Abstract
Rotation of any tooth needs to be corrected in the initial phase of orthodontic mechanotherapy. Derotation of posterior teeth provides space in the arch and also allows the treatment progress. During rotation correction, undesirable forces make an unwanted movement of the adjacent teeth, which increases the duration of treatment. This case report aims to fabricate and introduce the modified Nance palatal arch that easily allows derotation of the tooth without producing undesirable side effect on adjacent teeth. 
 Keywords: modified Nance palatal arch, derotation, rotated premolar
Highlights
Tooth rotation may be defined as the mesiolingual or distobuccal intra-alveolar displacement of the tooth around its long axis.[1]
The rotation of permanent tooth can be caused by two main etiological factors; first is pre-eruptive disturbances which include injury to tooth bud in childhood, cyst, tumors or supernumerary tooth interferes with the eruption of the tooth.[3,4]
Aim of the current case report was to fabricate an appliance that can be used for correction of severely rotated premolar without producing undesirable side effect on adjacent teeth
Summary
Tooth rotation may be defined as the mesiolingual or distobuccal intra-alveolar displacement of the tooth around its long axis.[1]. The anterior teeth can be derotate by elastic archwires, but posterior teeth need more attention for correction.[6] Elastic archwire on posterior teeth for derotation can cause undesirable force on adjacent teeth.[7] Aim of the current case report was to fabricate an appliance that can be used for correction of severely rotated premolar without producing undesirable side effect on adjacent teeth. Case report: Diagnosis and treatment planning molar with satisfactory oral hygiene. Fixed modified Nance palatal button with transpalatal arch for anchorage purpose and derotation of premolar was given to the patient. To produce coupling force bracket were tied with the help of elastic chain from the molar tube and lingual button from the loop of modified Nance palatal button.
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