Effective Orthodontic Techniques for Overlapping Teeth

Overlapping (crowded) teeth occur when there is insufficient space in the dental arch to accommodate proper tooth alignment, causing teeth to shift, overlap, or rotate. This condition often complicates oral hygiene and can affect both aesthetics and function. In cases of severe crowding, effective orthodontic techniques must be able to create space, align teeth, and maintain occlusal balance.

One method that has been studied is the use of vertical loops in the Begg technique, as described in the research article “Penggunaan Vertical Loop pada Perawatan Gigi Berjejal Parah dan Crossbite Anterior dengan Teknik Begg” published in the Majalah Kedokteran Gigi Indonesia (UGM). The study by Herna Juliana Nainggolan, drg. Wayan Ardhana, MS, Sp.Ort(K), and drg. Christnawati, M.Kes, Sp.Ort(K) explains that vertical loops can increase wire flexibility and facilitate leveling and unravelling of anterior teeth, even in severe crowding cases.

Technical Basis: Begg Technique and Vertical Loop

The Begg technique is a classic fixed orthodontic technique that uses round-section wires, loose-fitting brackets (ribbon slots), and light forces with minimal friction. In the early stages, thin wires (e.g., 0.014”) are commonly used to align teeth and create space.

A vertical loop is a small additional loop formed in the wire (usually in the anterior or interproximal segments) to:

• Increase the effective length of the wire
• Increase wire elasticity and flexibility
• Provide horizontal (mesial/distal) as well as buccal/lingual forces on overlapping teeth

With vertical loops, the wire can more easily adapt to the ideal arch form, allowing faster leveling (evening tooth height) and unravelling (straightening misaligned teeth).

Case Studies and Effectiveness of Vertical Loops

In the cited study:

• Two cases of severe crowding combined with anterior crossbite were treated using the Begg technique with vertical loops.
• The initial stage used 0.014” wire with vertical loops to create space and correct tooth position.
• After several phases, the results showed:
  • Correction of anterior tooth inclination (more upright front teeth)
  • Closure of residual space
  • Improvement in overjet, overbite, and interdigitation to achieve normal occlusion
• The researchers concluded that the use of vertical loops in the Begg orthodontic technique is highly effective in correcting severe crowding and anterior crossbite.

Reported advantages of this technique include:

• The ability to correct overlapping teeth even in extreme conditions
• Light forces, making treatment safer and more comfortable
• The ability of loops to generate horizontal movement while reorganising tooth positions

However, some challenges were also noted:

• Patients need to be cooperative, especially during the early stages of treatment
• Oral hygiene can be more difficult when loops and wires are present
• Initial discomfort due to the loops

Clinical Strategies and Practical Tips

To optimise the use of vertical loops and the Begg technique, the following tips are recommended:

1. Appropriate loop design
   The loop should be large enough to provide flexibility, but not too large to weaken the wire or cause irritation.
2. Gradual and periodic activation
   To avoid trauma, loops should be activated gradually and periodically (e.g., every 2 weeks) to ensure light forces and controlled movement.
3. Oral hygiene management
   Since wires and loops can trap plaque, oral hygiene education is essential—use interdental brushes or special orthodontic floss.
4. Monitoring tooth position and occlusion
   Regular check-ups are needed to ensure movement follows the treatment plan and does not cause unwanted effects (such as excessive tipping, unwanted rotation, or premature contacts).
5. Patient cooperation
   Patience and cooperation from the patient are crucial, especially during the early phase, which may feel more uncomfortable.

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Severe tooth crowding is a significant orthodontic challenge. The study “Penggunaan Vertical Loop pada Perawatan Gigi Berjejal Parah dan Crossbite Anterior dengan Teknik Begg” demonstrates that vertical loops can be an effective solution for correcting these cases. The combination of the Begg technique with vertical loops allows simultaneous space opening, leveling, and unravelling with light forces and better control.

References
MKGI, Herna Juliana Nainggolan, drg. Wayan Ardhana, MS, Sp.Ort(K), dan drg. Christnawati, M.Kes, Sp.Ort(K), Penggunaan Vertical Loop pada Perawatan Gigi Berjejal Parah dan Crossbite Anterior dengan Teknik Begg, https://jurnal.ugm.ac.id/mkgi/article/download/8192/6355

Author: Rizky B. Hendrawan | Photo: Freepik