All On Four Dental Implant Procedure Review: Is It The Best? –Ramsey Amin DDS

The All on 4 dental implant procedure has become quite popular. You probably even hear about it on radio and TV advertising. Even many dentists don’t really understand it. It is sometimes advertised as the “smile and a day” procedure.   All on four is simply a treatment option for replacing all of your teeth on the upper or the lower with just four dental implants. It is possible to replace all of your teeth in just 1 day. In fact I have been doing this for the last 15 years.

You just have to be very selective that you are the right patient for this type of procedure. I don’t suggest that the final teeth are made on the same day because you will not be able to test the teeth for how they look, feel or bite.  There are many steps to achieve a really good result and a full mouth reconstruction.

The All on 4 Dental Implant Procedure Video Review

There is a lot of hype about all on four. What is perceived is not always the reality. In this video I will review several things you should know about total teeth replacement with “ALL ON FOUR”.

Some advantages are:

Some disadvantages are:

  • Under engineered–only four implants are supporting what 14 upper natural teeth would do.
  • Cost is reduced by making a “fixed hybrid.” These are essentially fixed dentures which have high maintenance and break very often.
  • No implants are placed in the molar areas of your mouth where the bite force is the highest

Here is a patient a decade ago:

 

Generally speaking, 6 dental implants on the upper and 5 dental implants on the lower are minimum number for stable long-term bone.

This should be combined with an all zirconia or metal ceramic bridge rather than a hybrid, which are plastic denture teeth fused to a base metal. Depending on the size your jaw and bite force, you may need up to 8 dental implants on your upper jaw and 6-8 on your lower jaw.

Sometimes bone grafting cannot be avoided and is necessary to obtain good long-term results for you. You may require sinus bone graft if your sinuses are farther forward in your mouth.

I would strongly suggest all porcelain teeth, preferably CAD milled Prettau, if you have enough space from top to bottom. Porcelain teeth don’t stain, chip and break like plastic hybrid denture teeth do. I would also suggest that all on four or all on 6 or 8 are held in by screws rather than cement, if at all possible, based on dental implant angulation. This video should clarify a lot of questions you may have.

The all on four dental procedure is really heavily marketed and is rarely the best option but **can work for some**.

Remember your teeth are your body parts. I truly believe a customized solution for your particular situation is best. Some dentists just plan all on 4 dental implants for all patients regardless of their unique situations.

It is the equivalent of trying to make your mouth fit the prefabricated teeth, rather than making teeth to fit your mouth.

If my mom or dad were to ever need to replace all of their teeth, this is not the way I would do it.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry


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102 thoughts on “All On Four Dental Implant Procedure Review: Is It The Best? –Ramsey Amin DDS

    1. RamseyAminDDS Post author

      Wow…that fall sounds scary!!!

      Please contact Sophia or Angie at the office. They can help you schedule an appt with me.

      818-846-3203

      Reply
  1. Mohamad

    Dentist told me my 26 yr old son’s front teeth are in poor condition. 6 teeth (in one row) affected. Its either dental implants or extraction and replaced by dentures. For dental implants she mentioned about implanting on 4 teeth linked by a ‘bridge’. I’m not sure if this is the so-called ‘All on 4’ bridge thing. Of course the cost is pretty steep – about roughly 16-17K US dollars. She preferred this method quoting his age as a reason. What i hope Dr Amin is whether you can give advise on what would be the next best course of action should we be unable to afford this implant method thing? Partial dentures? Full dentures? Removable or fixed? Any advice would be greatly appreciated.
    Thank you very much.

    Reply
    1. RamseyAminDDS Post author

      It sounds like just the four front teeth will be replaced with implants which is a far better option for someone his age than a full arch replacement with an “all on four”

      The cost sounds within range. This is a highly complex procedure to have done the right way the first time. This area of the mouth is particularly prone to long-term bone loss.

      I suggest you seek out an expert to treat upper front teeth in a young man like your son. Of course there are other options that are less costly but this is often the best. Should he decide to have implants later in life it will only become more costly and more complicated because of likely substantial bone grafting that will be needed.

      Reply
  2. siacri

    when one is dirt poor and still in their mid 40s the choices become limited to what is the cheapest route to avoid the embarrasment of dentures that slip out and the concept of bone loss and facial deformation becomes a serious worry…especially if one is single.. im suffering because im afraid of that toothless shrunken face look that people get when they opt for removable dentures…no insurance will cover or assist with anything but standard dentures.. we sure can pat for the mistake we make years later…

    Reply
  3. Alison GOULBOURNE

    Dear Ramsey
    I play the clarinet and sing as part of my job so the position of my teeth is very important and makes a huge difference to me being able to do my job properly.
    I had the all on four procedure done on my lower jaw however it feels like my teeth are in a totally different position so the teeth or rather the acrylic feels restrictive to me using my tongue properly and the teeth feel further in my mouth. Facially I feel my lower lip is not supported in the same way which makes it feel odd when I smile.
    Too be honest the lower lip and shape just do not look the same as before. I had a pointed lower arch which has been replaced by a rounded arch. Why the dentist decided to alter the shape of my mouth I have no idea but this has knock on effects to how my mouth and face looks and works.
    He said he has no mould of my teeth as they where as it was destroyed making the one in my mouth so there is no reference to how it was. There are however 3 D ex rays. I was wondering can these be used to make a mold? If they can at least I do have a reference from which to explore getting this right.
    I have watched my mouth change and this has had a devastating effect on my confidence. Could I possibly send you before and after photos of my mouth . Maybe you could give me some pointers in ways I may go forwards? I would be grateful if these photos were kept private though.
    Kind regards
    Alison

    Reply
    1. Traci

      I have full dentures upper and lower and bc of cost I got 2 implants on bottom bc bottom dentures don’t stay without implants. They stay for the most part with enough poligrip both stay. I dred it sometimes but I also did the bone grafts. If can save your teeth then do it bc it can’t redone. I had all crowns and eventually my teeth started to fail so I knew it was quick fix but I don’t think the tops were that bad. I got 3 opinions as well. Now I’m used to them. Make sure you guys do your homework that’s all I’m saying

      Reply
    2. Karen Allen

      Hello Dr. Amin,
      I hope you have a solution for me…I searched your blog for any information on the care and cleaning of the “All-on-4” dental implants and I may have missed it. I must say that I can’t complain because after the implant procedure was done (5 on top and 6 on the bottom), temporary dentures were placed in my upper and lower jaw to allow healing. I followed their directions almost 100% of the time. I didn’t chew anything I couldn’t mash with my fork for approximately 4 months and after the implants were tested for stability, new impressions were made. After the permanent ones (not porcelain) were placed, I had to go in a few times for “adjustments” but I can’t complain about much. I’ve asked the oral surgeon, my dentist, and the lab about oral hygiene but they only said to avoid using toothpaste and just keep doing what I am doing. The oral surgeon recommended that I return to his office for a deep cleaning once a year. He will remove them and clean them in his office at no charge. Is once a year enough??? These teeth fit pretty tight and I struggle to even get a “Super” floss under them. Toothpicks aren’t flexible enough and “Soft Pics” just seem to rip my gums up. At this time, I am using the Waterpik 3 to 4 times/day using a mixture of 1 oz mouthwash in the “tub” of water. If my teeth feel dirty, I just need to use a toothbrush to clean them with water. It really doesn’t do the trick. I’ve cheated a few times and used toothpaste to get that stuff out but worry that I am going to ruin them. Do you have any secrets to keeping these teeth clean?

      Reply
      1. RamseyAminDDS Post author

        The problem oftentimes comes down to design and whether or not the inner surface of the bridge is made completely convex or concave. Oftentimes we are forced to make some areas of the bridge concave in order to support your lips while other areas can be made convex which is more cleansable. All this has to be considered in the design right from the beginning. Please view this blog post about 3-D design of full arch Bridges whether they are all on 4 or more implants. The video is really good at showing you what I am talking about.

        If some of the concavity can be taken out in your bridge, the bridge can be removed and recontoured to allow for more space for cleaning and the use of super floss. Ideally the material is real porcelain or solid zirconia which is far smoother than an acrylic hybrid.

        Please leave additional comments on that post which is more appropriate in your unique situation

        Ramsey A. Amin, D.D.S.
        Diplomate of the American Board of Oral Implantology /Implant Dentistry
        Fellow-American Academy of Implant Dentistry

        Reply
  4. Alison

    I would also like to mention I paid £10,000 for my initial surgery and was then charged another £5,000 for the final prosthesis.
    When the implant didn’t fit properly
    I was made to feel like I was creating problems.
    With no impression kept I had to have a wax version put in my mouth for a few hours and had to decide if it felt right.
    This happened three times at least.
    Surely records should be kept Incase things go wrong?
    I was told the impression Gets destroyed when the teeth are made.

    How do I get over the stress of this.
    I was told nothing that truly represents the experience and reality of this procedure
    Which leaves me feeling scared and uncertain as what to expect in the future.
    Night after night I go over this
    Every time I look in The mirror
    I am reminded.
    This seems to be the most poorly regulated medical procedure out there.
    I had eight teeth removed with only the front two teeth loose.
    I now feel that surely there was another way.
    I was told it was better to do it this way as it would be harder to perform this procedure in the future.
    I was not given alternatives I wa stood this was the only alternative to a denture.
    I was led to believe that what I was getting would feel like my own teeth
    And weirdly it was not called a denture but implants which was very confusing

    i now don’t play my clarinet very much which is not very good as I teach the instrument.
    What this dentist has done to me has been devastating.
    I have a very reel sense that I have suffered a sort of negligence
    Through mis information lack of information and no care plan
    How can dentists get away with this
    How is it this procedure is not properly regulated and that dentists do not have to follow a proper care plan

    Reply
    1. RamseyAminDDS Post author

      I was very troubled when I read your comments. Dentistry is supposed to improve peoples lives not the opposite.
      Unfortunately, the public believes that replacement of all teeth with all on 4 or any other type of dental prosthesis is “easy.” It is far from that! There are thousands of details that go into every decision that I make before restoring someone within “all on 4, 5, 6, 7, 10” whatever the number is…

      The contours of natural teeth and the contours of a full arch of replacement teeth are very different. Sometimes people’s bone skeleton relationship do not allow for proper lip/skin/facial support unless part of the bridge is bulked out. This does not mean everything and everyone has to be bulky and “hyper contoured.”
      This can be controlled by how the implants are positioned and the 3-D design of the implant teeth. Every single patient I treated go through a series of prototype’s and temporaries to mimic the final. This would allow you to test drive everything before going to the final. I review all of this up front with an extensive exam and photography with virtual 3-D planning.

      Implants are unfortunately not teeth. They have contours that are not like teeth especially if you have significant bone loss and require a gum and bone replacement with pink ceramic. This pink ceramic can be made very smooth and fitted it can also be made way too thick for given situation.

      Perhaps you can just have the Bridges redone by a more experience dental implant provider?? Unfortunately a lot of what I do is redo cases for patients that chose to have treatment done in a less costly manner but were unimpressed with the final results or had complications.

      I appreciate your comments. Let me know if there is anything I can do to help.

      Very respectfully,
      Dr. Amin

      Reply
  5. Alison

    I had an all on four implant procedure done with a dentist in the uk in 2014. Unfortunately he did not give proper consultations leading up to the procedure so I was not aware how different my mouth would be.
    I am a clarinetist so the positioning of my teeth is very important. I was told it will just be like your own teeth, this of course is not true. When I came to have the final prosthesis fitted not only was it not what I expected it did not fit and the angle of the teeth made it unfit for purpose. The teeth sloped inwards and the amount of plastic in my mouth restricted my tongue. The teeth seemed in a completely different position in my mouth. We spent a further year trying to get this right but he did not keep the impression of my teeth so there was nothing showing the shape of my lower teeth or where they sat in my mouth. He did not take photographs so there was absolutely no record from which to work.
    I still wake in the night feeling angry. I feel that his patient care was extremely negligent and I am very worried as he seems to have no aftercare plan.

    my advise to anyone planning this procedure is to do your research and make sure your dentist has a proper care plan. Make sure you ah e proper consultations before you get this procedure done find out how he keeps records of your mouth before and after. Keep reference of the position of your teeth because he may not!!! Take photographs.

    I have been left feeling like I have been through a very expensive procedure with results that have changed how my face looks and the teeth are nothing like your own teeth. I wake up worried about my mouth nearly every night and the anger is still there.

    He told me, and I can hardly believe he said this, if we told people everything nobody would get it done! Surely you have a right to know all the pros and cons before you make a decision

    Reply
  6. Christal

    I read one of the comments where her teeth feel bulky and not natural at all ! I just want to put this out there because I am in total shock of the feel of my new teeth also 🙁
    I watched video after video and no one ever explained the true feel of these things ! ( at least what I ended up with)
    I now know that many many doctors are taking advantage of people by promising one thing and totally giving something else! ( and they end up with a pocket full of money while we look for a better answer!)……. I think you are an awesome person for putting this help out there, ( I, unfortunately, found you after the fact)…… I would like to suggest that more people start doing videos on their own personal true experience ( as I definitely plan to do)
    Again! Thank you for this site and all your help ?

    Reply
    1. RamseyAminDDS Post author

      Thank you for your very kind words. There is so much to this process of replacing all teeth and unfortunately very few people do it really well. unfortunately many patients choose treatment based on cost alone and think that an all on 4 with one dentist is the same as an all on 4 with another dentist….. Definitely not the case

      Reply
    2. Ethel Lee

      Yes; that was me.
      And I agree; no one prepared me for how unnatural this would feel, and it’s been two years.
      I just had a CT scan done to see if I’m a candidate for a permanent bridge. But my dentist didn’t give me confidence that the permanent piece would be significantly less heavy and bulky than what I have now. My hope is that it will be the width of natural teeth without the hard ridge, but now, I don’t know.

      Reply
  7. Terri

    Why do so many dentist do the implants one day and make you wear removable dentures, then come back 4-6 months for the permanent bridge to be put in? How much better is it to wait for healing with removable dentures then to use a temporary permanent bridge during healing?

    Reply
  8. Edward

    Great site. You are an extraordinary Doctor to provide knowledge to dental patients who do not live near you. Just like to add this page may use an edit.
    “Sometimes “advertised as smile and a day” Should be “advertised as smile in a day”.
    Unless it was done on purpose because the phrase is copyrighted in that case, very clever I knew what you meant.

    Now a little about me. Had a crown on #7 for 25 years until it fell off from decay. Tooth had good structure so it was hollowed then a ceramic tooth was made to fit in it. Sort of like a crown in reverse. I guess because ceramic is not ideal material for bonding to natural tooth that way it also fell out. I decided implant would be my best option. Bovine powder was used for the graft after extraction on 10/22/16. On 10/25/16 I developed a fever of 102.3 it has since come down after starting amoxicillin.
    My question is could the graft fail now due to the fever?

    Thank you for such an informative site. You are doing a great service.
    ed

    Reply
    1. RamseyAminDDS Post author

      your dates are strange because they are in the future! I’m guessing me meant to say 2015. Occasionally someone will develop a coincidental fever or some will develop a “surgical fever” if treatment was substantial. I would not worry about it too much at this time. Typically the amoxicillin though it started before the procedure. This blog post on antibiotics may help you understand when antibiotics are appropriate.
      Thank you for your very kind words. I do enjoy doing this and only wish I had more time!!!

      Reply
      1. Edward

        Dr. Amin, I should worry about my own edit. LOL. The dates were confusing because I used the wrong dates. I thought we were in Oct already instead of 09/22/16 for the extraction and graft then 09/25/16 for the fever. I was searching the net for possible fever cause for the very recent procedure and found your site. Thank you again for this great site. Not only is it great for patients I would say it keeps fellow Dentists on their best too. You are the best.

        Reply
  9. Ethel Lee

    I have a one-on-four upper and I am so uncomfortable by the weight and bulk of it in my mouth. Even though the palette is uncovered, my tongue can only rest on the hard artificial material. It doesn’t feel that much better than a traditional denture.
    My question: would a permanent solution be less cumbersome? Would I still have that ridge of hard material covering my upper gums and behind my teeth?
    Also, is it possible to upgrade to a permanent solution without having to start from scratch?
    Thanks!

    Reply
    1. RamseyAminDDS Post author

      It sounds like the design you have is very bulky. I find that many patients that have this done have not been prepared for what to expect. In my practice I design every one of these cases myself. Each mouth is so different in the transition from the palate to your natural tissue is one of the most overlooked area. Replacing of all the teeth is like replacing body parts. Making the teeth is more often more difficult and more costly than the surgical implantation itself. Yes it could be redone but you will likely need to start from scratch. I would suggest you find someone who is highly trained in this process and do not shop based on cost if you want this to be done properly.

      Very respectfully,

      Ramsey Amin DDS

      Reply
  10. Faizaan Rana

    Dr Ramsey,
    I am 24 years old and have been suffering from gum disease for the last 2 years. I have been seeing my gums and bone rapidly recede away especially on the front lower teeth. To the point where I now have no “papilla” between my teeth and have generalised bone lose horizontally of about 15% throughout my mouth according to my periodontist. We are working to treat the active periodontitis and stabilise my pockets so that I can keep my teeth. However my smile is very unaesthetic and I am considering that once my periodontal situation is stabilised to get a full mouth reconstruction so I can smile again and talk to people comfortably and stop feeling so depressed!

    Do you think I could be a candidate for All on 6 implants even with my bone loss situation ? The bone loss is even and I have lost about 20% of the height of the bone (in the direction of gum recession). Is it possible that I can get bone grafting to build back up the jaw bone and get a procedure such as all on 6 ? I would like to avoid all on 4 due to the reasons you have already stated. Due to my young age and previous gum disease status I would be looking for a highly personalised treatment to try and get the most long lasting implants possible and best function possible. Will I still have gaps between my teeth and lack of papilla between my teeth as I currently do with my natural teeth ?

    Are implants/bridges even a possibility for someone like me? Or would someone in a situation like myself be resigned to wearing dentures? I dread the though of having dentures in my mid 20s !
    Also I am from the UK, do you treat patients from abroad? I would be looking to come to an expert like you once I have saved enough money. I am aware that it may be difficult to answer my questions without seeing me, but could you try and give a general answer based on the information I have provided?

    Regards,
    Faizaan Rana

    Reply
    1. RamseyAminDDS Post author

      It may not be worth rebuilding all the bone back because he may end up with something that does not look as attractive. Sometimes leveling the bone downward a bit will allow 4 a much better restoration such as a Prettau zirconia style restoration. With the person as young as you,, but should be a last resort. If you’re roots are long, try to keep your teeth rather than extract them and have implants but if there is no other option then bone leveling may help you save money and have a better, longer lasting dental implant situation.

      Reply
    1. RamseyAminDDS Post author

      Burbank, California. Costs cannot be determined with out seeing you. Each situation is unique.

      Reply
  11. Doctor Finn

    This is an unbiased and accurate review of the all on 4 technique and i believe it to be an accurate description of the pros and cons, well done

    Reply
  12. Terri

    When you get the all on 4 or 6 or 8 is the temporary denture a fix denture that can only be taken out by you or another dentist? And then in 3-4 months when you are healed you come back for the temporary one? Or will the temporary one be a removable denture?

    Reply
    1. RamseyAminDDS Post author

      this is highly variable in depends on your particular dentist. In my own practice I would highly advise that a temporary that is fixed in place be worn in order to test drive a full arch fixed restoration such as all on 4 or the Prettau dental implant bridge.

      Reply
    2. Terri

      Why do so many dentist do the implants one day and make you wear removable dentures, then come back 4-6 months for the permanent bridge to be put in? How much better is it to wait for healing with removable dentures then to use a temporary permanent bridge during healing?

      Reply
      1. RamseyAminDDS Post author

        often this decision is made based on the density of your bone, how much bone you have and your bite structure. The upper jaw carries much more risk than the lower jaw for doing this. In general waiting longer is always beneficial while speeding things up adds a degree of risk especially for the upper jaw. Read this post about the process of replacing all teeth with a much better process been only using 4 implants for an entire upper jaw.

        Reply
        1. Terri

          When having the best of materials like what you use how long can someone expect them to last? I am 53. I went to a well known oral surgeon here in Florida. I was told I had plenty of bone. He said he would use 6-8 on top and bottom. He also said that if I ever had any problem that it would be taken care of at no charge. I would have to go to my other dentist for the bridge work which I think I would rather have it at done in one place. It just might be worth taking a trip to see you! I seen another post from someone that does not live close to you and you sent a private message to someone closer to them that you would recommend. By any chance is there someone in Florida?

          Reply
          1. RamseyAminDDS Post author

            Hmmm…not sure of the skill set for that particular procedure. Full uppers are complex

  13. NANCY

    what is the cost of fixed dental implant bridge and can you just brush them with out removing the and can food get in between the teeth.

    Reply
      1. NANCY

        Ilooking for the fixed dental implant bridge that you don’t have to remove and were food does not get in side and discoffort

        Reply
  14. Serge Anlo

    I agree with your statement. The all-on-4 treatment IS not the best option for replacing dentures. It is heavily marketed. No one that I have met ever said that they love their dentures, most especially their lower ones. As you are aware, once a tooth is extracted, bone loss begins. A floating lower denture is not very comfortable, let alone an upper denture with the palate covered with gooey fixodent.

    If my mom or dad will ever need to replace all their teeth, the All-on-six is definitely what I will have them do.. gour is NOT enough.

    two people I know are already having issues with their all on 4’s!

    Reply
  15. DrAminRocks

    If you get a prettau on the bottom jaw with 6 implants what happens if something breaks? Or an implant fails – is this money in the garbage? No one seems to have the answer to this. I hear what you are saying with the all on 4 – I would rather have 6 implants on my bottom jaw but after spending money I worry about failure of something

    Reply
    1. RamseyAminDDS Post author

      if it is designed properly, the bridge can be removed typically by just unscrewing it. A bad implant can be removed or treated and the monolithic zirconia Prettau dental implant bridge can still function on 5 dental implants. When the only have for implants and one of them fails it becomes “none on 3” rather than “all on 4”

      Implants are removed and treated for bone loss in about 5-10% of patients. It is better to design them to be strong then to lose all of your money and time because of under engineering

      Reply
  16. Dee

    I have only three good (natural) teeth in front on top, the rest of my top teeth are bridges or crowns all in need of repair. I was planning on going in for the all on four, but now I’m not sure. What would you recommend? Do you think individual implants and crowns are better than the all on four? Thank you so much for your advice?

    Reply
  17. Brenda

    Which is better the all on 4 or Implants Supported Porcelain Bridge, Full Arch (with 4 implants or is it the same thing?What about the overdenture? Whats your opinion on going to Mexico for this?

    Reply
    1. Brenda

      I am also wondering iif this is good or if the ones listed above are better”All on Six” System with fixed Porcelain bridge – MegaGen Thanks

      Reply
      1. RamseyAminDDS Post author

        HI Brenda,

        As I mentioned in this post, the all on 4 is a very under engineered design. If even one implant fails you’re going to lose everything that you paid for.

        Design your bridge with more than 4 implants is going to be key especially if it is in your upper jaw. These type of procedures are not done in 1 day like the commercials say. They require many visits and are the most complex restoration that a dentist can make. Traveling to Mexico may save you some money, but I have seen some disastrous results. It ends up causing more to retreat a situation than if it was just done right the first time.

        I would suggest a minimum of 5 implants on the lower in 6 implants on the upper with a porcelain monolithic zirconia bridge such as the Prettau. You can also make smaller segmented Bridges rather than a roundhouse bridge depending on your unique situation. Find the expert in your area to do this for you.

        Respectfully,

        Ramsey Amin DDS

        Reply
    2. RamseyAminDDS Post author

      HI Brenda,

      As I mentioned in this post, the all on 4 is a very under engineered design. If even one implant fails you’re going to lose everything that you paid for.

      Design your bridge with more than 4 implants is going to be key especially if it is in your upper jaw. These type of procedures are not done in 1 day like the commercials say. They require many visits and are the most complex restoration that a dentist can make. Traveling to Mexico may save you some money, but I have seen some disastrous results. It ends up causing more to retreat a situation than if it was just done right the first time.

      I would suggest a minimum of 5 implants on the lower in 6 implants on the upper with a porcelain monolithic zirconia bridge such as the Prettau. You can also make smaller segmented Bridges rather than a roundhouse bridge depending on your unique situation. Find the expert in your area to do this for you.

      Respectfully,

      Ramsey Amin DDS

      Reply
    3. RamseyAminDDS Post author

      HI Brenda,

      As I mentioned in this post, the all on 4 is a very under engineered design. If even one implant fails you’re going to lose everything that you paid for and the time it took.

      Design your bridge with more than 4 implants is going to be key especially if it is in your upper jaw. These type of procedures are not done in 1 day like the commercials say. They require many visits and are the most complex restoration that a dentist can make. Traveling to Mexico may save you some money, but I have seen some disastrous results. It ends up causing more to retreat a situation than if it was just done right the first time.

      I would suggest a minimum of 5 implants on the lower in 6 implants on the upper with a porcelain monolithic zirconia bridge such as the Prettau. You can also make smaller segmented Bridges rather than a roundhouse bridge depending on your unique situation. Find the expert in your area to do this for you.

      Respectfully,

      Ramsey Amin DDS

      Reply
  18. Brandon

    I need to get an idea of cost for All on 8 for my upper.
    Porcelain vs non-porcelain etc.
    Also I need 3 implants on my lower.
    My bone structure is still in tact.

    Thanks!

    Reply
    1. RamseyAminDDS Post author

      This is a massive question that cannot be answered without seeing you. Even though your bone is “intact” it does not mean that things will be simple or difficult. There is a lot more to it than just the bone. I would suggest you find somebody who does a lot of full mouth dental implant reconstructions. I recommend you for looking to have 8 implants placed on your upper jaw. You cannot believe how many all on 4 restorations I ended redoing because one implant failed causing it to become “none on 3.”

      The upper jaw is always more complicated and costly than the lower jaw. They can vary from possibly as low as $20,000 for some non-porcelain options to $60,000 depending on the need for grafting and temporaries. Sinus grafting is often commonly needed for the upper jaw but sometimes it can be avoided by a purposeful tilt placed on the rear most implants as long as you’re sinuses don’t come too far forward. This post on digital treatment planning for Prettau dental implant bridge may help you understand some of the variables involved.

      Sometimes doing segmented small Bridges is better than a roundhouse single unit but it will depend on your unique situation.

      I hope I have helped you at least a little bit

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  19. Mike Fulara

    Thanks for your information. I have recently contacted Dr in Las Vegas about an all on four procedure. He claims to do the entire procedure in a three day visit. He has his own milling plant on site and they make the bridge there immediately. I am very skeptical and would like your opinion of his work. He claims to be the only dentist in the world able to accomplish this procedure in a three day visit……..complete and permanent.
    Look forward to your opinion
    Mike

    Reply
    1. RamseyAminDDS Post author

      For the last 16 years I have provided this teeth and a day procedure. It is an excellent procedure….. But, I would never deliver a permanent bridge within 3 days. I only deliver a temporary bridge.

      The problem is, there is no way to test things such as cosmetics, function, TMJ position, etc. There is also substantial surgical swelling which makes contouring the bridge to your gums almost impossible. This could leave gaps or extra gum between your bridge and your natural gum…. Although it is possible, I don’t think the result is as good as waiting for short period of time. You may end up with your expectations not being met. The temporaries allow the time to work out all the details so that you and your dentist have made sure that all is as perfect as can be.

      Maybe if technology evolves more I would consider it but I would not do this on my own family as of 2015.

      I’m sure I have confused you more than ever now!!

      Happy Thanksgiving

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
      1. Debbie Thompson

        He is so right in what he is saying , please don’t have it done as it’s impossible to have all your teeth and be permanent in 3 days ,your mouth and gums need weeks if not months to settle,I’ve just had all on 4 top and bottom£30.000 and am now really worried that I haven’t had enough implants placed

        Reply
    2. RamseyAminDDS Post author

      For the last 16 years I have provided this teeth and a day procedure. It is an excellent procedure….. But, I would never deliver a permanent bridge within 3 days. I only deliver a temporary bridge.

      The problem is, there is no way to test things such as cosmetics, function, TMJ position, etc. There is also substantial surgical swelling which makes contouring the bridge to your gums almost impossible. This could leave gaps or extra gum between your bridge and your natural gum…. Although it is possible, I don’t think the result is as good as waiting for short period of time. You may end up with your expectations not being met. The temporaries allow the time to work out all the details so that you and your dentist have made sure that all is as perfect as can be.

      Maybe if technology evolves more I would consider it but I would not do this on my own family as of 2015.

      I’m sure I have confused you more than ever now!!

      Happy Thanksgiving

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  20. Jim

    Thank you, Doctor. I am going for a Clear Choice interview today. Your video was very helpful in giving me some ammunition when I walk in.
    Much appreciated.

    Reply
  21. Rick Wagner

    I’m probably not on the right blog, seen you had something concerning gum grafting, but couldn’t find it again. Quick question in addition to previous, I agree with you 300% about all on 4 being under engineered (short term solution)… In order for additional implants I would more then likely need a certain amount of bone grafts, can this be accomplished while I wear the all on 4 bridge and can my new zirconia and current implants be utilized in the upgrade lets say to 6-8 implant foundation? Thanks

    Rick

    Reply
    1. RamseyAminDDS Post author

      Hi Rick,
      I just sent you a reply a second ago.

      You can transition to a better bridge such as the prettau and wear the current all on four in the meantime. This will take some excellent planning and skill On the the part of your dentist. The grafts can be done simultaneously and may work better with you already in a fixed bridge.

      The all in four is weak. Zirconia is very strong AS LONG AS IT IS THICK ENOUGH AND FITS PASSIVELY. If not, it will break. Watch out for cheap imitations! Go to someone that really knows what they are doing. These are tough cases.

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Reply
  22. Rick Wagner

    Interesting topics and opinions, thanks for being online.I have a all on 4 completed and have mostly been happy (21/2 years and rolling), zirconia is ready for install now, an upgrade to myself. Haven’t had to go back for breakage now for 10 months (have had 3 incidents either tooth broke off or bridge broke in two), now that its time to go back I have been having a bit of infection in one of the front implants, it appears to be stable, no or very little swelling, but “several threads” are showing above the bridge, gum loss I suspect at a minimum. I remember I had a horrible amount of bone loss in this area to start with.
    I may be guilty of too hard or too much brushing on the gum line and the channel of the bridge, waterpik daily. I guess what I’m getting at is if the infection is due to implant exposure is there any way to clean and graft gum over existing implants that are accessible? Thanks, Rick

    Reply
    1. RamseyAminDDS Post author

      Hi Rick,

      This post Will help you understand what is likely happening around your implants. The best way to avoid bone loss around an implant is to have the implant have tons of bone on the outer wall of it. This strengthens the system.

      http://www.burbankdentalimplants.com/what-is-peri-implantitis-and-what-do-i-do-about-it-bone-loss-around-dental-implants-burbank-dentist-ramsey-amin-reviews/

      This is going to be a tough situation to deal with especially if threads are showing.

      Reply
  23. heather

    dear dr amin i sent you an email two dys ago did you get it i am patiently waiting for your comment, i have a blog i set up and so many people including children have denteno genisis imperfecta, and do not know what to do about it, my mom had it so she took control and did what was needed for me as a child through pedodontists ect, had all teeth that chew covered with metal and front teeth bonded, i was very young when i went into the hospital for this treatment, the only thing she never agreed with was the braces, but the prostodontist said he would not work with us if we didnt do it, the orthodontist, said he had worked on several children with this, it was awful braces were so painful had to be put up under the gums because no enamel, finally my mom took me to another orthodontist, who said they must come off immediately, hardly any roots with these teeth , and small little baby teeth, they never really grow, and no canals, calcified. she had to move back everything he did, needless to say i got a new prostodontist too, finally got everything done, got all teeth crowned and was done i felt beautiful it was completed after my graduation from high school, i was like a little bird finally set free from 18 years of hiding my smile,i have helped a few people on my blog by telling my story no braces! not for these teeth anyway, but after my car accident thats when the trouble started, and i decided to get implants, i wasnt an easy case,as i later learned the bone in a denteno genisis patient is also like that of a child it stays thin and small to hold baby teeth it doesnt get fatter like adults so implants are not just the answer to this situation more extensive work is needed like bone grafts or sponges or all the new techniques out there , i went to the school in boston had a hip graft, and implants were placed , and earlier implants that i already had were reinforced also with the bone harvested, this is no easy procedure, today they have more newer ideas like sponges and other things, so anyway i am just waiting to hear from you than you so much for taking y;our time to help me

    Reply
    1. RamseyAminDDS Post author

      Hi Heather,

      I never got your first email. Only this one. Sorry!!

      What is your question???

      You told your story, but I don’t know what you are asking.

      Your case is complex and I am certain the bone grafts are needed.

      Please cut and paste your entire story when you ask your question.

      Sorry and thanks for posting!!
      :-).

      Reply
  24. Chris

    This is very interesting; thank you for posting . I recently had the all on four top and bottom ( I got six implants top and 4 bottom , the original plan was to have permanent top and bottom detachable. Now I am being offered permanent bottom also, but with less warranty and the teeth went from, monolithic milled teeth, to pmma overlay teeth….. What exactly does that mean?
    Thank you so much .

    Reply
      1. Christal

        I’m now going into month 8….. Still in tmps, sounds like I traded the screwed in bottoms! For all tmp teeth!!!!! They are basically cut down screwed in dentures! I hate them! Everything I eat sticks to them!!!! I have to brush immediately after I eat!!!!! These absolutely do not feel like my natural teeth! ( as I was told ) in already thinking about upgrading to better teeth! But at this point! Don’t really trust this dr anymore ! What would u suggest I do????

        Reply
        1. RamseyAminDDS Post author

          You need to have a conversation with your dentist about expectations and be very clear with what it is you are actually getting. Keep in mind that dental implants are not teeth, they are replacement teeth that are trying to be made to mimic your original.

          Reply
  25. heather dill

    i want to say also i am very far from you as it looks like you are in California so there would be an expense of flying there, i am such a mess,i really need help i dont know if you would consider using me as a teaching thing or something to keep cost down but if ryou could let me know what you think , i just liked that you seemed honest and upfront so i hope i get an email from you or something to let me know , i am considering going to the school here in florida to see what they say and someone told me about going to brazil as it is way cheaper just dont know where to turn as i have a child to take care of too, she is only two. i use to think i was finally pretty and got my self confidence back when i was 18 when i finally restored all my teeth but now i am in temporaries they are literally falling apart because they are temps but no one can do me i have seen so many here and i even flew to ny and was turned away again by a famous dentist and i didnt tell him i needed a payment plan, he just didnt want to be bothered. everything is money people dont care anymore.

    Reply
  26. heather dill

    you probably wouldn’t be interested in helping me because everyone turns me away since i have been through so many procedures with dentists who start stuff with me then don’t finish because they cant handle my case so they give me some lame excuse to dump me. i put a lot of money into my mouth to try to fix it including braces which actually damaged me more than helped because i have denteno genisis emperfecta. i had full mouth crowns and was in a car accident which damaged a few so thats when all my problems started ,could not match what was in my mouth and some teeth were failing so needed to go the implant route, so from there one mess after another now since the economy failed i have been short of money and i had a baby and a miscarriage so that took money and my time to heal and now my child is two i am trying again to fix my mouth i dont have a lot of money need some kind of payment plan my mother said she would help all she can. she has denteno too but has false teeth and hates them. was going to get all on four but saw your video and is leary now . i was told i am not a candidate for that . i have many implants , already went through four failing in lower front, had removed, was very bad , had a bone hip graft done then replaced all four, they are failing again due to the implants themselves having an issue, so need removed i am in much pain everyday as my lower is a mess

    Reply
    1. RamseyAminDDS Post author

      This is a very complex question that cannot be answered without a detailed examination and X-rays.

      The all on four is very under engineered especially if you’re considering this for the upper jaw. Long-term results are not promising.

      Consider doing something better by having more than just four implants.

      Reply
  27. Raymond E LaVigne, DDS

    excellent presentation. Very refreshing to hear what you said that reinforced what I believed was true about “All On Four”

    Reply
  28. Gary brinton

    I would first like to say that you video was very informative and helpful in my plite to have a good dental outcome. I would like to find out more on your 7 or 8 on one implant for the bottom. At this time I am working on the top teeth. I am going through my restoration work now and have three implants in and more to go. I would just like to know if it is better to do all individual implants or a all in one. I am not rich but I do enough overtime to pay for what is needed. I now am spending approximately 2300.00 per tooth. I am 52 and I want to get a lifetime of use out of the new teeth, this is my delema. I would like to know what you think would be my best option?
    Thanks again for your help and support…..

    Gary Brinton

    Reply
  29. David K

    I would first like to say thank you. There are not many dentists out there with the knowledge that you have that are willing to donate some time to answer questions by the public…. Anyway to cut to the point, I am a 24 year old male and I need a total mouth restoration. When I was a teenager I didn’t have the best oral hygiene habits and my adult teeth suffered as a result. In early high school I visited a pediatric dentist and had extensive work done on ALOT of my teeth. Mostly fillings and metal crowns (rear molars), and on my front teeth I also had fillings. Well my front teeth fillings were white at the beginning, now after about 7-8 years they are completely yellowed and look absolutely horrid. Additionally a lot of the fillings I had done have since withered away and are pretty much non-existent. I went to a local dentist in my area and she suggested a slew of work. A total of 2 single implants (I believe one of them would have been a 2 or 3 tooth bridge), 9 root canals (plus crowns), and a slew of other work. The total tag for the plan was north of $50k. Well I didn’t have the funds available at the time (4 months ago), and of course I wanted multiple opinions, but my main objective was to get a figure so I could get my finances in order to be able to tackle the project. Well I am now close to having my financial situation in tact and able to do this, so I am shopping around for the procedure.

    Recently while researching online, I ran across a dentist 3 hours away from me offering what’s called a FrontRow only procedure. It consists of a complete makeover of teeth #6-11, and he says it’s compelted with Porcelain crowns. After reading your blog, I thought you may have an opinion on this procedure. My main question is whether this is a “too good to be true” procedure or not. If you would like to take a look at my situation, I have copies of my x-rays, and mouth pictures, as well as the treatment plan the local dentist recommended if you can/would like to give a personalized opinion. I live a little south of Tampa, Florida.

    Reply
    1. RamseyAminDDS Post author

      Hello David,

      It sounds like you need a whole lot of dental work. In order to have a healthy, strong and attractive front teeth, the back teeth must be taken care of. If you just focus on the front row of 6, you are bound to have problems in no time at all.

      Unfortunately no type of dentistry lasts forever. Having the best type of dentistry you can afford and maintaining it is going to be the key. Your diet, oral hygiene and the condition of your natural teeth below the crowns is going to be the main determining factors for how long all this will last.

      I’m hoping you have eliminated smoking, soda and any other bad habits.

      At age 24, I be very hesitant to remove all of your teeth and replace them with an all on 4 or even a Prettau dental implant bridge. If your teeth can be saved in a predictable fashion with limited dental implants that would be best for now. Keep in mind this will be constant maintenance project for the rest of your life. I would suggest you find a really good dentist and have a completely treatment plan to help to keep your teeth for a lifetime.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  30. FF

    my all on four broke a year after placement….it happened because ***one*** implant failed. $30,000 down the drain…I wish I had come to you.
    ;-(

    Reply
  31. Kathy Nedvecki

    I got my snap on dentures two years ago and have been going through complete hell ever cents. My dentist that I’m going to now has not been able to get the denture to fit right it is my lower denture they only place to implants and everything gets underneath it that I eat food anything gum it moves all over the place it’s just been horrible. My question is do I need to more implants or is two implants suitable for a 36-year-old woman. I would love to hear back from you I spoke with your right-hand lady for whoever she has and she was awesome. She answered every one of my questions told me I should blog you’d answer back. That maybe You could refer me to somebody that’s in Utah that really knows her stuff about dentures or I could have a mold of my mouth done and sent to you and you could do my denture.I would love to hear back from you. I just need somebody that knows what they’re doing I can’t go on another two years in that same situation that I’ve been In. I’m embarrassed of my mouth I don’t want to go out in public. Please help

    Reply
    1. Ramsey Amin DDS

      Hello Kathy,

      2 implants is just not enough. If your 75 years old and he had been wearing dentures for years and years and you just needed a little bit more support, then I would say 2 dental implants is enough.

      An implant over denture with only 2 implants will always lift and rock. I would suggest converting your existing denture by adding at least 4 more implants and having a fixed porcelain bridge such as the Prettau dental implant bridge. I would avoid the all on 4 procedure for somebody your age.

      Prettau dental implant bridge

      good tips on finding a dental implant dentist:
      How to Choose an Implant Dentist

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
    2. David K

      This is his webpage about the procedure (I hope I am allowed to post this, I just need an opinion, not trying to advertise or anything like that.

      Reply
  32. Shell

    Dear Dr.,
    I’m 29 years old and yesterday, I had an Ossifying Fibroma removed from my mandible and teeth 19 & 20. The tumor had encompassed these teeth and a large portion of my buccal plate (left side) could not be saved.

    The surgeon told me to come back in 3 months for grafting and implants. Could you explain to me why grafting wasn’t done right away? Why wait 3 months? Maybe to make sure it heals well since the loss was due to a tumor…. Also, once he does the grafting will he wait to place the implant screws so the bone has time to grow? He is an oral surgeon and I know it can take a team of dental professionals to get the job done, but so you have any advice for me.

    Thank you in advance 🙂

    Reply
    1. Shell

      I had already had the biopsy performed 6 weeks prior and the ossifying fibroma came back benign. Why wait another three months to graft?

      Reply
      1. RamseyAminDDS Post author

        Your situation is unique enough that it is probably best to stage things rather than try to combine anything. I hope it is going smoothly for you. Sorry for the delayed reply. Your comment got picked up into the spam filter.

        Reply
  33. vince

    I really like this post!!! I am a dentist also. I have seen so many all on 4 Bridges fail. I’m sure this is the calm before the storm as so many of these low-cost clinics are doing these. We will both be doing a lot of redo cases to help these patients that had all on 4 dental implants that did not work

    Reply
    1. Ramsey Amin DDS

      Hi Vince,

      Unfortunately, I have seen the same problem. For the last 30 years we have been using tried-and-true techniques using the proper number of implants now many people think you can just cut corners and use less anchors. Our biology has not changed, and dental implants are still made of titanium.

      Dr. Amin

      Reply
  34. Bobby Smith

    Dr. Amin – I am so glad I found your web site. The information is so helpful. I only wish you were located in my area (Georgia).

    I am 55 years old. recently went for a consultation at ClearChoice for the All-on-Four. I was told that, while I have very limited amount of bone, they could still do it for my upper. They also told me that it was likely that I wouldn’t have enough bone left if I wait a year to do the procedure. While I know and have been told by several dentists that I have limited bone, I am skeptical that a year could make such a big difference. Do you have any opinion on this?

    Thanks again for all of your help!

    Reply
    1. Ramsey Amin DDS

      Hello Bobby,

      Bone loss is progressive in nature. Until the bone get all the way down to the very base it typically continues to shrink on a yearly basis. The sooner you have the procedure done, the higher chance of success and the less chance of complications occur.

      If you have very limited bone I would not suggest the all on 4 dental procedure. All on 4 is great if and only if you can use super long and wide implants in all locations. If your bone is limited this means that you’re for implants are going to be tiny. I would suggest a minimum of 6 implants on your upper jaw especially if smaller implants need to be done. Think about it, you are trying to replace 14 teeth that have more than 20 roots with only FOUR dental implant roots.

      This is why suggest the implants must be very large but you must have enough bone to be able to use large implants only use 4 implants.

      Also be sure to consider what type of teeth you will be getting. The clear choice dental implants that are typically provide plastic denture teeth on a metal framework. You will replace this many times over. I would suggest porcelain fused to metal or monolithic zirconia such as Prettau. Of course this is more costly but it will save you in the long-term. Most of these Bridges chip or break within the first 2 years and then continues to do so.

      Prettau Dental Implant Full Mouth Bridge

      The Process of “Permanent” Fixed Dental Implant Teeth -5 Steps to Replacing All Your Teeth

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, CA

      Reply
  35. Shari Jacobs

    great video, thanks. Extremely informative.
    Want to know how you feel about 6 implants on top, asking for zirconium piece, but do you approve of using a bar?

    Reply
    1. Ramsey Amin DDS

      Thank you Shari,
      6 implants on the upper jaw with a zirconia fixed bridge is excellent. A bar is only going to provide you with an overdenture. 6-8 implants on your upper jaw is going to provide you long-term support for the naturally soft bone of the upper jaw. Remember that the lower jaw is much more dense and therefore less implants can be used. I’m strongly opposed and almost all situations to and all on 4 situation on the upper jaw.

      I would suggest having a Prettau zirconia bridge on 6-8 implants for your upper jaw. This is an excellent prosthesis that when done correctly is likely to out last any dental restorations on the planet.

      these web links should help you:

      Prettau Dental Implant Full Mouth Bridge

      The Process of “Permanent” Fixed Dental Implant Teeth -5 Steps to Replacing All Your Teeth

      Fixed Dental Implant Bridge vs. Implant Denture – What is the REAL Difference?

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  36. Ashley

    Hi Dr. Amin,

    I recently had a endodontic retreatment on a tooth (#12). My first root canal was in 2007 by a general dentist. A little over a year later I started developing an abscess in my gum above the tooth. Since then I put off taking care of my situation with any dentist. My face swelled up almost double in size so I had to visit a dentist at that point. Having no insurance whatsoever with a minimum wage job has been my only excuse.Two months ago I went to a dentist close to me that was considerate of my financial situation and referred me to the endodontist. I return to the dentist after the retreatment next month for, “A follow up is to remove the original crown and look for any decay. Possibly needing surgery on the tip of my root”. I know what needs to be done but having no one to rely on for help makes it more difficult. I’m very confused about what I should do. I’m putting trust into this dentist and don’t know if its the right choice.

    Reply
    1. Ramsey Amin DDS

      hello Ashley,

      You may want to consider having dentistry done in a local dental school. This may save you about 25%. The dental school typically only performs pretty basic work because it is done by students. Just expect to be there for a very long time for each appointment which will average between 3-4 hours to have just one tooth done. Given your situation, this may be a good option for you to get more bang for your buck. Most major cities have a dental school.

      Good luck,

      Ramsey Amin DDS

      Reply
  37. Catherine

    Hi
    How expensive is a sinus bone graft and is it guarantied for the implant to be secured? What can you have placed while the bone graft heal? And how do I find a good bone graft/implant dentist in New Jersey ? I live in secaucus. Thank you

    Reply
    1. Ramsey Amin DDS

      Hello Catherine!

      Nothing in medicine or dentistry can be guaranteed to work…that is against the law to promise a patient. That being said, sinus bone graft done by a skilled dental implant practitioner is likely to be successful. This allows very long implants to be used which are much more stable than short implants.

      Depending on the type and size of sinus bone graft that you need, the cost can vary from $500-$5000. I would suggest finding a dentist who has similar qualifications and is a Diplomate of the American Board of Oral Implantology. I only say that because these dentists have been board-certified in their peers have examined them through rigorous process to make certain they are good.

      Here’s a link that will help you

      http://www.burbankdentalimplants.com/how-to-choose-an-implant-dentist/

      😉
      Very respectfully,
      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, CA

      Reply
  38. Georgia

    The “All-On-4” dental implants totally changed my life. I wish I would’ve come to your office sooner. The teeth keep breaking and I’ve only had them for 18 months. They looked good when they first started, then they just started to change and stained like my old denture teeth. I also have pain around one of the four implants in a bad smell around it.

    I see why you are kind of against it. I wish I would’ve read your information first and come and see you. I live in Los Angeles. Any advice?

    Reply
    1. Ramsey Amin DDS

      Hello Georgia,

      I am sorry it has such a negative experience with the all on four dental implant procedure.
      It seems like once a week now I am seeing patients were having their bridges break. Yes they are just denture teeth attached onto metal. If the problem is only with breakage, I could replace your all on four bridge to a Prettau monolithic zirconia bridge.

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      It sounds like you have problems with the bone though. You are likely going to have to remove the bridge to access the implant that has the problem. Hopefully the bad implant can be treated with a bone graft. If you lose just one of four of the anchors, you’re going to lose the whole bridge.

      You’re welcome to come see me in my office since your so local.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

      Reply
  39. Gen. Paul

    great website by the way. I’ve learned so much here. thank you for all of your time you spend on this site. I see you’ve been doing this for many years now! keep up the good work

    Reply