Abstract
Functional appliances are primarily orthopaedic tools used to influence the facial skeleton in a growing child. These appliances may be fixed or removable. A fixed functional appliance referred to as the Repositioning Nance Appliance (RNA) was developed and a case report is presented. The RNA is a fixed functional appliance consisting of bands on the upper first molars joined together with a 0.036-inch stainless steel wire that is bent around the anterior contour of the palate. Just lingual to the upper incisors the wire is complemented with an acrylic Nance button, which is modified with a downward and backward incline projection. The labial aspect of this projection is smooth and when the lower incisors come into contact with it, they are directed into an edge-to-edge relation with the upper incisors, brought about by forward positioning of the mandible. This has the net effect of relocating the mandible into a Class I relation. A 14-year-old boy in his late mixed dentition stage of dental development presented with mild crowding, a horizontal growth pattern and a skeletal Class II jaw relation caused by an underdevelopment of the mandible. Treatment was initiated using the RNA and continued for a period of 18 months. This was followed by full fixed appliances for another 12 months and resulted in Class I skeletal and dental relations, a reduced overjet and an improved facial profile. The RNA, if applied correctly is a simple fixed functional appliance that can be used with confidence, comfort and economy to both the patient and orthodontic practitioner.
Similar content being viewed by others
References
Moyers RE (1988) Handbook of Orthodontics. 4th ed. Chicago: Yearbook Publishers
Graber TM, Rakosi T, Petrovic AG (1977) Dentofacial Orthopedics with Functional Appliances. 2nd ed. St. Louis: Mosby
Mc Namara JA, Brudon WL (1992) Orthodontic and Orthopedic Treatment in the mixed dentition. Ann Arbor: Needham Press
Tulloch JFC, Proffit WR, Phillips C (1997) Influences on the outcome of early treatment for class II malocclusion. Am J Orthod Dentofacial Orthop 111(5): 533–542
Fishman LS (1987) Maturational patterns and predictions during adolescence. Angle Orthod 57(3): 178–193
Ricketts RM, Bench RW, Gugino CF, Hilgers JJ, Schulhof RJ (1979) Bioprogressive Therapy, (part 4)USA: Rocky Mountain Orthodontics
De Vincenzo, Winn JP, MW (1989) Orthopaedic and orthodontic effects resulting from the use of a functional appliance with different amounts of protrusive action. Am J Orthod 96: 181–190
Wieslander L (1974) The effect of force on craniofacial development. Am J Orthod 65(5): 531–538
Dawjee SM (2003) Camouflage orthodontic treatment for a skeletal class II patient — a case report. SADJ 58(4): 160–164
Nanda RS, Kierl MJ, Prediction of cooperation in orthodontic treatment. Am J Orthod Dentofacial Orthop 1992; 102(1): 15–21
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dawjee, S.M., Khan, M.I. & Hlongwa, P. The repositioning Nance appliance: a fixed functional appliance and case report. J. Maxillofac. Oral Surg. 8, 68–73 (2009). https://doi.org/10.1007/s12663-009-0017-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12663-009-0017-8