Should I Have Large Gaps Between my 4 in 1 Dental Implants and the Gum Line?

I have a complete set to 4 on 1 tooth implants upper and lower. Is it normal that there is large gaps between the implants and the gum line, that I can feel my implant post in this gap and that you can see the screw holes even after they are sealed.

Doctor Answers 12

All on 4, Dental Implants, Teeth in a Day

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The question is how long have you had the implant and hybrid denture?  If it has been a number of years, you may have some bone loss around the implants or adjacent spaces.  This can cause the gaps.  If it is a consistent problem, then a reline might help.

If you feel the post of the implants then I would definitely have a dentist check this out.

Hope this helps.

 


Houston Dentist

All on 4, gap between gum and implant

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It really depends on what type of case the dentist was doing.  Some dentists want the gap so the patient can clean the area much better.  Other dentists do a hybrid case where the prothesis is up against the gum and there is not gap.   Much harder to clean for patients.  Ask the dentist who did the work to get a better idea if it is normal.

 

 

Leonard Tau, DMD
Philadelphia Dentist
5.0 out of 5 stars 3 reviews

All-on-4 Denture fit.

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The all-on-4 dental implant protocol is different between offices. The initial, temporary, bridge may have some gaps to allow for cleaning. Other schools of thought make the fit tight as to mould the gums and prevent ingress of food particles. Similar designs are made for the final bridge i.e with small gaps for cleaning or tight fit. The size of the gaps should be large enough to allow a brush, floss threader or waterpik to enable cleaning you should probably not feel the posts. Hope this helps.

Dan Hagi, DDS
Toronto Dentist

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Spaces under the hybrid prosthesis

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Hybrid prosthesis is a great treatment modality and has been used for a while now. The great advantages are that it gives you a comfort of having fixed prosthesis, excellent ability to chew and aesthetics.  You have to remember that like everything in life different treatment options have advantages and disadvantages, and the disadvantage of this kind of prosthesis is that space that you are talking about. Sometimes it is bigger sometimes it can be smaller, but main reason for that space is that you could keep the implants clean. If you feel that the space is excessive, changes can be made and every Implant Prosthodontist knows how to do that. I would recommend to go to the same dentist who made those prosthesis for you and let him know about your concerns. If your doctor agrees that space is too big he can fix it, and it is an easy fix. Good luck!

Zina Kaleinikova, DDS, MS
Cleveland Dentist

Gaps and Dental Implants

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Some gaps are okay as they help you to clean the area with floss or WaterPik. How long have you had your dental implants? If you are still wearing a temporary set of teeth the gaps may be larger until your permanent set is fitted and placed. Otherwise, if it has been some time you may have experienced some shrinkage in the bone and/or surrounding tissue. If it is bothering you, discuss this with your surgeon. They can usually help make the fit a little more snug and comfortable for you. 

Gaps under the gums was the old school design for All-on-4

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The old method of making these appliances was to leave a gap in between the gums and the appliance for the lower jaw. This allows the patient to keep it very clean. There is really nothing wrong with this design unless the patient does not like it for some reason. 

For the upper jaw, there should not be any gap because this will lead to a "lisp" when speaking. 

Space allows for proper hygiene

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Depending on your bone/tissue level, the abutments that hold the prostheses in your mouth will be noticeable if you pull your lip up. The purpose of having visible abutments is for optimal hygiene purposes. You MUST be able to pass the bridge floss underneath the prosthetic in order to keep plaque and tartar from building up around your abutments and on the underside of the bridge. 

Depends on the Time Line

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If you've recently had extractions and your All-on-Four prostheses delivered, it is not surprising to have a gap between the gums and the acrylic. As healing takes place, the bone and gums will shrink and stabilize and often create a gap that is usually closed at the time of making the final restoration.If the hybrids are recent, it is fairly common to have a "high water" design on the lower prosthesis to aid in keeping it clean. We try to have a fairly intimate fit to the gums on the top to prevent saliva, food, and water from passing over the top during speech and eating. If you've had the restorations for a while, then you may have had further bone loss and recession that has caused the gap to widen. This is worth discussing with your dentist. Depending on the material, you can likely have that area relined to fit more perfectly. If you feel the implant, it may actually be a component of the restoration (called a multi-unit abutment) that sticks out of the implant and the denture rests on. If it's the implant itself, the dentist should closely monitor it to make sure that implant stays healthy. 

Andrew Currie, DMD, MS
Atlanta Dentist

All on 4 Gap between gums and implant

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This prosthesis is a very expensive investment, which would mean you will want to get as much information from your dentist to maintain this prosthesis. So maybe the space created was one of the ways the doctor was trying to assist in the maintenance of your hybrid denture. However, make sure that their is not a fabrication flaw on the part of the lab. It can easily be missed, but it can be corrected with minimal downtime for you.

James Magee, DDS
Altamonte Springs Dentist

All On Four Dental Implant Prosthesis

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I believe the "Gap" you are referring to is the normal spacing between the dental implant abutments securing your hybrid denture.  Since all of your teeth in each arch ( a total of 16) were replaced by a total of only 4 implants, there is going to be a large space between them.  This is ok and to be expected.  If you are able to actually see the implants or abutments, the denture was most likely fabricated so it would be easier for you to clean.  There are different ways to fabricate the denture for attachment to the implants, so this should be discussed with the dentist that made the denture which attaches to your implants. 

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.