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Many times patients within their 20-30s have presented with teeth that continue to break down no matter what they do. These patients get very frustrated spending money over and over again trying to save their teeth. In those cases where there is continually decay and infection, then the better solution may be to have All on Four or better yet All on Six... In your particular case, you may benefit from a combination approach, which is crowns on natural teeth that can be restored and implants in those areas where the teeth need to be extracted or where teeth are already missing. A thorough examination with a CBCT would be required for an accurate assessment.
When enhancing a smile using All on Four when teeth need to be extracted, then it is important to make sure the transition line (seam between the implant bridge and gum) is hidden above the esthetic zone or view when smiling. This is achieved with leveling immediately after the extractions before the dental implants are placed. By doing this, the gummy smile can be easily corrected.
One can have the teeth, gums and overall look changed when having an All on Four or Six procedure. It is best to wait for everything to heal within the first 4-6 weeks before any alteration. There are some dental provides who offer the final bridge the Same Day, however, there may be areas of gaps under the bridge once the initial swelling goes down.
It appears that there may be some rough edges on your All on Four restorations. I would suggest your dentist remove them and polish them in the lab followed by sealing them with a dental sealer. This is far more effective than trying to do it in the mouth. Peroxyl is a great rinse to help soothe your tongue and gums while these sores are healing.
There are several ways to retain an All on 4/6 type of implant bridge restoration. These include both cement retained and screw retained. The advantage of a cement retained bridge is that there are no holes in the biting surface that require filling and the bridge may not be as bulky. However, these are slightly more complicated to retrieve. With a screw retained restoration, retrieval is more simplified if the bridge needs to be removed for some reason. Either way there should be a small space in both options to be able to use a floss threader or super floss. Otherwise, a waterpik and daily oral hygiene would assist in maintaining the area.
