Angle Pearls palate for hygiene, but it is fixed to the molars so the patient cannot remove the appliance from the mouth or lose it. Maintaining adequate oral hygiene during distalization is a major advantage, and it was felt that providing this modification to the pendulum appliance to make it more " hygiene friendly " would be considered a significant enhancement to its existing design. Another advantage of not cementing or bonding the appliance in place is that chairside activation and adjustments of the distalizing springs can be performed much more easily whenever indicated. The appliance has acrylic occlusal coverage over the first and second premolars. This discludes the maxillary molars from occlusal forces and facilitates distalization. There is no contact from canine-to-canine between the appliance and the anterior teeth. Distal and intrusive forces are provided by round 0.032-inch TMA springs activated at 30°-45 once inserted into the 0.036-inch lingual sheaths of the maxillary first molar bands. In most cases, mandibular fixed appliances are placed at the same time as the Iino distalizer to help level the lower occlusal plane (Figure 4). The appliance is checked and reactivated as needed every four to six weeks until an overcorrected super Class I molar relationship is achieved. At this point, the appliance is discontinued, and a Nance holding arch is inserted. Full fixed appliances are then placed in the maxillary arch, and distalization and space closure of the remainder of the arch are initiated. Winter 2022 PCSO Bulletin 45