Travel specialists have expertise and experience in
correcting moderate to severe teeth and jaw
disorders in children and adults.
surgery, a combination of jaw surgery and
orthodontics, can remedy "toothless" or "gummy"
smiles, deficient chins, protruding underbites and
overbites, and other problem areas of the face
including lips, neck, nose and cheeks.
Our medical center treats hundreds of patients with
jaw disorders every year and has one of the
country's largest groups of academic surgeons.
Orthognathic surgery focuses on improving the
patient's appearance as well as the functionality of
the jaws and teeth. Functionality is increased when
teeth fit together firmly, making biting and chewing
Surgery also alleviates the grinding and pressure
associated with most oral disorders, and prevents
further damage to the affected teeth. Having the
jaws in proper alignment also reduces the chance of
developing disease or deterioration in the
Patients also enjoy an enhanced facial profile,
since oral disorders frequently affect facial
balance and aesthetics. Most cosmetic procedures can
be completed during the same surgery as the jaw
Depending on the needs of the patient, surgery is
performed on the upper jaw (maxillary osteotomy),
the lower jaw (mandibular osteotomy) or both.
Surgery is completed entirely inside the mouth,
leaving no scars on the chin, jaw or around the
Treatment of TMJ
MAkeover Travel specialists have significant
experience treating disorders of the
temporomandibular joint (TMJ) in adults and children.
centers use a multidisciplinary treatment approach.
Oral and maxillofacial surgeons try to find the best
treatment possible for every patient, often working
with specialists from pain management, neurology and
An evaluation begins with a thorough medical history
to learn about symptoms and related medical
conditions. A physical exam is performed to
determine whether the problem is caused solely by
the TMJ. This exam can include a complete oral, head,
and neck exam (including testing the patient's bite
and range of motion in the joints), a neurological
exam (used more frequently for patients with severe
or chronic pain), and basic X-rays, CT scans and
magnetic resonance imaging, as needed.
Treatment options include anti-inflammatory
medications, minimally invasive "joint flushes," (arthrocentesis)
and various types of TMJ surgery (arthroplasty).
About TMJ Disease
The temporomandibular joint (TMJ) is located just in
front of each ear, where the lower jawbone (mandible)
connects to the skull. This "ball and socket" joint
allows the jaw to move up and down, from side to
side, and in complex circular motions. The TMJ helps
people eat, swallow and speak, in addition to
supporting the jaw.
TMJ function can be affected by disease (infection,
rheumatoid arthritis), injury, general wear and tear,
and congenital abnormalities (people who are born
with a deformed TMJ). All these events can lead to
potentially significant pain and difficulty in
opening and closing the jaw.
Both the "ball" (condyle, or end of the jawbone) and
the "socket" (articular fossa, formed by the
surrounding temporal bone) can be affected. The
small piece of cartilage that acts as padding
between these bones (the disk) can also become
damaged or displaced due to constant use or other
conditions. When the TMJ components become damaged,
causing the once smooth and lubricated joint to lose
its flexibility and range of motion, this results in
problems opening and closing the jaw, eating,
speaking and other facial movements. Symptoms can
include moderate to severe pain, and popping or
of Jaw Surgery Offered at Makeover Travel
Maxillary osteotomy (upper jaw)
This procedure is used for patients with a receded
or deficient upper jaw, as well as patients with an
open bite (apertognathia).
When operating on the upper jawbone, cuts are made
below both eye sockets, so the entire top jaw,
including roof of the mouth and all upper teeth, can
move as one unit. The teeth and jaw are moved
forward until the teeth are in a position that
allows them to fit firmly with the bottom teeth.
Once the jaw is realigned, tiny screws are used to
hold the bone in its new position. These screws are
smaller than a bracket used for braces, and become
integrated into the bone structure.
Mandibular osteotomy (lower jaw)
This procedure is typically used for patients with a
receded lower jaw or an open bite.
on the lower jawbone, the cuts are
made behind the molars and lengthwise down the
jawbone so the front of the jaw (teeth and all) can
move as one unit. Once completed, the jaw slides
smoothly to its new position, and screws hold the
jawbone together until it heals.
A severely receded lower jaw is often accompanied by
a deficient chin, which can be remedied with
cosmetic surgery. Typically, surgeons can alter the
jaws and restructure the chin, if needed, during the
Apertognathia is a condition patients are unable to
properly use their teeth due to the significant
oval-shaped gap between the upper and lower teeth in
the front. This gap results from excess bone growing
only above the molars. What is normally a flat, even
surface, is now angled so the upper teeth do not
touch when the patient bites together. To remedy
this condition, surgeons shave away or completely
extract the excess bone.