When both anterior and lateral development are needed, but patient compliance is a problem, the fixed Magill Sagittal to Advance is an excellent solution. Shown here, second molars are present. An anchorage unit is created by joining the bicuspids and molars together with metal tubing on the lingual aspect. The tubing accepts a sliding wire which allows the anteriors to move forward when the appliance is activated. Activation is accomplished by engaging the unique buccal drive tubes with an Allen Wrench. Lateral development can be achieved by turning the central screw one turn each week.