| Field | Value |
|---|---|
| ID | OA-0161 |
| Type | anchorage |
| Category | anchorage |
| Fixed/removable | fixed |
| Primary function | maxillary anchorage; space maintenance |
| Malocclusion target | anchorage in extraction cases; post-distalization retention; space maintenance |
| Inventor | Hudson C. Nance (1947) |
| First year | 1947 |
| Period | historical / current |
| Status | current |
| Uses TADs | no |
The Nance holding arch (Nance appliance) was described by Hudson C. Nance in 1947. It consists of stainless steel bands on the maxillary first molars connected by a palatal wire, with an acrylic button resting on the anterior hard palate. The palatal mucosa in the rugae area is densely attached and non-compressible, providing resistance to mesial molar drift through tissue contact. It is one of the most common maxillary anchorage devices in extraction and distalization treatment.
Anchorage is derived from two sources: (1) the molar bands resist tipping through the rigid wire connection, and (2) the acrylic button transfers reaction forces to the hard palate mucosa over a broad area, resisting forward movement of the entire appliance. When space-closure mechanics move anterior teeth distally, the molars are the anchorage units — the Nance prevents their mesial drift. After molar distalization, the Nance is used passively to hold the molars in their new distal position while braces close the space.
Maxillary anchorage reinforcement during premolar extraction space closure; post-distalization retention (holding molars distally after Distal Jet or Pendulum treatment); bilateral maxillary space maintenance after premature primary molar loss; as part of a distalizer system (Distal Jet uses a Nance button as its anchorage component). More effective than a TPA alone for cases requiring significant anchorage because the palatal button adds tissue-borne resistance.
The acrylic button can cause palatal tissue irritation or even ulceration if it impinges directly on the mucosa — must be kept 1 mm off tissue at delivery, accounting for tissue compression during function. Poor hygiene leads to food trapping under the button and mucosal inflammation. Patients with very shallow palates have limited button coverage. The fixed nature means it cannot be easily adjusted. Palate tissue contact means the appliance cannot be left in indefinitely — tissue monitoring at every adjustment visit is required.
palate
the anterior palatal vault; typically thumb-sized, covering the rugae area
attached to the button
After bands are seated on the model, bend the wire so it runs anteriorly along the palatal vault contour, turning at the midline to form the button support arms. Build the acrylic button by layering directly over the wire on the model — the button should cover a broad area (larger = better anchorage) but the tissue-facing surface must be smooth and polished. The button should be ~1 mm thick and leave at least 1 mm clearance from the model tissue. Solder the wire ends into the molar bands. CFL Hayes Nance variants include standard, omega-loop, bonded (no bands), modified, and combo (with habit crib). The 3D workflow digitally designs both the wire and button from a scan model.
.
flexibility.
vault shapes.
Update](https://www.orthodontic-update.co.uk/content/articles/transpalatal-nance-and-lingual-arch-appliances-clinical-tips-and-applications)
Orthodontists](https://burkeredfordorthodontists.com/nance-holding-arch/)
IJCMPH](https://www.ijcmph.com/index.php/ijcmph/article/view/3910)
business notes.