A Nance palatal arch is a method of reinforcing anchorage to help prevent mesial movement of maxillary first permanent molars. It is recognised that it is difficult to maintain oral hygiene around the appliance and that iatrogenic damage can occur. We present a case of a 22-year-old male patient in whom the palatal mucosa became necrotic, palatal bone became exposed and long-term periodontal damage occurred. We describe the case, his treatment and the resolution of the inflammation as well as exploring the causes for the damage and alternate treatment options.
BearnDR, AlharbiF.2015. British orthodontic society national audit of temporary anchorage devices (TADs): report of the first thousand TADs placed. J Orthod. 42:214–219.
2.
GoshgarianRA. 1972. Orthodontic palatal arch wires. United States Government Patent Office. Alexandria, Virginia Patent number 3792529.
3.
JambiS, WalshT, SandlerJ, BensonPE, SkeggsRM, O'BrienKD. 2014. Reinforcement of anchorage during orthodontic brace treatment with implants or other surgical methods. Cochrane Database Syst Rev. 8:CD005098.
4.
KurodaS, SugawaraY, DeguchiT, KyungHM, Takano-YamamotoT.2007. Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort. Am J Orthod Dentofac Orthop. 131:9–15.
5.
NanceHN. 1947. The limitations of orthodontic treatment; diagnosis and treatment in the permanent dentition. Am J Orthod. 43:36–84.
6.
SandlerJ, MurrayA, ThiruvenkatachariB, GutierrezR, SpeightP, O'BrienK.2014. Effectiveness of 3 methods of anchorage reinforcement for maximum anchorage in adolescents: a 3-arm multicenter randomized clinical trial. Am J Orthod Dentofac Orthop. 146:10–20.
