orthodontic therapy, Dr. Maxwell Fogel and Dr. Jack Magill introduced their “Combination Technique” (Fogel & Magill, 1969). The Combination Technique’s philosophy was based on combining the positive and significant attributes of Begg lightwire and Tweed edgewise techniques to produce a system that corrected malocclusions quickly and easily for the orthodon- tist, with much less pain and a shorter period of time for the patient, while producing American Board of Orthodontics quality, standards and results. _Outline of the Combination Technique StageI: Light-wirephase(Tipping) 1. Reduce protrusion 2. Un-crowd incisors 3. Open the bite (restore vertical dimension) 4. Class I molars and cuspids 5. Begin closing extraction spaces 6. Upright mandibular incisors 7.CephalometricX-ray tocheckuprightingofthe mandibular incisors StageII:Bracketalignmentphase (Leveling) 1.Levelandalignmaxillaryandmandibulararches 2. Closure of extraction spaces 3.Preliminaryuprightingofcuspidsandbicuspids 4. Preliminary correction of rotations 5. Preliminary correction of axial positions StageIII:Edgewisephase(Uprighting) 1. Detailed axial positioning of all teeth 2.Lingualroottorqueforlabialaxialinclinationof the maxillary incisors 3. Root paralleling in extraction areas 4. Desired uprighting of molars 5. Artistic positioning of incisor segments 6. Complete correction of rotations 7. Residual space closure Retention Two years — indefinite _Overview of the Combination Technique philosophy The Combination Technique incorporated three stages of appliance therapy: StageI The initial stage was called the light-wire or tipping phase, employing 0.014, 0.016 and 0.018 round wires, which required approximately four to eight months to achieve desired results. This first phase employed Dr. Raymond Begg’s concept of light, continuous forces to uncrowd anterior teeth, open the bite (restore vertical dimension), reduce the protrusion, begin closing extraction spaces and uprightingmandibularincisors,allwithoutstraining the posterior anchorage unit. The Begg philosophy and mechano-therapy produced light, physiologic forces through the use of one-point contact, free- sliding, non-binding and continuously moving teeth that were connected to the archwire (Begg, 1961). Drs. Fogel and Magill created this appliance by ortho2_2012 A review of the original Combination Technique and philosophy Author_Dennis J. Tartakow, DMD, MEd, EdD, PhD, editor in chief, Ortho Tribune This article qualifies for C.E. credit. To take the C.E. quiz, log on to www.dtstudyclub. com. The quiz will be available on Sept. 17. _c.e. credit part I