When posterior and lateral development are needed, but patient compliance is a problem, the fixed Magill Sagittal to Distalize is an excellent solution. Essentially the reverse of the Magill Sagittal to Advance this appliance's drive tubes are anchored to the bicuspids instead of the anterior lingual acrylic. It allows the anteriors to be used for anchorage -- by first activating the central screw and then expanding the acrylic segment laterally. Subsequent activation of the buccal drive tubes distalizes the posterior segments. Note: In this example the second molars have been extracted. As with all Distalizing Sagittals, vertical dimension must always be evaluated and second molar removal considered in the interest of expediting treatment.