|Year : 2021 | Volume
| Issue : 1 | Page : 104-105
Winged nance palatal arch: An adjunct to tooth movement
Rajkumar Maurya1, Harpreet Singh2, Pranav Kapoor2, Poonam Sharma2, Babita Niranjan3, Ashutosh Dubey4
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 Submission||21-Sep-2020|
|Date of Decision||19-Dec-2020|
|Date of Acceptance||03-Mar-2021|
|Date of Web Publication||22-Apr-2021|
Dr. Harpreet Singh
ESIC Dental College and Hospital, New Delhi
Source of Support: None, Conflict of Interest: None
| 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 Aug 2];39:104-5. Available from: https://www.jisppd.com/text.asp?2021/39/1/104/314361
| Introduction|| |
The Nance appliance or Nance palatal arch (NPA) 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. 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. 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].
| Method of Fabrication|| |
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 3: Treatment progresses maxillary occlusal view depicting canine alignment|
Click here to view
| Discussion|| |
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|| |
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
Conflicts of interest
There are no conflicts of interest.
| References|| |
Nance HN. The limitations of orthodontic treatment; mixed dentition diagnosis and treatment. Am J Orthod 1947;33:177-223.
Singh P, Cox S. Nance palatal arch: A cautionary tale. J Orthod 2009;36:272-6.
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.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]