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Clinical Pearl
5 (
); 166-168

Modified Nance palatal button

Department of Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Faridabad, Haryana, India
Department of Prosthodontics, Crown and Bridge, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences, Dharwad, Karnataka, India
Address for Correspondence: Dr. Nitin Arora, 65, Shakti Vihar, Pitam Pura, New Delhi - 110 034, India. E-mail:
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
This article was originally published by Wolters Kluwer and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

How to cite this article: Arora N, Arora M, Singh AK, Revankar AV. Modified Nance palatal button. APOS Trends Orthod 2015;5:166-8.


This paper describes modified Nance palatal button by which problems encountered in the palatal region around the acrylic button during space closure and molar distalization can be minimized.


Nance palatal button


In orthodontics, patients having critical and moderate anchorage requiring placement of Nance palatal button, the common problem encountered during space closure is inflammation of palatal mucosa beneath and surrounding the palatal button due to transfer of forces onto the palate through the acrylic button. For the treatment of inflammation, retraction has to be stopped and adjunctive medicines (antibiotics, as well as nonsteroidal anti-inflammatory drugs) has to be given which further decreases the tooth movement.[1,2]

Occurrence of this inflammation can be reduced and prevented by modifying the Nance palatal button with permanent soft liners that will reduce and distribute forces to the underlying oral structures enhancing patient comfort.[3-6] The system GC-RELINE soft (GC Dental Products Corporation, Japan) is a permanent soft liner based on addition silicone and is available in safety cartridges. The steps for chairside relining are as follows:

  1. Check and adjust the Nance palatal button (removable/ fixed) in the oral cavity [Figure 1].

    Figure 1: Nance palatal button in patient’s mouth

  2. Disinfect the appliance and relieve 2 mm of tissue surface of the palatal button. Clean and dry thoroughly.

  3. Apply primer R and gently dry with air [Figure 2].

    Figure 2: Primer is applied on the relieved tissue surface of palatal button

  4. Dispense material from the cartridge to the tissue surface of the palatal button. Working time for the reliner is 2 min at 23°C [Figure 3].

    Figure 3: Dispensing of reliner material

  5. Seat the whole appliance in the mouth for at least 5 min [Figure 4].

    Figure 4: Seated appliance with reliner material in patient’s mouth

  6. Once the reliner has set in the patient’s mouth, remove the appliance. Excess material is removed with the scalpel [Figure 5], progressively trim and finish with the bur [Figure 6].

    Figure 5: Excess material is removed
    Figure 6: Trimming of edges

  7. Apply modifier at the edges of palatal button to get a smoother finish.

  8. Check the fit of the appliance in the patient’s mouth [Figure 7].

    Figure 7: Finished modified Nance palatal button

Soft tissue inflammation and patient’s discomfort caused by tongue thrusting habit breaking appliance with acrylic button and distalization appliances with acrylic button in the palate can also be reduced and prevented to a certain extent by modifying the appliance in a similar way [Figure 8].[1,2]

Figure 8: Seated tongue thrusting habit breaking appliance with reliner material in patient’s mouth

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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