The Direct Bond Suture Expansion uses direct bond occlusal pads for retention, instead of banding 1st bicuspids and 6-year molars. This key feature not only facilitates movement when a crossbite is present, but, because it covers the buccal cusp tips, also prevents tipping. Add in the rigid framework and you have a design that creates a movement primarily orthopedic in nature -- especially beneficial for patients in the early mixed dentition stage or early adult dentition stage. Not recommended for patients who are in the late stage of mixed dentition -- loose or exfoliating teeth will greatly compromise appliance anchorage. Note: When delivering this appliance, be sure to maintain a dry environment. Special instructions (along with all necessary supplies) can be provided via SML.