(updated January 2024)
The all on 4 dental implant full mouth solution is not without problems. In fact, many patients come to me to fix all-on-4 dental implant problems and remove failed implants. It is a major decision to have this treatment done.
In very skilled hands, this procedure has a very high success rate. There can be problems both long-term and short-term. These complications can be minimized by having treatment with a very experienced team that cares about the long-term outcome.
Keep in mind that the term “all on 4” is a catch-all term for full mouth dental implants. It could be all on 5 or 6 as well. The number of implants is not as important as where they are placed in the mouth (AP SPREAD)
The current thinking is that 4 implants is enough. That was not always the case. I have found the success of all on 4 to be equal to that of all on 5 or 6. Having more implants sometimes causes some of the complications listed below! Even my own thinking has changed over time after more than 10,000 implant placements and 22 years of experience. More is not always better!
I feel like it is my responsibility to make sure there is good information on the positives and negatives of all-on-4 dental implants and all-on-6. These are meant to inform you, not to alert you.
Ramsey Amin DDS
The experience level of the all-on-4/6 team
The experience of the surgeon performing the all on 4 procedure is most important for long or short-term success. Ask your surgeon to see results from 15-20 years ago. There is no doubt that a dentist who has done this routinely for a longer time often has a higher success rate.
The laboratory making the bridge can literally make or break the success or failure, as well. There is so much to the lab fabrication process. It is similar to building a complex architectural structure. It only takes one thing done incorrectly to cause problems years later.
For example, when zirconia is made, it has to be sintered and cooled at a certain rate over several hours. Some do not have the patience for this, which leads to a broken bridge. These are details at a microscopic level that cannot be seen by the patient.
So what are some other reasons why all on 4 dental implants fail? Let’s learn more…
9 Common All-on-4 Dental Implant Problems
1) Bulkiness of All-On-4 implants
The all on 4 or 6 dental implant replaces not only your teeth, but it replaces missing gum and missing bone, as well. This is why there is a pink component. Because it is replacing these 3 things it is going to feel bulkier then your natural teeth. Sometimes zygomatic implants can have a little bit more thickness on the bridge on the inside of the upper as well.
Unlike natural teeth that are not connected to one another, the bridge is a solid horseshoe shape. It is important that it is connected from one side to another as that gives “cross arch stability” which is critical for long-term success. A full set of dental implants that have severe bone loss or significant underbite or overbite tend to be a little bit bulkier than those with regular bite and moderate bone loss.
2) Broken All on 4/6 dental implants
There are not any all on 4 dental implant bridge materials that are indestructible. The preferred material is zirconia for the bridge. When made correctly, zirconia is the most durable material for the bridge (not zirconia bone implants). It is important that the bridge is designed to be convex and easy to clean everywhere while at the same time maintaining a minimum material thickness to prevent fracture. Most of the all on X dental implant bridges that fracture often are due to bite problems or insufficient bridge thickness from the gumline to the top of the teeth. I am not talking about the width but rather the height. If it is not the right dimensions it will crack in half. Sometimes having too many implants also causes this to happen
Fracture of the all on 4 dental implant bridges most common with patients that have acrylic fused to metal bridges. These are often referred to as a “hybrid.” Because acrylic is a plastic, the teeth fracture off. They also wear down in just a few years. I never do hybrid acrylic fused to metal implant restorations. These are essentially plastic dentures attached to the implants!
The implants in the actual bone can also fracture. This is more common when softer, grade 4 conical implants are used. This is more common in the Asian brands of dental implants. I prefer a grade 23 titanium alloy made in America or in Europe. I have yet to personally ever have an implant fracture but I have treated MANY of them as implant complication rescue/salvage procedures.
Implants are fused to the bone so they have no give. There are no shock absorbers like teeth. Some people that grind their teeth also have higher risk of fracture. They can need a night guard and/or Botox/Xeomin in the chewing muscles to control the bite. A bite that is not level can fracture zirconia or hybrid all on 4/6 implant teeth.
3) Heaviness of Zirconia Of All On 4/6
Very few people have a problem with the heaviness of a zirconia all on 4 bridge. Usually within a few hours they have adapted. Because the material is very strong and it is heavier than acrylic. Some people will say that there is a loud sound when they click their teeth together. As long as the facial measurements are correct this should never be a problem unless you are purposely smacking your teeth together making a clanking sound.
4) Implant Failure After The All On X Implant Bridge Is Inserted
Implants can fail. If implant failure happens after the final bridges done there are very few options to replace the implant while keeping the same bridge. Usually if an implant fails in the midportion of the bridge it can be removed and the all on 4 can be supported by the remaining implants.
If the implant is on the end, the terminal support, oftentimes the entire bridge would have to be remade even if multiunit abutments are used. I have done some creative things in the past to salvage and fix many all-on-4 dental implant problems and fix failing situations.
5) Bone Loss/Gum Recession
It is possible for the metal of the implant itself or dental implant abutment to become exposed. It is not uncommon for just the abutment to show especially on a lower full arch all on 4/6. Sometimes this is purposely done in order to make the teeth very “highwater” cleansable. If this occurs where the implant showing because of thinning gum or thinning bone then usually a gum graft can be done to cover it and slow down/stop the gum recession.
The way to avoid this is to have thick gums from day 1. Some people genetically have much thicker gums than others. Those that have thin gums often need gum grafting taken from the palate.
6) Infected All-On-4 dental implants
Infection can happen after the surgery or can happen years later. Infections that happen early are usually easily treatable. Late infections can cause bone and gum loss around the implants (peri-implantitis). It is important that you are monitored by a skilled dentist that knows what they are looking at.
Infections generally enter through the pockets between the bone and the gum. Daily home oral hygiene and not smoking/vaping are probably the two biggest factors in prevention of infection of full mouth dental implants.
Recurrence of your original gum disease can come back around the implants. There are times where the bad bacteria that destroyed your teeth can return to do the same damage around the implants. This can sometimes be prevented by using special antibiotic cocktails at the time of or just before the all on 4/6 surgery.
Infection around implants is often called peri-implantitis or peri-implant mucositis.
7) All On 4 Dental Implants Have Less “Feel”
Because all on 4 dental implants have no nerves it is hard to “feel” your bite all the time. This is referred to as “proprioception.” In time this will begin to feel more normal. You will not be able to feel temperature such as cold with the teeth but that is not necessarily a bad thing.
8) Speech May Become Altered
Speech alteration from the all on 4 procedure is usually temporary. Most people will regain their current speech pattern after a short time. It takes some time to adapt. Because the teeth feel thicker some people just need a little bit longer. This can be greatly reduced by using facial scan and digital scanning technologies in the pre-design phase before surgery is ever done. On a rare occasion a speech therapist may be required.
9) Lack Of Lip Or Face Support
I have written on this topic extensively. It is imperative that your lip and face look and feel good with the all on X dental implant full mouth restoration. Lip and face support is hinged upon your pretreatment diagnosis and measurements. If the bone leveling is accurate, the lip or face should be able to be supported with a fixed bridge rather than a removable snap on overdenture. This is often based on the skill of the providing dentist.
For some who have facial wrinkles, additional skin fillers may be needed. This is rarely the case in my practice where we use facial scanning technology to accurately determine lip position. It is important that the teeth get tested with prototypes to make sure the lip and face are filled out well.
Too much lip and face support may lead to lip biting while to little may lead to tongue biting. A problem can occur if the “transition line” shows when you smile. This is the line between your natural gums and the gums of the all on 4 implant bridge. Preferably this line is hidden and the lip and face do not feel caved in. This is very much an art to achieving good facial profile without looking old too toothy.
What to do if you’re experiencing all-on-4 dental implant problems
Sadly, about 35% of what Dr. Ramsey Amin D.D.S. performs is “re-do” implant dentistry…saving, removing, or replacing failed dental implants with problems.
Not only do we treat patients for with complex single front tooth to full mouth (all on 4 implants), but unfortunately an increasing amount of patients who have problems with dental implants. Some travel from all over the USA to see Dr. Ramsey Amin
The first step to fixing all-on-4 dental implant problems is to schedule a consultation at my office. We will then discuss all of your options to fix the failed dental implants. Once we decide the best course of treatment, we will schedule a subsequent appointment.
Hello Dr Amin
My name is Jan and you replied to me in April of 2023. I had the All on 4 procedure in Oct 2022. Many problems with my temporary fixed prosthesis. My dentist referred me for a second opinion to the specialist that had trained them in the all on 4 surgery and procedures. He is located 1.5 hours away in Fresno, Ca. Supposed to be the best of the best in knowledge of the All on 4 procedures, travels the USA teaching the digital implant surgery process. He opened up my VDO and scanned my mouth, made The first set of teeth which he didn’t like because they were too narrow on the arch and were painful. The second set made on a titanium bar when the screws were tightened put to much pressure on the implants ( very very painful )the upper and lower front teeth closing hit edge to edge. After the third attempt he didn’t know what the problem was. He basically said he could take out the abutments and put the implants to sleep. He wasn’t a fan of the snap in overdentures . The location of the implants was good and they were healthy. After paying so much for the 8 implants I didn’t want to disable them and give up on the all on 4 concept. I am now back with the surgeon and dentist that did my surgery. Between the two dentists there has been 10 attempts to make the digital dentures. With each set the upper and lower front teeth are edge to edge and when chewing food after a while the bone around the implants ache. Also my lower teeth are wider than the top teeth so when I close the lower teeth do not fit under the upper teeth. ( occlusion is not like puzzle pieces fitting together) the lower jaw slides forward making upper and lower teeth edge to edge and the arch of teeth are too narrow in the front canine area. These are digital processed, does the scan show how your jaws close on each other when you naturally close your mouth? When these teeth are secured on the implants the upper and lower teeth are not aligned when closing my jaws. Too much pressure on the implants because the teeth are not fitting together properly. Do you have any idea why the digital program always set the upper teeth back to far ( not enough lip support) or is it the lower teeth to forward.? With the constant pressure of the upper and lower teeth hitting when I eat or chew the tissue around the implants hurt and my mouth stays sore. I wear a night guard and even had Botox in case I was clenching at night. Apparently there is a defect in my bones or face structure that the scan doesn’t detect. I have been in pain for 16 months and still wearing the temporary fixed dentures. It seems impossible for the designer to find a design and the lab to process a prosthesis that fits my arch and isn’t painful. Would you recommend trying the snap in overdentures? Or would I have the same issues because they are implant supported also? Feel hopeless and at a loss knowing what to do next! Thank you so much.
Hello Dr. Ramsey Amin,
I had All ON-4 dental implant surgery on 10/16/2023. I lost my 25-year-old daughter on 9/5/2023. I had the appointment in place before the death of my daughter and she was overjoyed I was finally getting my teeth fixed after saving for so long. My husband and I thought about canceling the procedure but then felt it would honor our daughter to have the procedure done. I am giving you this background because, besides the complications
(we had quite a few mishaps) with the surgery and my being under stress (no nightguard was given until my 3rd visit on 10/30/2023), and some research I have been doing, I came across bruxism. I never thought I had this problem, but wondering, if due to the stress of losing my daughter, I have been grinding to the point that I have pain in my lower implant. The pain is targeted to left-right molar pain when I try to chew, throbbing in the whole lower jaw, the throbbing has changed to more of a sharp pain since 1/15 2024, when my first after-surgery x-ray showed a line (space) in the right front implant, that was tightened that day (1/15/2024), a new second x-ray taken, and no line (space) was seen.
To this date 2/4/2024 I am still having pain and in my temporary. I am being told the pain is because of poor blood circulation, and it will take a bit longer to heal. He did do an ISQ, I do not have a copy of my records yet, but the numbers were 40 through 60 across the bottom implants.
I now regret I did this with the emotional stress and pain I was under. I am in physical pain with my bottom implant and feel it may be a failed implant. Should I have pain? My surgery was 3 months and a week
I’m deeply sorry to hear about the immense loss you’ve experienced with the passing of your daughter, and the subsequent challenges you’ve faced with your dental implant surgery. It’s understandable that you and your husband decided to go through with the procedure as a way to honor your daughter’s memory, especially considering how much it meant to her that you were taking this step for yourself. The emotional and physical stress you’re going through is significant, and it’s important to acknowledge the strength it takes to navigate such a difficult time.
Regarding the pain you’re experiencing with your implants, it’s not uncommon for stress, especially at the level you’ve been enduring, to manifest physically, such as through bruxism—where you might grind or clench your teeth, sometimes without even realizing it. This can indeed put additional strain on your dental implants and the surrounding muscles and tissues, potentially leading to the symptoms you’re describing. A nightguard can help mitigate the effects of grinding but not 100%.
It’s also worth noting that the ISQ (Implant Stability Quotient) values you mentioned, ranging from 40 through 60, can indicate varying levels of stability across your implants, which might explain some of the discomfort you’re experiencing. However, these values can also change as the healing process progresses.
Given the complexity of your situation, both emotionally and physically, it’s understandable to feel regret and concern over the procedure, especially when the healing process is complicated by factors like bruxism and the stress you’ve been under.
In our office, we often employ treatments such as Botox to help relax the muscles involved in bruxism. This approach can provide relief from the pain caused by the constant grinding or clenching, particularly in complex cases where traditional methods may not be sufficient. Botox can help alleviate the muscle tension and reduce the stress on your implants, which might be beneficial in your case, especially considering the ongoing pain and the complications you’ve faced post-surgery.
It’s important to continue closely communicating with your dental specialist about your concerns and symptoms. Sharing your emotional and physical state, including the stress-related bruxism, can help them tailor your treatment plan more effectively. Also, consider discussing the option of using Botox or other muscle-relaxing treatments to address the bruxism and potentially alleviate some of your discomfort.
Remember, it’s perfectly normal to seek a second opinion if you’re uncertain about your current treatment plan or if you feel your concerns are not being fully addressed. Your comfort and healing are paramount, and exploring all available options to support your recovery is crucial.
Please take care of yourself during this challenging time, and don’t hesitate to reach out for support, whether from healthcare professionals, family, or friends. You’re navigating a tough journey, and it’s important to have a supportive network around you.❤️
Hello Dr. Thank you in advance for taking the time to respond to so many people. Pretty cool. I had an upper denture for 20+ years and last June my incisor broke. I decided it was time for a permanent solution so I elected for the all on 4 due to the benefits of non removable teeth and no down time with no teeth. In early Sept. I began Phase I which was pulling 4 more teeth and bone grafting to build up arch deterioration identified by my surgeon. I had temp flippers in top and bottom for 3 months while this healed. Phase 2 was 3D imaging etc. that took place in November. Phase 3 took place December 13th and consisted of removing the 15 remaining teeth and 4 upper/4 lower implants.
Today is my 6th day since surgery and I’m not in significant pain nor do my temporary teeth hurt my mouth. My swelling is mostly subsided and had no visible bruising. So good things but my speech is difficult like many have mentioned and some bite issued with the right sides contact.
My question is regarding the temporary teeth. First off it was determined immediately after surgery while my temp was being fitted that the center line of front teeth was going to be off. To my left and it pretty obvious the upper was not fitting as expected. After reading all of people here it would seem that redo of the upper would be required. My dentist says they absolutely cannot take off the temp until week 12 when my final teeth would be installed. She is insistent that this fitment is not an issue and will all be corrected with the permanent teeth. To date I have spent $56K and my final permanent teeth are over $20K 12 weeks from now.
Shouldn’t the temp teeth be the time to work out these issues? I am leaning towards finding another professional to evaluate my current condition and complete the rest of the work with the permanents as well.
Sorry for the long explanation, and thank you in advance for your attention. Your responses are really unlike anybody I have come across. I am really blown away that you afford as much time and attention to people that are not your clients. This is a life altering procedure you are give your professional perspective on and that deserves the highest praise in the world.
If you were local I would already have called and made an appointment for your services. Thanks you Doc
Thank you for your kind words and happy holidays to you too! Regarding your All-On-4 procedure and the temporary teeth, if there are significant changes needed, it’s advisable to make another set of healing teeth (PMMA) before moving to the final ones. If the implants were placed with high torque and are on multiunit abutments, you can typically start this process around week 6. However, if the bone was soft or if there are no multiunit abutments, it’s better to wait for about 12-16 weeks. I use facial scan technology to precisely address these kinds of issues. It’s essential to get the temporary teeth right, as they set the stage for the final ones.
Hello, I just found your website today. I had the All on 4 implants on the upper and lower in July 2023. My upper prosthesis has broken in half four times, in the exact same place, #7. Can you please tell me what could be causing this? I hate to tell you what my oral surgeon has to say. Please advise. Thank you.
Several factors could be contributing to the repeated breakage of your upper prosthesis at #7. These could include issues related to the material used for the bridge, the design and thickness of the bridge, bite problems, or the number and placement of implants. It is crucial that the bridge is designed to be both easy to clean and sufficiently thick to prevent fracture. The article emphasizes that both the surgical team’s experience and the lab fabrication process play significant roles in the success and durability of the implant. What did the surgeon say?
I went to a consultation because I had been wearing dentures for a year and I was starting to notice bone loss. At the consultation, I spoke with the surgeon and I asked him if I would need bone grafting and he said “no.” I trusted him, plus I didn’t necessarily want to do bone grafting, but I would have if I knew it was necessary. They never spoke to me about it again, never gave me an option or nothing about it, at the time I didn’t think this was odd because he said i didnt need it. I had “all-on-4” procedure done on 10/19/2023. The temps they put in were absolutely ridiculous looking. The tops were slanted and the bottoms looked like a rollercoaster. The bottoms felt like they were not wide enough. I had to over extend my bite to get them to touch. Alright, they are temps i told myself. So a week later I go back and tell the dentist my concerns. He told me I was wrong about the width, he told me he could extend my teeth, after I requested that he just add material to bring my gum line down, but he suggested not to and I believed him because he is supposed to be a professional. Then he puts two pieces of rubber in my mouth and takes scans and then gives me an appointment for 10 days later. Then he gives me my final prosthetics (which i though was wierd because how could they even have fixed my issues, or even tell what issues I had a week after surgery when I was still swollen?) I leave and throughout the day I realize my bottoms are jabbing into my tongue. I open my mouth and look in the mirror and my bottoms are completely off the ridgeline on my left side and curved into my tongue. They were hurting me, so I called and asked if i could come in and have them taken out and replaced with the temps again, not because I like them, but just because they were smaller and didn’t hurt. To me, its absolutely ridiculous that they missed the ridgeline. They told me it was necessary because of my “extreme case of boneloss.” Yet they never told me before the surgery that if I didnt do bone grafting I wouldn’t be able to have teeth on my ridgeline? Does that sound right to you? I asked my dentist why I was never given the option to do bonegrafting and he said because it has a low success rate and its time consuming. Every concern I have they give me a cookie cut response “each case is different” “your case was too extreme” BTW: Bone grafting was included in the package I paid for if i needed it. The surgeon said I didn’t need it and that was the last we spoke about it.
I feel like i’m getting the run around here.
I’m truly sorry to hear about the challenges and frustrations you’ve been experiencing with your dental treatment. It’s understandably distressing when things don’t go as expected, especially with something as important as your teeth!
Regarding the bone grafting, it can indeed be a complex decision. In some cases, especially with significant bone loss, it might seem like a necessary step. However, based on the article bone grafting is not always required for successful implant procedures, even in cases of substantial bone loss. The success of procedures like “all-on-4” often depends more on the strategic placement of the implants rather than the quantity of bone available. It’s important to trust that your surgeon made this decision based on their professional assessment of your specific situation.
That said, it’s concerning to hear about the issues you’ve faced with the temporary and final prosthetics. It’s crucial for these to be comfortable, functional, and aesthetically pleasing. The process of adjusting to new prosthetics can indeed be challenging and sometimes requires several adjustments. Rarely, it is not possible.
In your case, going through the temporary PMMA process seems like a sensible step. This process allows for a period of adjustment where any necessary changes can be made before finalizing the permanent prosthetics. It’s a phase where both you and your dentist can assess the fit, function, and appearance of the prosthetics and make necessary adjustments. This approach could lead to a more satisfactory and comfortable final outcome.
Dear dr Amin, i had a full set implant 5 up and 6 lower jaw. I still have the prosthetics until October when i get the permanent fitted. I have a lisp due to the bulkiness of the prosthetics where my tongue is touching the sides of the lower back of the prosthetics.My questions are, will the permanent teeth stop the lisp and ive noticed i can see some of screws between my gum line and the prosthetics,is this normal at this stage until my permanent teeth are placed ? Any advice would be greatful.
Without seeing you I can’t exactly answer this. Is there a gap under your bridge?
Generally speaking how far do the abutments stick out of gums I have my first set of temps And I know It’s normal for there to be a gap in between the gums end and the Temporary implant But it seems like The gap has gotten bigger and The abutments Are sticking out further than they were before but there’s no pain or swelling or bleeding So if they are Being pulled further out of my gums just slightly is that a bug problem or is that OK as long as they don’t become loose
It is ok and normal during the healing process for most cases 😉
https://burbankdentalimplants.com/gap-space-under-my-implant-bridge/
Is having upper all on 4 implants only . . . and leaving lower teeth as is more problematic than doing both upper and lower? Will the upper all on 4 be comfortable in conjunction with original lower teeth?
If your lower teeth are health AND the bite plane is flat then keep your teeth!
My all on four teeth constantly click clack when they touch each other. Does this ever go away or is there a hack to get it to stop? The filling in the access screw holes stopped the sound for about 2 days. The fillings have sunk deeper down the access holes and no longer stop the sound. Should the filling be flush with the teeth?
When you talk naturally do they click?
No, While I’m talking I don’t get alot of clicking except certain words. When trying to smile or close mouth between words you can hear them well. I’ve had my finals in about 2 and a half months and they are zirconia. Even when trying to put them together slowly and softly the sound is a hard click. Is this normal? I find myself trying to leave my teeth apart to avoid the sound of accidental touching.
Sound when you touch is normal but I think your measurements are “over opened.”
Most people never even really touch. They just get super close together.
Hello,
I would like to thank you for your response to my questions. Much appreciated.
Thank you for the reply. I cannot find my original post. Is there a way that these implants can be removed and I can convert to traditional dentures?
Hello,
I currently have 4 implants on top (2 zygomatic) and 6 on bottom. These are my permanent ones and they are feeling awful. They are very tight and click when I speak. They are a lot more bulky than the prototypes were but my prosthodontist does not want to remake them. I am devastated about how this has turned out and I am completely lost. I feel myself slipping into a very dark place. Can these implants be removed even though the have fully integrated? Also, can I opt for traditional dentures at this point? Thank you for your response.
If the prototypes were acceptable thickness why were the finals thickened? It cost a little bit more but you can add titanium bars under the zirconia and make them thinner.
Can you post an x-ray to a public Google Drive? There is no way to Post xrays here so you would need to posted publicly.
You can even post some of your photos as well if you want me to see it.
Thank you for your quick reply. Is there a way to remove these intergrated implants and convert to traditional dentures?
I think we recently talked? Is this you?
Hello,
Thank you for taking the time to read my comment. I had the all on 4 procedure done December 1, 2022. They place 4 on top (2 Zygomatic Implants) and six on bottom. From the beginning I have had discomfort of pressure and tightness in the upper arch and numbness in the bottom. The numbness finally subsided about 3 months into my healing process. I received my first set of temps and the bite was severely off. They attempted to adjust it enough for me to wear them while a second set was made. Every time I would eat, there would be horrible pain in the upper back implant area. They decided to.put me back in my healing teeth until the new ones come on. The new temps were not any better. They were extremely tight in the upper arch and the nerve pain and numbness returned. They told me all this would be resolved with the permanent ones. We’ll that is not the case. They are very tight and I feel like they hit whenever I move my mouth. At this point, I want them out of my mouth. My question is, can these implants that are integrated be removed and traditional dentures placed?
Again, thank you for your time.
It was great meeting you. I hope I have helped 😇
have had 4 front bottom implant teeth in now for 6 months. my speech is still off, but dr. says it sounded ok to him.these are permanent bottom teeth and 1 top eye tooth. i don’t even like to talk to people because to me its like I don’t say the letters correctely. they don’t hurt, just my speech is off at different times with certain letters, mainly the S sounding words.any advice? been back 3 times for dr to shave off front and backs . says he can’t shave anymore off, would be to thin and might break. any advice?
A speech therapist might help but it is possible your “vertical dimension of occlusion” is too open. Has it improved?
Is it normal after three month to have a little movement of the temporary teeth?
No. Get this looked at asap
Hello Dr Amin,
Thank you for the April 17 2023 reply to my many pleas for help.
I believe you are 100% correct, the surgeon that did the alevoplasty surgery and placed the implants has 25 years experience. The prosthodontist has at least 25 yrs experience. The problem is the turnover in the lab leaves them with inexperienced staff that is not familiar with the digital designing and processing technique. Ill fitting non passive. This procedure (no extraction of any teeth) the bone and tissue reduction with 8 implants placed was 56K (not really cut rate) Hopefully this will all work out, I have given up on what could possibly be the problem. After 6 attempts to correctly taper the upper arch teeth resulted in the midline being off at least 1/8 inch, and the arch being to tapered and tight. Front upper teeth over jet and loss of lip support. You would think the midline is not that complicated to correct. I have excepted the fact that I may soon have to remove the implants to relieve the pain, expensive lesson learned! You helped me to understand that this procedure is not for everyone. I wish I had just went with conventional dentures, but had to try before I knew. Bless you for helping so many people.
Wishes for good health and happiness.
Had all on 4 upper and lower done in April the temporary teeth I have to move my jaw to the left so the bite is closing. With my natural bite just the right side goes together. Now feels like the fight side moves some up and down when I bite down with any pressure
It sounds like your bite just needs to be re-aligned for the finals?
Is it normal for my bottom ones to move or wiggle up down and side to side? Like there is a little play I. Them ?
No …you need to get this looked at!
Dr, Amin,
I am still on my first temporary All On Four implant plate. My issue is that I cannot bite hard without pain. If I press on the upper plate I can feel pressure like its moving, but the surgeon says it is not. He says the tissue is very healthy. Any ideas? Also, the temporary has an over-bite that covers my original lower teeth. Is this normal?
Usually we try to make the bite more normal not create an overbite unless you are lacking lip support as mentioned in the article. The best thing you can do to check for pain as have the bridge removed and check the torque and percussion sensitivity on every multiunit abutment individually. That will allow the surgeon and you to test every implant individually to see where the pain is coming from. You might have a failing implant. I hope I am wrong!
I have had my permanent All on 4 implants on the upper arch for about 3 months. Why do I keep biting the inside of my bottom lip when I chew? After this happens, the inside of my lip gets very sore and develops a blister for about 3, or 4 days. My dental office keeps saying it takes time, but I am starting to regret getting this done. Could the upper teeth be set too far back?? I am feeling so discouraged…
The teeth are not in the right position. You need to make another set of teeth at new measurements before the finals and then test it. A facial scanner would be a HUGE help.
I just had my upper hybrid done today. I hate the aesthetic and it’s covering like half of the roof of my mouth. Is this normal? Do these things typically get fixed with the final?
Think of your new dental prosthesis—like a bridge for your teeth—as if it’s a custom-tailored suit. You wouldn’t want the tailor to just guess your size and hand you the final product without first making sure it fits perfectly, right?
Well, if your dentist wants to be absolutely sure that your new teeth fit your mouth just right, work well when you’re eating and speaking, and look good. To do this, they make a prototype, which is a lot like a rough draft or a practice version.
This prototype is called a “full arch protype” and it’s like a rehearsal for your mouth. Here’s why it must be ideal before making the final piece:
Fit: Just like a shoe has to fit your foot comfortably, your new teeth must fit in your mouth perfectly. This means no pinching, no discomfort, and no loose parts.
Function: You need to be able to chew and talk as you normally would. The prototype helps to test all these functions. If there’s something not quite right, it’s easier to adjust the prototype than to change the final product.
Form: Your smile is important! The prototype helps to see how the final prosthesis will look. It’s your chance to say if you’re happy with the appearance or if there are changes you’d like to make.
Foundation: Imagine building a house without a blueprint. The prototype serves as a guide to make sure the final prosthesis will be exactly what you need.
By taking the time to make the prototype perfect, the dentist ensures that the final prosthesis will be comfortable, functional, and aesthetically pleasing, avoiding any unexpected problems or adjustments after it’s been made. It’s all about making sure you end up with a smile that feels as good as it looks!
Hi Dr..I had the all on 4 procedure done just last month on March 22, 2023. After surgery my entire face was black and blue including my chest plates. The pain was excruciating. They tried to stick the temps in but it was too painful and I was so swollen. To date, I still have no teeth. They keep adjusting the temps. My main issue I cannot chew with them. My mouth feels like it’s filled with tons of teeth leaving no space or room to chew. And feel a little pain and very uncomfortable. I have returned to this office 16 times hoping to leave with teeth but have not. The dentist are making me feel like I’m the problem. I’m told to just wear them and in couple of days they will Feel better. Not true. I’m told these are just temporary and my Permanent teeth will be different. I’m suppose to wear these teeth that I can’t eat with, are centered to the left and show a mouth full of bottom teeth which my original smile never exposed my bottom teeth. I have been without teeth since last September after an accident. I can’t take this anymore and I’m starving. I just want to pay for the surgery and get out. Found a dentist who uses modern technology and consult with him this week. I’m still black and purple from the surgery.
Oh gosh you’re having a bad time. Your situation sounds dreadful. You must be so down. Those teeth are not very comfortable to eat with. I had problems but nothing as bad as yours. I have permanent teeth now and they are not one bit comfortable, but I will have to accept them now. Like you, my dentist thinks I am complaining about nothing and said every thing is normal. It’s not normal and I have invested all my savings etc and I have teeth I don’t like.
I hope you can get sorted soon. Try cream soup and mash the bread in it then let it cool down a bit and let it slip down. Jelly and ice cream is good and yogurt. You must eat , or you will get run down. I will send positive thoughts to you.
God bless
Padraig
I had all on four full denture surgery over 5 years ago. They are the titanium bar kind. I have had a problem with the bottom one cracking in half. I have had to have it redone 4 times and this time they reinforced the left side which kept cracking and now have a crack on right side! The bottom denture is on 5 implants the top has four. I am now on my third prosthadontist and no one seems to be able to tell me why this is happening. I’m not a clenched or grinder so why is this happening?
There are several reasons why an All-on-4 de might continue to break, including:
Bite force: If you have a habit of grinding your teeth or if your bite is not aligned correctly, it can put excess pressure on the All-on-4 bridge, causing it to break. Consider BOTOX
Poor fit: If the All-on-4 bridge is not fitted properly, it can cause undue stress on certain areas, leading to fractures or breaks. This is called PASSIVITY — this is the likely reason in my opinion besides possibly high bite force.
Poor quality materials: If the bridge is made from low-quality materials, it may not be strong enough to withstand the forces of everyday use and may break.
In January 2022 my wife had 27 teeth extracted (one cracked do to periodontal disease years earlier) and all-on-4 upper and lower dental arches placed. At four months the post op arches were replaced by prototype acrylic arches. She has complained since week 2 post-op that the teeth felt too tight, as if her shoes were a few sizes too small. There are no signs of implant failure. The abutments have been torqued to 35 and the arches to 15. Recently, a consulting prosthodontist reduced the torque on the arches to 10 and for the first time since the post op arches were removed and retightened at about 2 weeks, she had no pain with reattachment of the arches. The manufacturer’s guidelines call for 12-15 torque. They are currently tightened to 10 and she thinks that there may be some improvement in the overall pain for the first time in 15 months. Have you ever heard of this? She’s been telling her primary prosthodontist since since two weeks post op that they felt too tight, but he kept telling her all was well and refused to reduce the torque on the arches. Is it safe to keep the arches slightly looser than the manufacturer’s recommendations?
This is a great question. The degree of torque has nothing to do with it.
Likely the bridge has a lack of passivity.
Passivity in a dental implant bridge refers to the degree to which the bridge is able to fit snugly and securely onto the implants without putting any undue pressure on them.
A passive dental implant bridge is designed and manufactured in a way that allows it to sit comfortably on the dental implants without causing any unnecessary movement or pressure. This is important because if the bridge is not passive, it can create stress on the implants and the surrounding bone, which can lead to implant failure, discomfort, and other complications.
In my office I used digital impression and methods to reduce any chance of possible errors.
Think of it like a jigsaw puzzle. A well-designed jigsaw puzzle fits together seamlessly and snugly, without any extra gaps or pressure points. Similarly, a well-made dental implant bridge fits onto the implants in a way that is smooth and secure, without causing any unnecessary pressure or stress.
Reading the article and all comments.
My mom had a all on 4, 7 months ago.
No relieve from pain. Had one implant fail around tooth 11. Begged another oral surgeon to remove one from her midline that we found out later was sitting on her main artery. That pain got better. We think she may be allergic to the titanium. She only has her healing caps on and her lips and red, swollen and have bumps. Been to 4 oral surgeons, seeing a pathologist this week. She is addicted to pain meds now after 7 months in pain with no relieve. Most doctors around her won’t touch her because it is someone’s else’s work. Would could be causing this pain? Where can we go for help.
Find out the exact brand and model of implant used. Please reference the thread above. I have an idea for you that has worked in the past. I treated a patient EXACTLY like this a few months ago. Also, please upload an x-ray to a public share file such as google drive to this thread please
Hi
I had my permanent all on four fitted yesterday and what a disappointment. I was so excited and looking forward to to having the new teeth I did not sleep well. The problem is, the teeth are clanking when I move my mouth. If I walk up, down the stairs the teeth clunk all the time even when I walk I can hear them. Can this be sorted? I mentioned this to my dentist when he fitted them and he said it was normal, is this so. I have read all your comments and you make things easy to understand. I am so disappointed and just cancelled a holiday that I was due to go on Saturday. I will look forward to hearing your comment. Thank you and god bless you for taking time to respond to all the comments.
Your vertical dimension of occlusion is off. The vertical dimension of occlusion refers to how far apart your upper and lower teeth are when they come together. When this dimension is “over opened,” it means that the upper and lower teeth are too far apart from each other.
This can happen due to improper measurements. When the vertical dimension is over opened, it can cause problems such as jaw pain, difficulty in biting or chewing, make your teeth hit together when you speak, and even changes in the appearance of the face.
Think of it like a door that doesn’t close properly because the hinges are loose, and the door is hanging too low. In the same way, when the teeth don’t come together properly, it can cause discomfort and other issues.
Was it like this in the temporary phase?
Thank you so much that all make perfect sense
Hi Dr Amin
Hope things are well with you!
I had the all on 4 fixed immediate load implant procedure Oct 5, 2022
I have had a lot of problems trying to wear the temporary fixed dentures. The implants are completely healed and very stable in the bone, no issues there. The problem is the dentist has had 3 sets of temporaries made, changed some abutments, removed more tissue and made 2 more sets. None of the 5 fit and caused a lot of pressure and a pulling sensation when the retainer screws are torqued. It feels like something is squeezing the arch together, after a few hours wearing them it starts aching. The digital program is new to this office so my dentist is at a loss as to what could be the problem. He has a out of town designer he is depending on. I have been in his office 1-2 times per week for 5 months getting adjustments and new temporary teeth to test drive. Should have been getting final dentures and I am still in pain with the temps. All of these digital dentures are to wide across arch from canine to canine. They are kind of square and my mouth is a slightly tapered U shape. The left side teeth are close to the arch, the right side teeth and gum tissue from the canine back to molar is out about 1/8 inch past the arch. When I smile my lip gets caught on top of the canine, the canine and teeth on each side of it rubs on the inside of upper lip. My dentist said the position of the gum tissue and teeth on the denture should not make a difference in the pressure on the implants. I am not a doctor but I feel the pulling pressure in the implants when all 4 screws are tightened and I bite.Do you think since it has been several months and apparently the fixed screw retained dentures are not working for me, that I should try something different? Can these implant abutments be converted for snap on over dentures or would I have the same problems with those because they are still implant supported. I am so heartbroken because I invested so much money, dealt with so much pain, and am at the point I just want to get free of the pain. Wearing the fixed dentures is painful, having no dentures in my mouth is painful because the implants hit each other. Please if you have any suggestions on what I can do, I would appreciate your thoughts on this mystery! Could the dentures being to wide affect the implants, the retainer screws do line up with the abutments, could that be possible but still cause this pulling pressure and pain in palate above the implants. Thank you Jan
Please see my other reply
Hello Dr. Amin
Have you ever heard of a problem with implants interfering with the Cranial Rhythm. I have the all on 4 implants with temporary prosthesis. When the retainer screws are torqued the upper arch feels like it is being squeezed together. Have been dealing with this for 6 months and several sets of temporary prosthesis. The implants seem to be strong and solid. My dentist doesn’t know why this is happening. I read an article on line about the cranial function, according to this doctor/ dentist having a implant prosthesis or bridge that crosses the midline can interfere with cranial fluid function. Therefore headaches and the squeezing across the anterior arch is the issue. The dental office lab has printed several sets of the oral scanned digital teeth. The first few sets were to square across the upper arch (canines rubbed lip) and the midline was off to the right. The last set was milled, the dentist had the lab taper the arch and correct the bite and the midline. In doing that the teeth feel to tight across the arch (like they were moved in to far), the midline is about 1/8 inch off (now to the left) and the front teeth are now shorter. My upper lip looks flat and the bottom of my lip kinda folds under my teeth. Lost the lip support with the changes . Why is it so difficult for the lab to produce a digital fixed prosthesis with the midline and teeth in the correct place? I have tried the printed and the milled. What could have happened to change this prosthesis so much, the same scan was used to make them both? Just a different design. This one is more painful than any of the previous! I know they are having problems in their lab but isn’t the digital dentures pretty standard if you have all the detailed measurements in the program? I am afraid I will have to down grade to the snap on overdenture if it is impossible to correct these issues with the fixed. I know some of the articles read online is not accurate, and you have years of experience with the dental implant procedures. Have you ever heard of this Cranial Rhythm interference or had a patient that experienced the arch squeezing sensation when all the retainer screws are torqued ? If it is correct, should I have this checked by a cranial chiropractor as the article suggested? Could all of these issue be from a poorly designed and ill fitting prosthesis? You have replied to my questions before and I sincerely appreciate your time! Thank you
Dr. Amin Thank you so very much! I think you are correct, the bridge for my all on 4 is not passive with the implants. It has been 7 months and 7 sets of the digital bridges and none seem to fit comfortable. No one seems to know how to fix the problem, and if it continues it will eventually cause the implants to fail. I am going to convert to the overdentures, the fixed are so painful they make me feel sick and I have to live with it until I can get to the doctor to remove them. You have been very helpful, bless you for taking the time to answer so many questions!
Dr. Amin
A huge thank you!
I am in the process of the all on 4 procedure. Lots of problems but I can read the comments you have given others and keep a positive attitude. It is very uplifting in todays world that a doctor would take the time to answer questions and give advice. I am a 68 yr old woman and you are educating me in dentistry, I read your post and watch your videos. All very interesting. Thank you and God bless!
you are very welcome
Dr. Amin,
THANK YOU SO MUCH for caring about people enough to take the time to answer important questions! May the kindness that you put out to others be returned to you, a thousandfold.
Sincerely,
Jami Smith
I have an acrylic upper all on 4 and just lost a tooth. About 4 yrs old. Can it be repaired or should I go with porcelain?
Material: Zirconia is a ceramic material that is known for its strength, durability, and biocompatibility. Acrylic fused to metal is a combination of acrylic resin and a metal substructure.
Strength: Zirconia is a much stronger material than acrylic fused to metal, making it a good option for patients with bruxism or a strong bite. It is also less prone to chipping or cracking.
Esthetics: Zirconia has a more natural and translucent appearance, similar to natural teeth, making it a popular choice for front teeth restorations. Acrylic fused to metal, on the other hand, may appear more opaque and less natural-looking.
Cost: Zirconia is typically more expensive than acrylic fused to metal due to its superior strength and esthetics.
When it comes to all on 4 bridges, zirconia is often preferred due to its strength and durability.
Hi I got full upper and lower dental implants with temporary acrylic. About 1 month later I started getting canker sores lower inner lip and under my tongue…about 10-12! My surgeon prescribed dexamethasone mouth rinse and it went away. After the medication cycle all the canker sores came back in exactly the same places..went on medication again. This cycle has occurred 5 times basically canker sores keep coming back in same spots. I’m getting final zirconia in a few days but I’m concerned why this is happening. I got blood work done to make sure I don’t have any diseases or making me immunocompromised. Have you come across a thing like this? I just don’t know how to cure my situation. Thank you
Are your lips rubbing the bridge too much? This is really odd!
Hi Dr Amin,
I’m 48 old female. It looks like I will need to put zygomatic implants and then all on X. Do you think it will last 20-30 years or I will need to think about another solution in the next 15 years?
Thanks,
Elena
Yes it is possible. But… do you have a lack of “AP spread” causing the need for the zygomatic implants? Do you have room for pterygoid implants as well. Will you get teeth right away?
I am having issues with my final prosthetic. It took four wax try ins and the lab guy decided he was done dealing with me. My bite doesn’t seem right and I am suffering from migraines as well as teeth clenching and grinding. I am at a loss of what to do know and am out tons of money.
Did you have teeth before the procedure? I use those digital molds and face measurements to dial in the bite. Botox for clenching?
Dear Elizabeth,
What part of the country do you live in? I ask, bcz I am going through something very similar! Thanks!
Hi ive had 8 implants on top arch, i went back after six month healing period the dentisg said one had failed but the dentist said it didnt need to be removed he unscrewed the bolt and stitched my gum over it , i had my full arch put on five days afo but the area where he stitched feels very heavy is this ok very worried
If the implant is failed, there is no way to leave it behind. Failed mean loose. Maybe it is tight but not in a great position to be used so it was ‘put to sleep’ under the gums?
My whole mouth acrylic implants are 9 years old and have never given me problems until about two years ago. I noticed the food I chewed was not all clearing away from my gum line. I could not “sweep” it away with my tongue(like my tongue was too short) so it would stay there until I could clear it with my finger or toothbrush. The food is stuck between my natural gum and my implant gum line. Brushing, finger or water pik clears it but I can’t always use these in public. I’m thinking of replacing the implants if this keeps up. I’m 86 years old and hate to spend the money this late in life but I may have too.
If it is acrylic you can “re-tread” the teeth and gums as long as there is a metal bar under it. The teeth have to be taken away to do this but it will fix everything!
Almost four months since all on 6 both arches. I speak with a lisp with this temp. Will the final set be thinner and no lisp?
That is a question for your DDS. I am not sure of the design, etc. A lisp is extremely uncommon. Maybe just the ‘gap’??
Hey David. I also had all on 6 recently and am now speaking with a lisp as well. It seems like the top temporary is too bulky. I understand why it is bulky; to add support. I just hope the finals have less of a footprint than the temps. When are you scheduled to get your permanent set?
Hi Dr Amin,
I had all in four surgery last April and was left with a collapsed face. From day one I was told this would get better with time, however the opposite is true, as the swelling went down, my face looks even more sunken in and I am left with lots of loose skin and wrinkles, which I didn’t have prior to the surgery. Prior to this surgery, I always looked young for my age (I am almost 57), people used to tell my I looked like I was 40, now I look like I am 20 years older. I am trying to figure out how I can get my face back, I don’t look like myself at all. I was not told this could happen. A different dentist told me they cut out all my bone and that’s why I am left with a sunken in face. Why did they cut the bone out??? Anyway, what’s done is done, I just want to know how can I get that bone built back out? The place that did this said there is nothing that can be done. My mouth is back behind my nose, I look awful. I had perfect front teeth, but let them talk me into taking them all out. I wish I had never had this procedure done, it’s devastated me. I just want to know if there is a surgery I can have done to reconstruct my face. Any advice would be greatly appreciated. Thank you! Jill
Oh gosh. You can be full recovered with new PMMA temps. You need to see someone with a lot of experience in this arena. Here are some articles on lip support.
Please let me know what you find out. I’m in a similar situation. 8 months still in temps. I feel like my life is ruined.
Hello Dr. Amin
I have all on 4 fixed immediate load temporary scanned digital dentures as of Oct 2022. Have had a lot of trouble with tissue soreness around the retainer screw ports and pressure in the palate above a couple of the implants when I bite. The dentist or the oral surgeon can’t figure out what is wrong. Last week the oral surgeon adjusted the dentures, he made all the teeth flat no cusps or points. I can close my jaws easier, but I still have the pressure and sore gums. I wear a night guard so I don’t think I am clenching or grinding. I think there is a hiccup somewhere in the digital program. Can you please tell me why he would make all the teeth so flat on these dentures?
I am a bit confused. Are the teeth screwed in or are they denture sitting on top of the gums? If they are dentures then it makes sense to flatten them in the interim before you have the fixed teeth. I am not a fan of this workflow. None of my patients ever wear dentures. They get teeth within 24 hours maximum to keep the pressure off the gums. These are all digitally fabricated off of facial scans and intraoral scans. I call it a blueprint prototype because it almost resembles the final and is really good looking.
Hi Dr. Amin, can I give a bit of my history? In 2019 I had all my teeth removed and porcelain conventional dentures made. I could not wear them because of collapsed bite my left jaw was bone on bone over closure , no room for denture to wrap around. Struggled for over 3 years trying to wear them. At this point I went to the oral surgeon and dentist ( same office ) they agreed that the all on 4 procedure would fix the problem. Having no direct pressure on the gum tissue. In Oct. 2022 I had the surgery smoothed bones, removed tissue and placed implants all on 4 with immediate loading temporary dentures. As off now I have had 2 intraoral scans and 5 sets of digital temporary dentures made and none of them fit correctly. As I explained before the oral surgeon cut the screw retained temporary denture teeth flat, which allowed my jaw to close better. Trying to correct VDO. At this same time he did a 2nd surgery, changed 3 of the upper abutments and removed more tissue from around them. This helped with the tissue pinching. The dentist then made the #5 set of dentures. I am now wearing the upper of that set, the lower did not fit. All of these dentures have been very painful. When I chew food or bite it feels like someone has a clamp around the arch of my teeth squeezing them together. My inside jaw and up in the palate above the implants ache, and when I use the water pik it feels sore on tissue around the screw access holes. It seems like the dentures are to wide for the arch and when the retainer screws are torqued, the pressure is trying to pull them together. I don’t know how the all on 4 fixed dentures are supposed to fit around the arch, these are very close on the left side and teeth follow the contour of the arch but on the right side the gums and teeth are about 1/4 inch out past the arch, as if the left side had been pushed completely to the right. There is a space above the right side canine like a shelf that my lip gets caught on if I smile to big. The dentist doesn’t think this is causing the problem. This surgeon has been doing implants for several years, but the intraoral scanning and digital dentures is a new thing they just started. The dentist keeps telling me he hasn’t had this problem with anyone else but he will keep trying to figure it out. It has been over 4 months I should be close to getting the permanent dentures and I am still having pain with these temporary teeth. The scanned digital dentures are supposed to be accurate in fit and reduce most of the issues people have with the conventional dentures, after 2 intraoral scans and 5 digital dentures. What could be the reason they are not fitting properly? I have told them I feel the dentures are to wide, my mouth is narrow ( sort of v shaped and all the dentures are more of u shape ) they rub the inside of my lip at the canine teeth. I am trying to be patient and do exactly what the doctors say is best, but the constant pressure and pulling feeling in my mouth is getting me down! I know you have a great deal of experience with implants and the digital dentures. Is there any part of my explanation that makes sense to you or can give you a clue as to what might be going on with me? I am worried that this continued stress on the implants will eventually damage them, so far they seems to be very stable. My gum tissue looks perfect no redness, irritation or sign of a problem. My dentist said he could use my mouth as the poster child with healthy gum tissue. All this yet it hurts like crazy with the tight, squeezing, pulling pressure. I don’t want to give up on the implants and fixed dentures but the pain has had a very negative effect on my health. Please if you have any suggestions, I would appreciate them! Thank you for you time. Jan
Hello Dr Amin, Hope you new year is going well. I have a odd question. I have all on 4 fixed dentures, scanned and digitally printed. In Oct 2022 I had oral surgery and implants placed, the immediate loading first denture had a approx. 1/8 inch off center midline. My dentist has made a total of 4 dentures and all of them do not fit properly, all have the same problem. He has at least 25 years experience in prosthodontics but the scanned digital dentures is fairly new to him. He has several patients with the all on 4 but I am the only one having these issues. I have had 2 oral scans, is there a glitch in the scans, is the designer missing something or is my mouth abnormal??? I am not really familiar with the digital process of making these dentures but when the midline was corrected in the digital program to remake my denture. Could this change have made the denture fit differently on my upper arch? When the retainer screws are torqued it feels like my teeth are being squeezed or pulled together toward the middle of my palate. After a few hours the tissue around the implants starts hurting. The odd thing is when the teeth are removed my gums look perfect no redness, swelling or sign of irritation. He is talking another surgery to remove tissue around the implants. Do you have any suggestions as to what could be going on or is this as confusing to you as to me? Thank you! Jan
Hi Dr Amin, hope you had a Merry Christmas! I am still having a lot of pain with the all on 4 fixed non removable denture. My dentist has digitally made 3 sets of temporary fixed dentures for me. They all have the same problem, when they are secured with the retainer screws. The gum tissue around the abutments gets very painful and it feels like there is a pulling sensation on the denture. Almost like the arch is to narrow and the access holes do not align correctly with the implant and when screws are torqued it causes the squeezing sensation. When I eat or bite it feels like my teeth are to close together. My doctor says the implants are fine no sign of any complications. I went last week for an adjustment on set #3 my dentist removed the denture and did the adjustment to relieve the pressure on the tissue. Painted them with dental paste, returned them to my mouth and had me bite on a cotton roll. At this point the upper denture broke in half, I am now wearing set #2 which is painful. My doctor said he doesn’t really know what is wrong, scanned digital dentures was made 1 mm from the tissue, and they should not be breaking. I go back Jan 3 to start making a replacement for the broken upper. This make no sense to me to continue making teeth if we don’t know why none of the 3 have fit properly. Please any suggestions or solution you might have would be appreciated! I have another week before I can see the doctor and this pain is making me miserable. I also worry if this pressure continues could it damage the implants? Thank you Jan
Can all of fours be converted to snap ons?
Yes. But why? That would be a down grade. What is going on!?
I had all on 4 full mouth done last Monday to Wed I am in agony it feels like they ate screwed in too tight..my gums are so.paonful also my right side chin is still numb since my t teeth removal last monday is this correct please?
Oh gosh 😫 depending on your particular situation, surgery, type of intravenous, sedation, skill of your surgeon. You could have significant pain.
The most common day for the pain to peak is three days after the procedure. That is typically when swelling and pain is at the maximum.
Being fully numb is not a good thing, but some light partial numbness would be OK.
If you are fully numb anywhere, this is something you want to discuss with your implant surgery right away.
I would definitely suggest some homeopathic Arnica, Montana pills.
What are you taking for pain? Were you given an intravenous steroid? Or are you given special long acting pain reducing anesthesia in the jaws?
Good Morning,
I have a question, 5 weeks post op oral surgery bone and tissue trimming plus implant placement 4 top 4 bottom with immediate loading. I have a temporary non removable denture the gums around the access screw holes are very sore. The dentist has removed the dentures twice, checked and said everything is fine, did minor adjustments and put them back. The mid line is off pretty bad on these temporary dentures, they actually sit at an angle. Could the pressure and soreness be that the denture does not fit properly. I feel a pinching feeling on my left upper back teeth when i bite, seems to be worse when waking in morning. Concerned this problem will damage the implants if not corrected. Do you have any idea what could be the problem? Thanks Jan
At five weeks out, I would definitely be concerned. Usually at that point there is no pain anymore. A panoramic x-ray should be taken and your pipe needs to be carefully checked. Hopefully none of the implants are failing.
Keep me posted and let me know if pain has improved.
In my practice, if we have a patient that has a slanted smile this is all corrected with facial scanning technology, and worked into another set of prototype teeth prior to the final.
Dr. Amin Thank you for your answer. I just got a new temporary fixed denture with the midline corrected. I am having a problem with the scanned digital teeth fitting correctly. If scanning is more accurate impressions, why do they put so much pressure on the gum tissue? I know that with the all on 4 fixed denture biting and chewing is weird feeling. Is it normal that the teeth feel to tall and won’t allow my jaws to close correctly? When my jaw is relaxed my teeth are touching and after a while I feel like I have been clenching them. Thinking of asking my dentist about converting implants to the snap on dentures. These screw retained teeth are very tight and painful and I can’t remove them to get relief from the pain. I have invested so much money and this is the second set of temporary teeth with the same results. What is your thought on this problem with the digital denture and do you think going to the snap on would solve the problem? Everything I have read on the subject says scanning is extremely accurate and digital dentures should fit with very little adjustments needed. Thank you
The problem is not the scanning. The issue is the measurement of your “VDO” is too large. You need another temp made with a smaller “VDO”.” Your dentist will understand this! Keep me posted.
Dr Amin, you are fantastic for answering these questions! I am totally confused with my fixed all on 4 dentures, tomorrow I go for a rescanning for what will be the 3rd denture. The one I am currently wearing is extremely painful it puts pressure on the gum tissue around the implants and also feels like someone is squeezing the arch together at the molar area.Have had 2 adjustments and when they are returned to my mouth and the retainer screws are tightened within a few hours the pulling pressure sensation begins. After a day or so my upper mouth feels numb on the gums above my front teeth. My dentist said he had not had this particular problem with a patient before. I think he is at a loss for answers to the situation. Could it be that this procedure was not for me? Do you think removing the implants and going to conventional dentures might be the answer, the pain is waking me a night and it is hard to concentrate when in pain all the time. Thank you, have a great weekend!
Is this a lower?
Hi Dr. Amin, I asked my dentist about the VDO. He listened but did not comment. Rescanned and making a different style all on 4 fixed temporary denture. Hopefully it will improve the situation. The problem is pain in the gum tissue around the implants when the denture is secured with the screws. Also the VDO problem. I am hesitant about questioning my doctor, he has 25yrs experience and I don’t want to make him angry, it is just so very hard to deal with the never ending pain. Thank you for the advise on my dilemma. If I don’t get this resolved soon, you are in Burbank which is not far from our location perhaps I need to see you. Thanks again, bless you for taking your time to help hurting people!
Understood and keep me posted!
Hello Dr. Amin
Happy New Year!
I have a question I need to ask about all on 4 dentures. I am three months into trying to wear the non removable immediate loading dentures. My dentist has made 4 sets of upper and lower digital dentures, all 4 have the same fit. When the retainer screws are torqued they feel to tight and after a few hours the tissue around some of the implants become very sore. When I chew food it feels like something in pushing up into my upper jaws in molar area both sides. My dentist has adjusted them all several times. Before I had this procedure my jaws collapsed or over closed and I could not tolerate regular dentures wrapping around my jaw because of no space. I had my teeth extracted in 2019 and had expensive porcelain dentures made, could not wear them. Tried 3 different dentist making traditional dentures nothing worked. In October I had the oral surgery and implant placement, I was told that would correct my jaw over closing problem. Now I have had three months of trying to wear these immediate implant supported dentures. My dentist is at a loss as to what the problem is, the scanned digitals are supposed to fit accurately with minimal need of adjustment. Do you have any knowledge as to what is wrong? I am in pain all the time. Thank you Jan
Hi Dr Amin, my situation is still a mess. My doctor has made 4 digital dentures trying to figure out what is wrong. I saw him today for an adjustment. I have the all on 4 fixed dentures with temporary immediate load,3 months with these. The bone and tissue surgery went well, I healed nicely and the implants seem to be fine. Since October 5, 2022 the day of surgery and the temporary dentures were put in, I have had pain in the gum tissue around the implants. 4 different digital dentures has been made and all have had the same problem. When they are put in place and the retainer screws are torqued, my tissue becomes very sore. The strange thing about this when dentures are removed my tissue shows no sign of redness, irritation or swelling. Today the dentist said it could be that the implants are to deep in the tissue and maybe another surgery to remove more of the gum tissue around them would take care of the problem. I have spent $60k on this journey and at this point I am very frustrated! I have been miserable for three months hoping the dentist could find what was wrong, I should have been getting the final denture by now. Is the scanned digital denture accurate in fit or could the designer have incorrect data in the program causing a glitch in the dentures? Do you think another surgery is the answer? Thanks Jan
Hi Dr Amin,
If you plane a fixed denture making all the teeth completely flat will that change the VDO. I have had a lot of issues with the scanned digital dentures they don’t fit. When the retainer screws are torqued the tissue around the implants hurt and then a squeezing burning sensation. My dentist sent me back to the oral surgeon, he said the implants are okay. He took the teeth out of my mouth, gum tissue looked good and healthy. Then he cut all the teeth completely flat, which allowed my jaws to close better. All my teeth just slide now , no points – since that adjustment when I eat or chew my front upper and lower teeth hit together. It is like the flat back teeth allowed my jaws to close better, but now my lower jaw wants to slide forward when I bite or chew food. Slight underbite, teeth hitting together causing a lot of pressure on the front of my mouth. They have made 4 different dentures, made multiple adjustments to all of them, nothing helps. Do you know what is wrong? Have you had any patients that just could not wear the all on 4 dentures? The scanning and digital program is kinda new to these doctors. I feel like there is a hiccup in the program somewhere, scan or designer?? It has been 3 months and I still have a lot of issues. Should I give up on the screw retained and go to snap on overdenture or something else? I know this must seem crazy to you, but if the scanned digital program makes dentures that are 99% accurate in fit, why does these hurt my gum tissue so bad? Please if you have any suggestions! Thank you Jan
Hello Dr Amin
I wanted to ask for your expert opinion on my problem. Five month ago I had the all on 4 with immediate load fixed dentures. I have had 2 oral surgeries trying to make this procedure work. My dentist is not familiar with the scanned digital dentures, this is new to their office. The dentist and the implant surgeon have at least 25 yrs experience. Both very nice men! I am wearing digital dentures, the lab they are using has made several sets of these dentures. 3 sets at first, second oral surgery removed more tissue and replaced 3 upper abutments, did a new scan because the denture would not fit the new abutments. He has made 2 new sets since then. None of them fit correctly. The first one had the midline off pretty far, they corrected that. The teeth slant from left to right and the right canine is out to far, when I smile my lip catches on the top of that canine. The prosthesis is to wide and doesn’t follow the shape of the arches. My mouth is tapered u shape in the front and they made the gums and teeth in a full horseshoe shape. The dentist said this has nothing to do with the pain. When the retainer screws are secured to the implants there is a squeezing pulling pressure like pliers on each side of my arch squeezing it together. Very painful, after a few minutes the squeezing sensation subsided but then my upper jaws have a constant dull ache above the implants, the bones ache then the pulling sensation when I bite. My dentist can’t figure out what is wrong, he took one of the upper dentures and made what he called a jig. After that he adjusted my current upper teeth to match that jig and it made the pain much worse. When he tightened the screws on the 2 upper front implants the pain lifted me out of the chair. He made another adjustment and the screws less tight. I am wearing them but they still hurt. I have been in his office 1-2 times a week for 4 months and each visit is about 2 hrs. I am sure he is tired of seeing me, but I have no choice when he does the adjustments it helps relieve the pain even if for only a short time. I have had 2 oral scans and 5 upper and lower test teeth so far. Last week I asked him to do the old school impressions that he was familiar with, scan it and compare to the intraoral scans to see if they were the same. I am desperate to find the answer to this mystery. The dentist has made so many adjustments to my current teeth, the upper has gaps between the gums and teeth, nothing is touching the tissue but up toward the palate feels very sore like it is bruised. The lower teeth are set out to forward, after adjustments to set them back they have no pink gum color, all white like the teeth! Both upper and lower very unattractive after all the adjustments they are pretty beat up. My lower jaw slides forward and the upper and lower front teeth hit when eating. Have to keep making the lower front teeth shorter. The molars in the upper arch seem to tall after each adjustment of the lower teeth ( which are all flat now) it allows my jaw to slide forward kinda like it is searching for a natural closing position. Sorry if that sounds crazy this is the only way I can describe it. The implants look great and are solid in the bone and my gum tissue shows no irritation or redness. I am worried that this constant squeezing pressure is going to damage the implants if not corrected. I don’t know how to handle the situation, I have been patient and understood that they have just begun with the digital denture program, and they are in a learning process of something new. After 5 months of pain and the jig incident that actually brought tears, 5 failed ( 1 upper broke in half) attempts to make digital dentures that fit correctly and the up front payment 54k. I am disappointed to say the least.
My dentist tells me he doesn’t know what to do next. His other patients that started this procedure at the same time I did are getting their final beautiful teeth. I am still at square one with the temps. Would it be appropriate for me to ask for a referral to a qualified dentist to finish the teeth and have them pay for the completion? Or just ask for a refund that is enough to cover the dentist that finishes the teeth? I like and appreciate my dentist but nothing is getting better, I am almost 70 yrs old, 2022 was a extremely sad and stressful year. I lost my son in May and started this journey with the teeth in October. This is affecting my health, I don’t want to hurt anyone’s feeling but I need to start living again without pain if possible. I personally feel that the patient file information, measurements, etc. is incorrect. After 2 scans and 5 dentures that all fit the same, something needs to be changed or corrected in the computer program. If his other patients have the fixed digital dentures, scans made with the same scanner, dentures by the same lab and they are working well for them, it only makes sense it has to be incorrect data in the program! What would you suggest? Am I correct in thinking that this constant pressure will eventually cause problems with the implants? Thank you so much. Jan
Hi Jan — thank you for your numerous comments I am going to try to summarize things here for you in a single answer. Ifeel terrible that you are having such a hard time with this. Typically in the hands of a skilled and experienced provider this goes amazingly smoothed as long as preplanning is done properly.
A fixed bridge is always going to be a much better option and much more comfortable than in overdenture.
I suspect that you did not have enough bone reduction space created and/or have issues with passivity of your bridge.
Bone reduction is the process of removing some of the bone in the jaw to create space for the implants to be inserted. If there is not enough bone reduction, the implants may not be securely anchored in the jawbone, which can cause several issues.
Firstly, the implants may become loose over time, leading to a loss of support for the bridge and causing discomfort and difficulty when chewing or speaking. This can also cause the bridge to shift or move, which can be aesthetically unappealing.
Secondly, inadequate bone reduction can lead to increased stress on the implants, which can cause them to fail prematurely. This can result in a bridge that is too thin and causing the lab to be forced to create a non-hygienic rigid lap shape.
Finally, insufficient bone reduction can also increase the risk of infection and inflammation around the implants, which can lead to gum disease and other oral health problems.
Passivity in a dental implant bridge refers to the degree to which the bridge is able to fit snugly and securely onto the implants without putting any undue pressure on them.
A passive dental implant bridge is designed and manufactured in a way that allows it to sit comfortably on the dental implants without causing any unnecessary movement or pressure. This is important because if the bridge is not passive, it can create stress on the implants and the surrounding bone, which can lead to implant failure, discomfort, and other complications.
Think of it like a jigsaw puzzle. A well-designed jigsaw puzzle fits together seamlessly and snugly, without any extra gaps or pressure points. Similarly, a well-made dental implant bridge fits onto the implants in a way that is smooth and secure, without causing any unnecessary pressure or stress.
It is also possible that your measurements are off such as vertical dimension etc. Being skilled with computer technology scanning rather than impression doing take some time. I can tell you that this is the only way that I do it in my office and it is tremendously accurate as long as you know what you are doing.
You might want to consider seeing a graduate prosthodontist training program at a local dental school. I am sure they could work all of this out for you. I agree that you need to start living again!
Ramsey Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Please see my other reply
Hi Dr. Amin
Sorry to keep asking questions! I guess I am desperate for any kind of answers at this point. In early October I had oral surgery in preparation for the all on 4 fixed dentures, the surgery went well and implants were placed. The temporary dentures were put in immediately. This was the first set which did not fit. My dentist has scanned and digitally made 3 sets of temporary fixed dentures, all which are very painful. All 3 when they are secured with the retainer screws pinch the gum tissue. After a couple hours my entire mouth is aching. Yesterday I went for a adjustment on the 3rd denture, he adjusted it put marking paste to check pressure points, put it back in place and had me bite on a cotton roll. At this point the upper denture completely broke in half. I am now wearing the 2nd denture that was made, it is miserable. When I asked my dentist why I am having such problems, he said he doesn’t know because it has been almost 3 months,and I should not have any discomfort at this point.My gum tissue shows no sign of redness or pressure, the implants seem to be fine, and he said the scanned dentures were made 1mm from the tissue! None of his other patients are having a problem like this. The dental facility has a good reputation, and this was a very expensive procedure, not like I chose a cheap rate facility! What is your thought on what this could be? I have been thinking about it, maybe I am allergic to something in these dentures but if this were the case wouldn’t the tissue in my mouth show some sort of reaction to indicate a problem. Even wondering if I could possibly have nerve damage from the surgery. Confusion!!!
Not looking forward to the next couple of weeks in pain, I have a appointment 3rd of January to start on making a new set of dentures. If he doesn’t know what is going wrong after 3 attempts to make a correct fitting denture, making another of the same seems pointless. Please if you have any suggestions, or idea as to what I could ask my doctor that would help. Thank you
I had Trueteeth upper done last week with 4 implants and I feel lots of pressure and very tender roof of mouth. Will that go away in time or are the temps in too tight?
when was it done?
I broke a theet eating.I have all on four.Can it be replaced? Thank you.
My guess is you have acrylic fused to metal bridges rather than zirconia. If that is the case, it can be repaired. Zirconia is better because it doesn’t break like that. What do you have?
I broke a theet eating.I have all on four.Can it be replaced? Thank you-
HI – I had all on 4 surgery done 7 months ago. I’m at the point where I have test teeth in but the pressure on the roof of my mouth is horrible, the lowers are so thick my tongue rubs on the sides and it feels like the back molars are too long because I feel like my jaw doesn’t close all the way. My speech is affected in that my “s” and “c” aren’t sounding right. The discomfort borders on pain. Is this something I just have to live with?
Hmmm..It sounds like your vertical dimension is over opened. Do your teeth hit when you are speaking with the All on 4 teeth? The sizing can be reduced but depends on your anatomy.
Sometimes my back teeth hit when I’m talking and sometimes my tongue gets in the way and I end up biting it when I’m speaking. Can you explain vertical dimension in layman’s terms please. I googled it but I don’t understand the terms used in the explanation
Vertical dimension of occlusion (VDO) has been defined as the lower facial height measured between two points when the teeth are touching. Thus, it is the vertical position of the upper/lower space in contact.
I have a full lower with 4 implants. I’m at the 6 mo
mark, but it appears I have a bottom of an implant that is exposed, it throbs & aches like a tooth ache. My current dentist just wants to cover it better with the final Zirconia. Any suggestions,
Thanks
But if it hurts you can’t cover it up! What do the x-ray and exam show?
Hello, found this website doing research into my procedure ( soon to come) I have no missing teeth currently.. two in the very back loose but not failing out… I take medication that causes rapid tooth decay and have decided the all on 4 full mouth restoration is the way to go.. currently I’m set for surgery in two weeks I’ve chosen the monolithic zirconia, with reading most others issues and pitfalls they run into im very concerned how do I make the best most informative decision? I’m in a better position then most as I’m much younger 33yrs old … and proactive about my choice sense I know in the future I could have all the issues with bone loss.. soft gums and so fourth .. currently I’ve been told by several ( I’ve seen at the very least 8 different implantologists all over the states and spoke to a few abroad) trying to find the absolute best I can ( I’ve walked away from several just bc I didn’t feel comfortable with their assessment) even though all have said I’m great candidate no bone grafting needed no sinus lifting .. nothing but teeth extraction and implants fairly straight forward .. however I’m still scared and feel like I really don’t know enough .. any advice for what to look for .. what to I should be asking the doctor? How do I know for sure I’m choosing the right doctor.. the right implants .. I’ve read through reviews .. looked over pictures of previous patients.. I’ve even read past employee reviews on the place I’ve settled on .. anything at all you can tell me to ask or look at to feel more secure that I’ve done everything I can to make the most sound logical decision I can and done my best to avoid pitfalls .. fails etc?
I think you have done a great job, figuring out who is the best doctor/office to treat you!
Besides social proof and your other research. The staff at the office should be strongly backing the Dr team. I find that when the staff truly believes in the treating doctor that is probably the number one thing! Also ask if they have treated other dentist/dentist relatives.
When is your surgery?
I had complete restorative dental implant surgery about 3 months ago.. I am in my 2nd set of teeth and and they Feel dry. After I brush my teeth I must rinse with some of moisture rinse. I feel like my lips are always sticking to my teeth. What can I do to make them feel better.
Are they plastic or zirconia?
Hi, I had all on 5 top and all on 6 bottom placed June 1, 2022 in Mexico. I go back for follow up and permanent fitting in 3 weeks. My question is in regards to my facial profile. Around my mouth looks like the teeth are too small or maybe too far back. My face looks aged and my lips are resting too close together. The shape of the bridge is almost too pointy in the front “if that makes sense” The bite is lined up fine and I am, however having issues with my “s” sounds. I am assuming it is from the fixed temps being to far back, its like I don’t have enough space for my tongue. When discussed with the dentist office I was told they could fix it when I come back in. Will this be something that can be fixed with the changing of the prosthesis? I have been very depressed and not wanting to go anywhere or see anyone as I look like an old lady with small fitting dentures.
Oh gosh. The lip support and “vertical dimension” need to be spot on or improved. It sounds like both may be off. How can I help?
Here are some links that may help:
https://burbankdentalimplants.com/?s=lip+support
Hello, I am so happy to find this post as Im in a very similar situation now at 36 yrs old. Do you mind sharing a hopeful solution? thanks so much!
Hello,
I wonder if you can help.
Recently I have had all 4 on 1 both upper & lower.
I was under or led to believe that these teeth were Zirconia.
I’m now back home in England after having three visits this year (so far) regarding the teeth cracking and falling out.
It’s now only come to light that the clinic fitted acrylic and I’m absolutely at my wits end what to do.
I’m corresponding with the clinic at the moment they have asked me to get a consultation back home as they said I’m not a suitable candidate for Zirconia teeth.
What’s the difference anyways they are not answering my question as to why.
Major difference!! The teeth should look white on x-ray. This means you have plastic teeth which wear, break and take in odors.
It is not a denture or “hybrid.” This means there is no plastic or acrylic teeth. The bridge is made of high strength zirconia porcelain. That means patients are not exposed to unhealthy, non-precious metal material.
Hello, my new all-on-X implants’ bridge (on the lower jaw) in the front looks like white teeth and colored pink tissue which is normal. But for some reason the tissue part on the back side of the bridge is not colored in pink. So for example when I yawn, I can see in the mirror the inside of my bridge and it shows a lot of white (instead of just white teeth with pink gum underneath it). Do you think it is normal or should I be asking my dentist whether this can be redone? Am I in my right to ask for such a change at no cost? Thank you in advance for your answer.
I do this on my milled temporaries, but never on the finals. Is this a temp?
Hi, no this is permanent.
My husband and I would appreciate some advice (hopefully positive news) on my urgent need for implants.
My age is early 50’s and I am/was an actress. My teeth needed to be removed 18 months ago for medical reasons. The dentures were a failure. Acrylic is difficult to wear. I use my temporaries when needed but I cannot eat with them. My DDS has told me implants are my only option.
HOWEVER- I have Fibromyalgia, IBS, along with sensory Allodyndia. In my research, I have read these problems can cause implant failure, pain even after removal, and other illness’ afterwards.
Obviously, I would like to hear if there is a way I could still have this procedure. The stress from not having teeth has already exacerbated my fibro, and I have regular IBS bouts, probably due to lack of nutrition, since I do not eat. Trade off’s. Except with no teeth, I am severely depressed, do not leave the house, and feel my life is over, ( I have also lost all of my family recently). I have pain and no teeth and now I read I might not even be able to get implants.
Reading about implants for all this time from generous doctors ( like you), willing to share their knowledge about all the latest innovations it seemed like there were techniques that could help me. but many doctors here in the Midwest have not heard of many of them.
With Fibro, could, ( assuming first you have a DR who cares enough about precision mapping and placement) having sensitivity to titanium be an issue? Even assuming, it’s pure grade titanium. Could Zirconia implants solve this? Or perhaps, a mouth with a too-heavy re-placement fixture? ( I am small, with a tiny mouth.) Just tossing around ideas.
We would be more than grateful if you can give us hope on this question.
Blessings
First off I am very sorry about the delay. This comment cut picked up in our spam filter. There are a lot of questions here. I think that you can certainly be treated in a very careful manner with dental implants. You need to be seen by a very skilled provider with a lot of experience. I have treated many patients with chronic medical conditions successfully. You also have the option to just have implants on the lower and may be have a nice denture made on top. What did you decide to do?
hello, i was hoping you found a great provider that understood your auto immune illnesses and are happy with the end result. Im finding myself in almost the exact situation and was hoping if you had any advice. thanks so much!
I’ve just had a 4in one implant, the temporary one. The permanent should be put in around October. To my surprise it was only 11 teeth, and I’m sure that the permanent will be the same. This means that 5 teeth are missing (3 on one side and 2 on the other side of the implant.) What can be done? I see my face changing in these last couple of weeks, Is it possible to put a bridge on either side?. My dentist is on vacation this month of August, but, I’d like to know now. Can you give me some suggestions?
10-12 teeth is normal. It depends on jaw size, jaw shape and nerve position for the lower. Sinus proximity for the upper.
Hi there, can someone please help, I just had full mouth restoration all on 6. 3 days ago. The prosthesis feels very bulky and when mouth is wide open looks bulkier than others I’ve seen pictures of. It is screw retained but the screws were placed at back of teeth part rather than on them meaning I have a thick part at back of the teeth. This may be because my implants were placed straight in my bone and not angled.
My issue is psychological. I am tormented by the bulkyness and the thought I can’t remove them. My dentist is abroad so going in and asking to reduce size is not an option. Can anyone tell me how long it takes to get used to this feeling? It feels right now like I never will!
This is something that I speak about with each and every patient before surgery. 😢 You can tell at the time of CT scan analysis if this person’s Bridge is going to be thick or thin. This is predetermined in the hands of a skilled practitioner with a lot of experience. This can change the treatment plan tremendously. If the implants are placed really far back sometimes that is because your teeth are further out than your bone and there is no option. This needs to be carefully evaluated. It may or may not be able to be changed. Speak to your dentist about this and be sure to be clear on what the final will feel like.
The problem with having dentistry done in another country is lack of access for follow-up. Where did you have your work done in where do you live now?
Treatment done in Turkey and I live in Ireland. Cost of same treatment here is astronomical. Yes I think the implants are further back because of lip support issue and my teeth therefore needing to be ‘further out’ in my mouth. I am getting a little more used to the feeling day by day but it’s still not ideal. I am considering travelling back in the future for check up etc and will see if anything can be done to ‘file down’ the inside piece, even a little makes a huge difference in how it feels. Thanks so much for your response.
Hi I am having the same problem, did you get the inside piece filed down? Any help would be appreciated
Hi, I have just recently had my temporary acrylic bridges fitted two days ago ready for my zirconia bridges to be fitted in just over 5 weeks. I have had 5 implant screws fitted upper arch and all on 4’s throughout. They feel so bulky in my mouth, my speech has adjusted, as in I have a lisp. They don’t feel like they sit on my gums correctly, they feel like they are dropping down more than being high up in the gums. They also feel like they are protruding forward making me look like a bunny. I have had a review appointment with my dentist again today but he advised me my permanent ones could be changed however temporary’s can’t.
Will my speech and the drop from my gums improve with the temporary’s on?
Just I’m really hating them and worried incase my permanent ones will be the same with the amount of money I have spent?
If it is a major adjustment, the temps should be remade. That is what I would do. I would only go to final if the changes are very minor. Going to the finals should be very anti-climactic as it should just feel like a better version of the temporaries but not that much different.
This way there are no surprises. That’s how I do it 😊
I have some implants on my lower teeth and have had to have 5 sets (full upper) on the top replaced because of breaking. What could be going wrong. I’m at my wits end on this.
It sounds like you have acrylic plastic bridges rather than zirconia.
Unfortunately those always break. They save a lot of money in the beginning but then they fall apart 🥹
Hopefully you can upgrade what you have. Zirconia has to be done well or it will break as well.
What do you have?
I have a question. I have a bridge on my upper left side with 2 implants and a cantilever. This was done less that3 years ago. I have had bad pain which is getting worse. I was told by my regular dentist that one is infected and needs to be replaced in a different tooth. Can this be cleaned up and fixed?
This link should help
https://burbankdentalimplants.com/failed-dental-implants/
If your implants feel to tight on your pallet roof of your mouth can that be fixed
Yes. But are they new? Is it removable by you or is it fixed?
I have had the 4 in one dental implants about 3 months ago. Why am i getting so much more sylvia with these than with my own teeth? I literally have moth fulls and then I drool. I used to have dry mouth, so this is very strange to me.
Does your face seem smaller or larger with the teeth in?
Hello!
I was wondering if someone with severe bone loss/soft bone/small mouth on the upper left hand side (no back teeth, up to the canine) would still be eligible for an all on x if bone grafting were to be done. Should that be an automatic zygomatic case? Also, if an all on x fails, can you still be a candidate for zygomatics?
This is an excellent question. You can be a candidate for all on X surgery with or without bone and with or without bone grafting. A zygomatic case should never be “automatic.” Zygomatic and pterygoid implants should be very carefully planned and only used when the benefits outweigh the risks. In my practice because I tend to see much more complicated cases so zygomatic implants are a normal part of my average week. Even if all on X fails zygomatic implants can still be a bail out. I plan all of my cases with the future in mind should a patient ever have a problem. What are your thoughts? Does it help you?
Thank you so much for responding. The issue is, I’ve been to some consults that have referred me out to get zygomatics, and one that told me I can get an all on x with bone graphs, ridge augmentation and possible sinus lifts. Considering I have soft bone, I really don’t know what “expert” to believe. As you know it’s a costly procedure, so the biggest concern is paying for an all on x that can fail being that I’m a complex case, or just getting zygomatics. I’m on the east coast (in nj)and they’re not very savvy over here about zygomatics. I’m 36, this is the last wreckage of my past I need to clean up, I’ve been saving for years, and just want to make the most educated decision as possible.
PS. Love all the educational videos you provide!
🙏🙏🙏
I am so happy I came across your website. Hello, my name is Debbie and 6 months ago I finally had to go in and have the rest of my teeth extracted, all 18 of them. Then 2 months later they had me come back to do the all on 4 implants. I had to have both surgeries done in the hospital because of my medical conditions. The biggest one being, having Refactory Generalized grand mal seizures. That’s why I had to have the implants, because with my seizures not being controlled my whole care team was afraid if I had a seizure by myself I would choke on my dentures. I had to stay overnight when the implants were put in, because they couldn’t stop the bleeding! They’ve only wanted to see me once since my surgery in Nov. 2021. That was my post -op visit. Question: They decided not to put temporary teeth or Anything, in my mouth because they said some of my bones were somewhat soft. So as of now I have been over 4 months without any teeth And without hardly any gums! This was done at IU Methodist Hospital.
They’ve done no X-rays to see if my implants are adhering to my jawbone. I can barely talk.
Is this a normal waiting time? I’m 65 and getting depressed cause I don’t want to go out. Any advice? Gratefully, Debbie
I am really sorry. This sounds crazy. The longest my patient would be without teeth would be 18 hours at the most! Really you have to transition through prototype teeth to make sure everything is going to fit you well. This generally takes a few months of testing. This is exactly why I do prototyping and put in nonremovable teeth within 24 hours of the surgery. This just seems to be excessive. I am sorry for all your problems including the excessive bleeding. It sounds like they do not have a lot of experience in these types of procedures. It has been many years of doing full arch implant cases on a regular basis and I am always able to provide teeth right away. At this point you just need to go through making temporary teeth to be sure everything is right before going to the final