My all-on-4 bridge is loose. How long can I wait before it causes damage to one or all implants?

I have had the all-on-4 dental implants for 3 years now with no problem. After eating something soft, my upper bridge started to wobble - no other symptoms. I'm hoping it's just a loose screw. I have three questions: 1) Would an implant fail suddenly like that after 3 years? and 2) If it's a screw loose, how long can it wait if I can't get to the dentist right away before it damages the implant and, 3) Why would a loose screw cause an osseointegrated implant to fail?

Doctor Answers 11

Visit your dentist ASAP if your All-on-4 is moving!

If an implant is going to fail, it fails usually within the first year that it is in your jaw. Unless something has dramatically changed with your health, it is not likely to fail "all of a sudden" after 3 years. 

The most likely situation is that some part of your appliance is loose. There are many screws in the All-on-4 treatment and they can loosen over time and cause things to move. You should see your dentist ASAP if any part of your All-on-4 is moving. 

A loose screw means that your prosthesis may be moving around and applying pressure unevenly at different implant sites. One of the most important factors to maintaining healthy implants for a long time is to have a well distributed biting pressure at each implant site. A loose prosthesis does not allow this pressure to be distributed well. 

This is why it is important to go to regular check ups for your All-on-4 prosthesis. By following a good check up schedule, any loose screws or any other little thing that is out of the ordinary can be adjusted before it becomes a problem. 

Stockton Dentist
5.0 out of 5 stars 7 reviews

Loose All-on-Four!

  1. It is less likely that an implant failed after 3 years.
  2. It most likely is a loose screw, which is the most common possibility.  I would try and see your dentist as soon as possible to have the screw tightened or replaced.
  3. Sometimes the forces that the bridge takes can cause the screw to loosen over time. The screw and implant are separated by the abutment so it is less likely that the loose screw results in implant failure.

Tejas Patel, DDS
Austin Dentist
5.0 out of 5 stars 4 reviews

Screws may loosen

The strongest muscle based on its weight is the masseter. With all muscles of the jaw working together it can close the teeth with a force as great as 55 pounds (25 kilograms) on the incisors or 200 pounds (90.7 kilograms) on the molars. 

It is possible that a screw has worked itself loose, you should have it checked ASAP

Mike Golpa, DDS
Las Vegas Dentist
4.8 out of 5 stars 48 reviews

Loose all on 4 bridge

This is quite common with all on 4. You need to see your surgeon right away to ensure nothing serious happened to your bridge. Your bite could be off, an implant could have failed, a screw joining the bridge and implants could be loose or the bridge itself may have cracked. 

Herbert Veisman, DDS
Toronto Periodontist
5.0 out of 5 stars 9 reviews

How to treat a loose All-on-4 prosthesis?

 Providing nothing is actually broken, there are many reasons why a dental implant screw can become loose.
The most common reason is that the screw is simply starting to become undone due to the harsh forces of chewing. If this is the case, then  it simply needs to be torqued down once again to the manufacture specifications. 
As far as how long you should wait before you have it checked, the answer is the sooner the better.A loose screw can cause problems to your dental implants that could've been prevented.If the prosthesis is moving then the forces  of chewing are not being evenly distributed among all the implants. It is also possible that a loose prosthesis can be irritating to the gum tissue around the implant,  which could lead to problems that also could've been prevented. 

I hope you found this information be helpful,
Dr Champagn

Richard Champagne, DMD
Freehold Dentist
5.0 out of 5 stars 5 reviews

Loose fixed bridge: get a consultation ASAP

The best approach would be to get in to see your dentist as soon as possible. Failure can happen at any time and the longer you leave it the more chances you have of expensive damage. It's very possible that a quick appointment could solve the problem with the loose bridge. 

Kathy Frazar, DDS, FAGD
Houston Dentist
4.6 out of 5 stars 10 reviews

You answered your own question

an osteointegrated implant means "one that has not failed and is firmly in the bone" Those implants themselves are firmly in bone and do not move.  However, there are several pieces and connectors, including screws  to the 4 0n4 that can loosen.

Even a dentist cannot tell which component has loosened, until you are seen in the office.  Do not wait.  The whole denture can break if improperly attached and wobbly.
it is possible that an implant has failed. you should have been checked and followed regularly after the initial placement .
It may be more simple, that a screw has loosened, or is lost.
A lot of loosening problems occur from improper adjustment of the both dentures come together. This requires a simple change to make the teeth fit together better, after all the other possibilities have been checked.

Paula S. Gould, DDS
Englewood Dentist
5.0 out of 5 stars 2 reviews

All On 4 Looseness

I would recommend seeing your dentist ASAP. It could be as simple as a loosened screw like you mentioned or something more serious. Some common issues that can occur include:

1. Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

2. Infection – This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection is a condition referred to as peri-implantitis. Peri-Implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

3. Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

Marielaina Perrone, DDS
Henderson Dentist
5.0 out of 5 stars 12 reviews

Loose all-on 4

I would not wait or delay fixing this.  Even if it is a loose screw, the inflamation from the gums can affect the bone beneath progressively.  If it is a loose screw, it is a quick fix and then a revision of your bite which may have caused it.

Victor Sanz, DDS
Chicago Dentist
5.0 out of 5 stars 3 reviews

Loose all-on-4 bridge.

If the bridge is not solid then you need to go in and see someone ASAP.   At this point there can be many reasons for the bridge being loose the most common is a loose screw but can be as complex as a broken implant.   The only way to find out is to get the bridge off and investigate.  If the screw is loose and it's likely a back implant then effectively the bridge is held on 3 implants and those are being over stressed.  This can result in implant lose if it continues for a prolonged time period.  Get in to see your doctor.  

Dan Hagi, DDS
Toronto Dentist
5.0 out of 5 stars 3 reviews

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.