Indications:

• Maxillary space maintainer after premature loss of primary molars.

• To preserve arch length during mixed dentition transition.

• Prevent mesial drift of maxillary permanent molars.

• Anchorage reinforcement in orthodontic mechanics (esp. Class II correction, molar distalization).

Contraindications:

• Poor oral hygiene (risk of palatal tissue inflammation under acrylic button).

• High, narrow palate (difficulty in fitting and stability).

• Partially erupted or severely tipped molars (poor band adaptation).

• Deep palate with insufficient contact for acrylic button.

Corrects / Maintains:

• Maintains arch perimeter by preventing mesial movement of upper molars.

• Provides maximum anchorage for retraction mechanics.

• Stabilizes molars during premolar/molar extractions.

• Holds molars in place during maxillary expansion retention.

Design:

• Bands cemented on maxillary permanent first molars.

• 0.9–1.0 mm stainless steel wire soldered to molar bands → extends anteriorly along palate.

• Terminates in a palatal acrylic button (rests on anterior palate, usually in rugae area).

Philosophy:

• Functions as a passive anchorage appliance.

• Resists mesial migration of molars by transmitting reactive forces to palatal vault.

• Provides more anchorage control than Transpalatal Arch (TPA) because of palatal button.

• Acrylic button provides palatal anchorage by contacting mucosa → distributes force.

Modifications:

• Removable Nance with acrylic button and clasped molars (less common).

• Modified Nance with hooks/tubes for attachment of elastics or extraoral forces.

• Split Nance (two acrylic pads) for easier hygiene.

• Can be combined with distalizing appliances (Pendulum, Distal Jet) and then converted into anchorage.

• Nance palatal arch appliance with incorporated tongue crib/guard

Advantages:

·         Maintains maxillary molar position after premature loss of primary teeth.

·         Prevents mesial drift during space closure or orthodontic retraction.

·         Acrylic button on palate provides additional anchorage support.

·         Custom-fit – comfortable and stable in the palate.

·         Durable – effective for long-term retention of arch form.

·         Can be combined with other appliances for complex mechanics.

Reduces relapse risk by stabilizing molars during mixed dentition or fixed appliance therapy.