The appliance is fixed onto the lower arch. The lower arch has to be prepared before insertion. The thickness and type of arch is chosen, its length is adjusted, locks are fitted and the Ritto appliance is then inserted.

Preparation of the lower arch before insertion. The lower arch should be cinched back the lower tubes.

Place the ball pin from distal to mesial into the head gear tube. Only in particular cases I advise the use from mesial to distal, because sometimes there is an interference among lower and upper bands, and the Ritto device.