A clinical study was recently undertaken to evaluate the dental and skeletal effects of the pendulum appliance (PA). In the present study, the appliance was modified by incorporating an uprighting bend into the distalizing spring during the second phase of treatment to avoid excessive distal tipping of the maxillary molars. The sample consisted of 20 patients: 8 females and 12 males, mean age 13.11 +/- 1.10 years. Eight of the patients were subjected to a slow rate of maxillary expansion. Measurements were obtained from cephalometric headfilms prior to (T1) and the day of removal (T2) of the PA. Treatment changes were analyzed and compared with the previous study. The PA with uprighting bends led to reduced molar tipping without significantly changing the effects of the PA, with the exceptions of 0.62 mm more anchorage loss of the maxillary incisor edge and increased treatment time. There was no significant difference in anchorage loss between the patients with and without maxillary expansion.