Fig. 4. Demonstration of the activation of the modified presurgical alveolar molding (PAM) appliance. A, Passive state of the modified PAM appliance after placement. B, Application of the force provided by right extraoral orthodontic elastic to the left surface of the button of modified PAM appliance. C, Application of the force provided by left extraoral orthodontic elastic to the right surface of the button of modified PAM appliance. D, Approximation of the two separate parts of the modified PAM appliance with the forces provided by orthodontic elastics.
