The Facegenics FME Activation Protocol serves as a clinical instruction guide for patients using a custom orthodontic expansion appliance under medical supervision. Following installation and a required five-day initial healing period, the activation schedule is split into two phases: a pre-split phase requiring 1 to 2 full turns per day until suture separation occurs, followed by a post-split phase reduced to approximately 2 to 3 full turns per week (0.27–0.4 mm weekly). The document details the central six-sided hex screw mechanism—where each single turn yields 0.133 mm of expansion—and outlines how to track turns using sequential markings (1A/2A/3A through 6) printed on the device.
Patients are instructed on proper operating technique using either a Swivel Activation Key or a dual-ended Rigid Activation Key, designed for varying leverage needs. Both keys require pushing/sweeping in a controlled manner toward the back of the throat or bottom teeth and strictly disengaging straight down toward the tongue to prevent accidental "back-turns". Critical safety warnings emphasize that overactivation or forcing resistance can cause severe tissue trauma, bone microfractures, or asymmetric expansion, whereas underactivation risks premature bone consolidation. Patients are advised to immediately pause activation and contact their provider if they experience persistent pain, device shifting, sudden loss of resistance, or excessive pressure.