How Effective Are the Nance Appliance and Transpalatal Arch at Reinforcing Anchorage in Extraction Cases?

Objective: This narrative review aimed to evaluate, based on current evidence, whether the transpalatal arch (TPA) and Nance appliance can effectively reinforce anchorage during fixed orthodontic treatment while also offering a comprehensive and in-depth overview of the existing literature on this subject. Materials and methods: A thorough literature search was performed across multiple electronic databases to identify peer-reviewed articles relevant to the review. Results: Evidence suggests that the Nance appliance does not provide absolute anchorage. Additionally, patients experienced discomfort and inflammation of the palatal tissues. The transpalatal arch is also insufficient for maximum anteroposterior anchorage, and existing studies on its effectiveness in vertical anchorage control are inconsistent with conflicting data. Conclusions: For patients with critical anchorage demand, mini-screws may be the method of choice, either solely or in combination with Nance or transpalatal arch, though they carry a risk of failure.