A vertical palatal incision, between premolar and molar, has shown to be the ideal location. This incision is made, 1 cm downwards as indicated on the picture. The flap is delivered backwards starting from the cervix of the teeth.

After the flap preparation a shallow cup hole is drilled in the palatal cortex with a 3.5mm round bur (IT.1011), 2-3 mm deep, 5-7mm downwards from the cervix teeth.

The form stamp (IT.0311 right side and IT.0312 left side) is pushed manually and vertically in the cup hole. Slight hammer taps can be helpful in adults.

The abutment plate (D.001) is placed in the same vertical direction as the form stamp, with the screw hole away from the teeth. The blue plate is intended for the left side of the patient. Normally there is no need for screws fixation. Only in exeptionally cases the osteosynthesis screws (DSSC05 or DSSC06) are indicated.

The inter-abutment distance is measured with an iron wire or caliper, of which one side is placed in the abutment sleeve. The length of the distractor should be as appropriate as possible in order to optimize the expansion possibilities. This is more critical as the palate gets narrower.

The cylinder of the Smile Distractor shows a blue mark on one side. This mark should be on the left side.

One side of the Smile Distractor is inserted in his abutment sleeve (blue side is left!).

Place the key instrument (IT.0314) over the middle part of the distractor body and start to activate from the front to the back.

A blocking screw (D.002) must be inserted in one of the two available treated holes, with the screwdriver (IT.0128). Place the blocking screw perpendicular over the cylinder, with a clear view of the screw hole. Turn gently with slight but continuous pressure. Once engaged turn tightly. One week after the surgery the activation of the Smile Distractor should be started by removing the blocking screw.