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Proper Shape Of Gums All on 4 Bridge

This one picture says it all. This is a temporary fixed all on 4 denture conversion bridge using 4 zygomatic implants. It doesn’t so much matter the type and number of implants as it does the shape of the underside of the bridge.

Temporary (not final) showing ideal convex contours

The bridge is convex in all aspects. If it is concave it can catch food and be harder to clean.

Sometimes I have no option but to make some areas concave in order to give better support of your lips. I try to avoid it though.

Proper diagnosis and planning of the bone leveling is what often determines this. It is determined BEFORE surgery…not when starting to make teeth.

Most bridges should have 5-6 implants but this is a special case.

Ramsey A. Amin, D.D.S.

Diplomate of the American Board of Oral Implantology /Implant Dentistry

Fellow-American Academy of Implant Dentistry 

15 thoughts on “Proper Shape Of Gums All on 4 Bridge

  1. Hey Doc.
    I have the all on four implants for about a year now. Because of the covid 19 I still have my temporary teeth. I have developed a decent size gap on the right side upper. I don’t have any pain but it is very uncomfortable. Does the gap itself cause the gum to become a little irritated? Some days it feels fine and can just feel the gap with my tongue. Other days it is really uncomfortable. Can I be irritating the gap with my tongue?
    Thanks Doc.

  2. Hi Doc Amin , I have all 4 hybrid plastic maxilla , the final bridge doesnt fit well. When my dentist screw the right side, he can not screw the left amd vice versa. Had 3 xrays but still he can’t figure out what was wrong.
    Then after a week , I came back , he tried to screw the 3 left (extremely painful that thwybhave to give me nolotil medicine ) and the 3 right then xray but it shows gap. He then tried to screw one more round on the right and one more PAINFUL round screwing on the left and then xray again. I still shows gap on the left and almost none on the right. The left which has gap on the xray the flange is digging into my gums painfully. While on the right which shows almost no gap in the xray , the intaglio is not even touching my gums.
    Please help me how to figure out ws was wrong ? Thank you in advance .Just incase you want to see my hybrid plastic on 4 maxilla
    Here is the link : https://youtu.be/HSRPI4lZjbU
    Thank you very much in advance Doc Ramsey.

    1. I saw the video. Unfortunately it doesn’t tell me too much. It sounds like the tissue is being over compressed a bit. Hard to say. It needs to fit passively not forced in

  3. Thank you, Ramsey Amin. You’ve done full sets zirconium for almost a decade and my dentist has done none. I’ve tried to research about the best options for me. Every article comments on zirconium:s heavier weight. I envision my mouth and jaw drooping down from the weight.😊. Thank you for sharing your expertise. Not everyone has it.

  4. My prosthodontist/dentistnis recommending zirconium all on four upper and lower to replace acrylic All on four. I’ve read that zirconium is very heavy and that is troubling me because of having a sensitive character. I know. Get over it. However, what can I expect in terms of the issue of heaviness.

    1. I have done these for almost a decade now…. I have never had a patient complaining about the weight. You will get used to it within 24 hours or less

  5. Hello Dr. Amin, I recently had a full set of all on four implants (from Clearchoice) it has been four months so far , with several problems arise. First problem was the way the gums were made, they weren’t even causing food to lounge more in some areas than others, then a couple of weeks later having a tooth fall off the temps. To must recently the top back part of the upper temps breaking from the last implant that was surgically inserted . ( gum and back tooth broken completely off) when I was eating lunch. All have not been repaired except for the tooth that was cemented back, . How should I address my dentist so I can fix the problems that I mentioned?? I have always been someone who hates to complain but I’ve spent way too much money to not be happy with my smile!!! Thanks for your response.

    1. Ugh..it sounds like his teeth are hybrid plastic denture teeth. Is that correct? I’m guessing there not zirconia or a more upgraded premium material?

  6. This looks like a huge amount of acrylic. Am I correct in assuming that you are only demonstrating the curve of the prosthesis?

  7. Very intelligent information _ you are just so good in every aspect of your work/ your attention to detail followed by your explanations just blow everyone else out of the game/ you never cease to amaze me, I admire your dedication and ability/ you are unique 😁 it saddens me that I do not live in america/ the time factor involved is the only thing holding me back at this stage in coming to see you ..kindest regards julie….

  8. Hi Dr. Amin, what is your input about fiberglass posts? I’m still needing a bridge from 5-13. 6,11 +13 will be extracted and replaced with implants and will hold up my bridge. They want to extract 5+7and implants on them, too. But they are still good teeth, just root canals and crowns right now. I came across the fiberglass posts idea on the internet and thought maybe I could save money on 5+7 by getting the fiberglass. The Allon4 is still a thought, just don’t have the money. Thank you so much

    1. just make sure that you are not “salvaging” teeth that will fail on you within 5 years only to end up pulling them out! Fiber posts are good but more importantly is a diagnosis and treatment plan and the ability to actually do the technique

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