A Fixed Sagittal can be used when arch length increase is required in a non-compliant patient or when a patient experiences speech difficulties when wearing an acrylic removable Sagittal. With the second molars removed (shown), the arch length gain is achieved predominantly by distalization of the posterior segments. With the second molars in place, movement of both the anteriors and posteriors will occur. If movement of the anteriors alone is desired, the cuspids will need to be combined with the bicuspids and molars to create a posterior anchorage unit.