The Nance appliance can also be designed removable. For an easier use, the MIA System is recommended. The loops from a preformed Quad-Helix appliance are eliminated so that only the active extensions with the lock are used and bent into the appliance. After this, the acrylic shield is added.
If the molars are to be slightly rotated, the posterior loops of the preformed Quad-Helix appliance are used and the extensions are horizontally bent into the appliance.
If additional extension for activation is desired, it is easier to use a preformed lingual arch which can be transformed into the Nance appliance without any problems.
