Is it vital to have a gap between the teeth & gums for cleaning? I have All-on-4 implants top & bottom fixed.

Question

The dentist that did it didn't leave a gap they are tight as with removable type. Also I assumed the only way to fix was with screws only to find out on the day of placement he was going to glue them, at present he has done a temporary cement. I think glued on would be disastrous particularly with no gap for cleaning as food will inevitably get forced under. Thank you

Lance Timmerman, DMD, MAGD · Answer

There is a specific shape that the all-on-four bridge should be designed so that it is easily cleansed (convex or flat) and is normally tight against the tissues.  Normally the arch is screwed into place, but it "could" be cemented in place, but if cemented it should be a resilient cement (or temporary cement) so that it can be removed without destroying the restoration.

Kerem Turgut Atasoy, DDS, PhD · Answer

Hello, this type of All On Four prostheses are mostly made with convex surfaces that we call hybrid, imitating the lost soft tissues and facing the tissue. The screw holes of these retained prostheses are then closed with composite fillings and removed by the doctor if necessary.There may be a very slight gap so that the bottom of the prosthesis can be cleaned. Waterpik devices that apply water with pressureare mostly uses for this purpose.

Dushyanth Paul, MDS · Answer

After the placement of All on 4s, your bone needs to fuse with the implants (osseointegration). During this period a lot of bone remodelling occurs accompanied with some shrinkage of gum tissues. This may lead to the development of gaps in between the prosthesis and the gums. 
Screwable prosthesis are used worldwide along with All on4s as it can be unscrewed and cleaned once in few months and then screwed back again.

Esam Abou Nahlah, DDS, MS, FICOI · Answer

Yes it is recommended to have a slight gap underneath for hygiene .
In the top arch this gap should be minimal so it won't  affect the phonetics ,

Ara Nazarian, DDS, DICOI · Answer

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.

Is it vital to have a gap between the teeth & gums for cleaning? I have All-on-4 implants top & bottom fixed.

Answers (8)

Answer: All on 4

Answer: All on 4

Answer: Cleansability in the types of (All on 4/6) Implant bridge restorations

Answer: Cleansability in the types of (All on 4/6) Implant bridge restorations

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Is it vital to have a gap between the teeth & gums for cleaning? I have All-on-4 implants top & bottom fixed.

Answers (8)

Answer: All on 4

Answer: All on 4

Answer: Cleansability in the types of (All on 4/6) Implant bridge restorations

Answer: Cleansability in the types of (All on 4/6) Implant bridge restorations

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Recommended reading

Everything you need to know about All-on-4 Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.