Nance palatal arch: a cautionary tale

Abstract

The Nance palatal arch is considered a useful means of maintaining arch length and reinforcing anchorage control in the orthodontic patient. Difficulty with oral hygiene around the Nance arch and inflammation and bunching of the gingivae under the acrylic fitting surface are common problems associated with this appliance. We present a case of alveolar bone loss and gingival recession around the palatal root surfaces of the upper incisor teeth following use of Nance palatal arch. A possible cause for this is explored and management of the patient after the Nance arch was removed is discussed.

Keywords:

• Nance palatal arch
• orthodontics
• fixed appliances
• root surface exposure
• periodontal surgery

Acknowledgments

The authors are grateful to Stephen Bagnall, Senior Orthodontic Technician, Ipswich Hospital for Figure 3 and Paul Ryan, Academic Clinical Fellow in Restorative Dentistry, Barts and The London School of Medicine and Dentistry for Figure 7.