OPTION 4

֍ Anchorage is conserved in the fixed appliance by: Nance button
֍ The nance appliance or Nance palatal arch (NPA) was one of the earliest modifications of the TPA, first described in 1947.
֍ The palatal wire is welded/soldered to the molar bands and is connected anteriorly by an acrylic button positioned in the highest part of the palatal vault resting on non-compressible mucosa.
֍ The button is made of heat-cured, cold-cured or light cured acrylic.
֍ Light-cured composite has also been used. Modifications of the wire design and minor alterations in the position of the button can also be made.
֍ A Nance button can also be used with a palatal crib.
֍ This increases retention of the appliance.

⸙ Key Concept:     
Reinforced anchorage
Reinforced anchorage is also called multiple anchorage.
֍ This is an anchorage situation where more than one resistance unit is employed.
֍ Resistance units become more effective when more units are added because the reactionary force is distributed over a larger area.
֍ Distribution of force over a large area means keeping the force light.
֍ This minimizes trauma and pain during treatment.
Examples
1. Use of transpalatal arch, Nance space holding buttons and lingual arch reinforces the anchorage unit.