Home | About Us | Editorial Board | Current Issue | Archives | Search | Instructions | Subscription | Feedback | e-Alerts | Login 
Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
 Users Online: 1447  
 
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size


 
  Table of Contents    
CASE REPORT
Year : 2021  |  Volume : 39  |  Issue : 1  |  Page : 104-105
 

Winged nance palatal arch: An adjunct to tooth movement


1 Dental Officer and Orthodontist, Central Government Dental Unit, Nagaland, Madhya Pradesh, India
2 Department of Orthodontics & Dentofacial Orthopedics, ESIC Dental College and Hospital, New Delhi, India
3 Department of Pediatric and Preventive Dentistry, Rishiraj Dental College and Hospital, Bhopal, Madhya Pradesh, India
4 Department of Periodontics, People College of Dental Sciences, Bhopal, Madhya Pradesh, India

Date of Submission21-Sep-2020
Date of Decision19-Dec-2020
Date of Acceptance03-Mar-2021
Date of Web Publication22-Apr-2021

Correspondence Address:
Dr. Harpreet Singh
ESIC Dental College and Hospital, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisppd.jisppd_408_20

Rights and Permissions

 

   Abstract 


Anchorage control during the correction of severely crowded dentitions has always been a source of concern during orthodontic therapy. The Nance palatal arch (NPA) has, in the past, been widely used for reinforcing anchorage in such cases. Modifications of the NPA have been reported for use as a fixed functional appliance or for molar distalization. Herein, a simple, effective modification of the conventional NPA is introduced incorporating two power arms, which can be used for unravelling of anterior crowding at the same time effectively augmenting molar anchorage.


Keywords: Anchorage, Nance, power arm


How to cite this article:
Maurya R, Singh H, Kapoor P, Sharma P, Niranjan B, Dubey A. Winged nance palatal arch: An adjunct to tooth movement. J Indian Soc Pedod Prev Dent 2021;39:104-5

How to cite this URL:
Maurya R, Singh H, Kapoor P, Sharma P, Niranjan B, Dubey A. Winged nance palatal arch: An adjunct to tooth movement. J Indian Soc Pedod Prev Dent [serial online] 2021 [cited 2021 Jun 21];39:104-5. Available from: https://www.jisppd.com/text.asp?2021/39/1/104/314361





   Introduction Top


The Nance appliance or Nance palatal arch (NPA)[1] is perhaps the most widely used appliance for reinforcing anchorage in orthodontics. The NPA is simply a maxillary lingual arch that does not contact the anterior teeth but approximates the anterior palate. The palatal portion incorporates an acrylic button that contacts the palatal tissue, which, in theory, provides resistance to anterior movement of the posterior teeth, thus maintaining arch length and reinforcing anchorage during orthodontic treatment.[2] Various modifications of NPA for use as fixed functional appliance, space gaining in molar distalization and for the management of ectopically erupting molars have been reported in literature.[3] Herein, we describe a simple, effective chairside modification of original NPA for use as an aid in active tooth movement in severely crowded dentition [Figure 1].
Figure 1: Pretreatment occlusal view

Click here to view



   Method of Fabrication Top


Winged NPA (WNPA) was fabricated using a 0.036” hard round drawn stainless steel wire, contoured, and soldered to maxillary first molar bands, and incorporating an acrylic button that rested on the palate slightly posterior to anterior palatine rugae. Since the adolescent patient presented with distally placed maxillary canines bilaterally, the basic form of NPA was modified to facilitate mesial movement of canines. This was done by fabricating an anterior winged wire framework consisting of two wings of 0.038” SS wire in the form of power arm (in line with the palatally positioned canines to be mesialized) incorporated into the anterior portion of acrylic button. The distally placed maxillary canines were mesialized using closed elastic power chain (Rocky Mountain Orthodontics Inc., Denver, CO) [Figure 2]. Favorably aligned position of teeth achieved in 6 months with aid of winged NPA is demonstrated in [Figure 3] and [Figure 4].
Figure 2: Winged Nance palatal arch in situ

Click here to view
Figure 3: Treatment progresses maxillary occlusal view depicting canine alignment

Click here to view
Figure 4: Maxillary occlusal view showing favorably aligned upper arch

Click here to view



   Discussion Top


The WNPA is a simple appliance which not only provides anchorage just like the conventional NPA but also act as adjunct for dentoalveolar movement. The length and direction of the anterior portion of the power arm can be adjusted depending on the desired magnitude and vector of tooth movement. Combination of a buccal fixed appliance and WNPA helps provide a balanced force system for effective movement of palatally positioned teeth. The WNPA also helps reduce the overall chairside time and precludes the need for expensive treatment modalities involving the use of mini screws and onplants.


   Conclusion Top


WNPA can be utilized as a versatile appliance for effecting desired dentoalveolar movements by altering the direction and length of the anterior power arm without compromising the basic integrity of NPA.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Nance HN. The limitations of orthodontic treatment; mixed dentition diagnosis and treatment. Am J Orthod 1947;33:177-223.  Back to cited text no. 1
    
2.
Singh P, Cox S. Nance palatal arch: A cautionary tale. J Orthod 2009;36:272-6.  Back to cited text no. 2
    
3.
Romano FL, Arid J, de Queiroz AM, Bezerra Segato RA, Filho PN. A modified Nance palatal arch for the treatment of ectopically erupting permanent first molars. J Dent Child (Chic) 2016;83:161-6.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

Top
Print this article  Email this article
 

    

 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Article in PDF (1,436 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
   Introduction
    Method of Fabric...
   Discussion
   Conclusion
    References
    Article Figures

 Article Access Statistics
    Viewed434    
    Printed24    
    Emailed0    
    PDF Downloaded101    
    Comments [Add]    

Recommend this journal


Contact us | Sitemap | Advertise | What's New | Copyright and Disclaimer 
  2005 - Journal of Indian Society of Pedodontics and Preventive Dentistry | Published by Wolters Kluwer - Medknow 
Online since 1st May '05