Non-Surgical TMJ, Overbite & Underbite Treatment

Houston dentist Dr. Ronald Konig is pleased to offer both removable anterior remodeling appliances (RGGA) and fixed anterior remodeling appliances (AGGA) for patients whose malocclusion or facial asymmetry may have previously required surgical intervention. With a remodeling guidance appliance, Dr. Konig can gently restructure the upper jaw allowing the lower jaw to come forward, helping eliminate breathing problems, severe TMJ, and irregular facial development.

If you have been told your TMJ, overbite, or underbite would require surgery to correct, Dr. Konig may be able to offer you a safe, effective, and nonsurgical solution. Please call us at 713-425-1302 to schedule a consultation and evaluation at our Houston office today.


Is an Anterior Growth Guidance Appliance right for me?

The best way to determine if this treatment is right for you is through an evaluation of your facial and jaw structure with Dr. Konig. During this evaluation, Dr. Konig will listen to your concerns, evaluate your symptoms, and examine your face and jaw, enabling him to make the best treatment suggestion for your needs.

You may be the ideal candidate for an anterior growth guidance appliance if you:

  • Have been told your TMJ will require surgery to correct
  • Struggle with breathing issues
  • Find chewing difficult
  • Have an asymmetrical facial structure

Real Patient Results

anterior growth guidance appliance before

Note tucked in midface
Upper and Lower Jaw

anterior growth guidance appliance after

Attractive Profile and
No TMJ after AGGA


How can an Anterior Growth Guidance Appliance help?

Reshaping the upper jaw to a more harmonious position can enhance the facial profile and appearance. The AGGA can also help alleviate problems associated with poor facial profiles, poor jaw alignment, and narrow mouths. TMJ issues, migraine headaches, neck, shoulder and back pain, dizziness, ringing in the ears, mouth breathing, and sleep disorders such as sleep apnea may be reduced or alleviated with the AGGA.


Types of Anterior Growth Guidance Appliances

We offer two types of anterior growth guidance appliances:

  • Removable (RAGGA) – the removable anterior remodeling appliance is best for children with crowding who are still waiting for adult teeth to erupt. Worn at all times, this functional appliance works to expand the upper jaw in all directions, creating space for adult teeth while restructuring the upper jaw for both aesthetic and physical benefit. Once the RAGGA has created ideal dimensions, orthodontic treatment is used to straighten the teeth
  • Fixed (AGGA) – the fixed anterior remodeling appliance is best for adults who struggle with severe TMJ or sleep breathing problems (apnea). Unique among dental expanders, the FAGGA remodels the upper jaw anteroposteriorly to create more tongue space, sometimes helps open airways, and improve TMJ issues. FAGGA treatment may also improve the appearance of the cheekbones, eyes, nose, and lower jaw
MG 6781

Upper Jaw with Initial Placement of AGGA

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AGGA  Upper Jaw Devlopment after 3 months

* Note the creation of space behind the cuspids

Following jaw devopment  with the AGGA, lingual wire is placed to ensure the jaw retains its new size and shape. As with a RAGGA, a special type  of orthodontics is utilized  used to move the other teeth forward to close any spaces created by treatment and to properly straighten the teeth.  This is protraction orthodontics as opposed to retraction orthodontics.


How long will an FAGGA last?

Anterior Remodeling may occur in two phases. The FAGGA, or ARA, comprises the first phase, in which the objective is to create more space in the upper arch and the airway. This can take approximately 7 months. Phase two of treatment may begin right away after the Anterior Remodeling Appliance is removed. In this phase, the objective is to reposition teeth for a healthier, more attractive smile. It can take 12 to 18 months to achieve this. Keep in mind that the benefits of Anterior Remodeling Appliance treatment may be noticed well before the first phase of the process is complete. You may notice a reduction in symptoms from TMJ or sleep apnea, a reduction in mouth breathing, and other changes as your tongue and upper arch respond to treatment. 


Are AGGA's painful to wear?

Generally, the Anterior Remodeling Appliance is very comfortable, though it can take some getting used to. Some patients may experience minor irritation to soft tissues that come into contact with parts of the appliance. It may help to apply orthodontic wax over areas that rub against the cheek or tongue. Beyond this temporary soft-tissue irritation, patients usually encounter no side effects or pain throughout their treatment. 


Additional FAQ'S

The AGGA is different in that is takes advantage of your innate physiological process rather than using mechanical force. Also, the AGGA is able to achieve some remodeling of the upper arch instead of just side-to-side growth, or width that the other types of appliances provide.

Whenever there is a fixed device in the mouth, there may be an increased risk of dental plaque and cavities. Fortunately, it does not take much to keep your Anterior Remodeling Appliance, and your teeth and gums, clean. Routine dental care should consist of brushing twice a day, taking care to touch all of the areas of the mouth, including the spaces around the wire arch support. Flossing is also necessary. A floss threader or water irrigation device may help reach the small spaces around the appliance. If you have questions about how to floss effectively while wearing your fixed appliance, contact us. We are here to help. During your installation visit, we can discuss how to brush and floss effectively to keep your risk of cavities and other dental problems low.

When wearing the ARA (formerly referred to as AGGA), you may be advised to avoid chewing sticky and hard foods. However, for the most part, patients can undergo treatment without having to make drastic lifestyle changes. 

Small Upper or lower jaws affect our appearances and also can increase one's risk of sleep apnea, TMJ dysfunctional, cause headaches and facial pain. Fortunately, there are non-surgical methods such as AGGA, DNA, and ALF appliances combined with other methods to correct these issues even in adults.

Invisalign can give some expansion usually not enough for narrow palates. Slow palatal expansion such as that with the Anterior Remodeling Appliance (AGGA) combined with Controlled Arch Orthodontics can give much more.  The Invisalign primarily uprights the teeth by expanding the bone around the teeth. The slow palatal expansion techniques can expand the palatal bones at any age.


More About RAGGA & Myofunctional Therapy

Tongue thrust, mouth breathing, and unusual breathing patterns may be common in children with midface deficiency. To address these issues, Dr. Konig typically suggests myofunctional therapy, an exercise-based treatment designed to improve the functioning of muscles in the mouth, throat, and face.

Myofunctional therapy focuses on exercises designed to eliminate tongue thrust, an oral health issue that can result in breathing and speech irregularities and alter the appearance of the face. Taking a multidisciplinary approach, Dr. Konig can combine myofunctional therapy with an anterior growth guidance appliance to correct issues caused by orofacial myofunctional disorders (OMDs) in children, helping restore comfort, improve appearance, and reduce risks of developing TMJ in the future. This combination may also be used with a FAGGA for adults who are already struggling with chronic headaches and other consequences of TMJ.


Schedule A Consultation Today!

If you live in Houston, The Woodlands, Sugar Land, Katy, or surrounding areas of Texas and believe you could benefit from an anterior growth guidance appliance, please call Ronald W. Konig, DDS, FAGD, LVIF, FIAPA at 713-668-2289 to schedule an evaluation today.

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Houston Cosmetic Dentist Serving Sugar Land, The Woodlands, Pearland, & Nearby Areas of Texas
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