Jaw, TMJ & Advanced Implants

What These Procedures Involve

Explained before you decide.

These are procedures patients choose — so understanding them matters. Here is how we walk through the three we are asked about most, without graphic imagery.

Fig. A · Alignment

The jaws, repositioned into alignment

When the upper and lower jaws don’t meet correctly, we reposition the bone itself — not just the teeth — so the bite, profile, and even breathing improve together. Sequenced with your orthodontist.

Fig. B · The Joint

A jaw joint that moves freely again

For joint disease that hasn’t responded to conservative care, we treat the joint directly — from minimally invasive arthroscopy to full joint replacement — to restore comfortable, quiet movement.

Fig. C · Anchorage

Anchored where the bone is strong

When there isn’t enough bone for standard implants, fixtures anchor into the dense zygomatic or pterygoid bone instead — giving a fixed, full arch to patients who were told they had no options.

Illustrative schematics. Patient-specific 3D renderings are prepared individually for each surgical plan.

How These Cases Are Handled

Surgeon-led, and never rushed.

These are elective and implant-focused cases — skeletal jaw correction, complex TMJ disease, and the bone-anchored implant work that more conventional practices cannot solve. They reward technical depth and an unhurried consultation, and that is how they are approached here.

Many of these patients arrive after multiple consultations elsewhere. We spend meaningful time on the consultation itself; most plans take more than one visit to finalize.

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Dr. Ramirez performing microsurgery under an operating microscope

The Operation

Orthognathic Surgery (Jaw Correction)

Surgical correction of skeletal jaw misalignment that cannot be resolved with orthodontics alone. Both single-jaw and double-jaw (bimaxillary) procedures.

Who this is for

Patients — most often in their late teens through early thirties — who have been told by an orthodontist that braces or aligners cannot fully address the underlying skeletal alignment. Many of our orthognathic patients have been on this conversation for years before scheduling a consultation.

The orthodontic-surgical timeline

Orthognathic care is coordinated work. We sequence directly with your orthodontist and present the full timeline at consultation — typically pre-surgical alignment, surgery, and a finishing orthodontic phase.

The Operation

TMJ Surgery

Surgical treatment of temporomandibular joint disease that has not responded to conservative management — including arthroscopy, open arthroplasty, and total joint replacement for end-stage disease.

Procedures included

Arthrocentesis and arthroscopy for early intracapsular disease
Open joint arthroplasty
Condylectomy
Total joint replacement for end-stage degenerative disease

A note for patients with long histories of jaw pain

We do not consider surgery first. Most TMJ patients are seen in consultation, evaluated with imaging, and recommended a course of conservative care before any surgical option is put on the table. If surgery is the right answer, we will be direct about that.

The Operation

Zygomatic & Pterygoid Implants

Full-arch implant rehabilitation for patients with severe bone loss who are not candidates for conventional implants or sinus lifts. Anchored in the zygomatic bone or pterygoid plates rather than the maxilla.

Who this is for

Patients — often in their fifties through seventies — who have been told they "don't have enough bone" for standard implants and have been bounced between providers. Zygomatic and pterygoid implants are not a fallback. For the right patient, they are the right operation.

Why on-site fabrication will matter here Coming soon

These cases depend on precise surgical guides. Our in-house 3D printing — coming on-site — will let the guide be fabricated, verified, and adjusted right here in the practice, within a much shorter timeline than outsourced fabrication allows.

The Operation

Full-Arch Rehabilitation

Complete oral reconstruction following full-mouth extraction — combining the surgical work and the prosthetic plan into a single coordinated treatment.

What the patient can expect

A long consultation. A clear written plan with timing, cost, and recovery expectations. A surgical team that has done this many times.

The Operation

Complex Exodontia

Surgical removal of impacted, ankylosed, or structurally compromised teeth in high-complexity presentations — most often as part of a coordinated implant or orthognathic plan.

Begin the Conversation

Request an appointment, or call our office.

Most Track Two patients arrive after research. We expect questions, and we plan our consultations accordingly.

Request an Appointment (586) 281-5615