When the molar is severely inclined and bodily movement is needed to upright it, only a fixed approach will suffice. But sometimes the teeth that would normally be used for anchorage are not available.

When this is the case, a removable appliance can be used for anchorage in conjunction with a fixed component on the molar. Here, an uprighting spring inserts into a fixed molar bracket that has a tube or slot. The spring then hooks onto the removable appliance which provides the necessary anchorage and prevents lingual tipping. When using this approach, it is essential to place an occlusal rest on the distal aspect of the occlusal surface to prevent extrusion.