Nance Holding Appliance

The Nance Holding Appliance combines a transpalatal arch with an acrylic button that contacts the anterior palatal rugae. This creates maximum posterior anchorage by preventing mesial molar drift.

• Transpalatal Arch — 1.2mm SS wire • Acrylic Button — 8-10mm diameter, contacts palatal rugae • Molar Bands — On maxillary first molars • Wire Connectors — 0.9mm SS wire from button to TPA

The acrylic button presses against the sloping palatal rugae, creating a physical stop that prevents the molars from moving forward. Combined with the rigid TPA, this provides the strongest non-skeletal anchorage available in orthodontics.

1. Intraoral scans 2. 3D-print model 3. Fit molar bands, bend TPA 4. Wax acrylic button — 8-10mm diameter, positioned at the deepest point of the palatal vault 5. Connect button to TPA with 0.9mm wire 6. Flask and process button 7. Solder TPA to bands 8. QC: Button position, TPA clearance, solder integrity

• Wire (TPA): 1.2mm ASTM F899 SS • Wire (connectors): 0.9mm ASTM F899 SS • Button: Heat-cured PMMA, 8-10mm diameter, smooth surface • Bands: Stainless steel, preformed • QC: Button contact verification, TPA position, band adaptation