What is the downside of All-on-4 dental implants?

Most people considering All-on-4 dental implants hope for a perfect, long-lasting solution to missing teeth, but it’s important to be aware of the potential downsides before moving forward with this treatment. While the All-on-4 procedure can offer excellent results when performed by an experienced team, there are several challenges and complications that may arise.

Check out: What are all-on-4 dental implants?

One of the first things you might notice with All-on-4 implants is the bulkiness. Since the implant replaces not only your teeth but also missing gums and bone, the prosthetic includes a pink component that adds thickness. Unlike natural teeth that are separate from one another, All-on-4 bridges are solid, horseshoe-shaped structures to provide cross-arch stability. This means your teeth may feel bulkier than before, especially if you have significant bone loss or bite issues such as overbite or underbite.

An important downside to consider is the possibility of broken implants or bridges. Although zirconia is the preferred material due to its strength, no bridge material is completely indestructible. Bridges sometimes fracture due to bite problems or insufficient height from the gumline to the top of the teeth. In addition, implants themselves can fracture, particularly if lower-quality materials are used. If you grind your teeth or do not have a level bite, the risk of breakage increases, possibly requiring additional treatments like night guards or muscle relaxants to protect your implants.

Another issue you may encounter is heaviness. Zirconia bridges are heavier than acrylic ones, which can initially feel strange. Most individuals adjust within a few hours, but the weight combined with the bridge’s bulk can take some getting used to. This is partly why the expertise of your dentist in designing and fitting the bridge matters greatly for your comfort.

Implant failure, although not common with skilled practitioners, can happen. If an implant fails after your bridge is in place, options to replace it without remaking the entire bridge are limited. For example, losing an implant in the middle of the bridge may be manageable, but failure at the end often means having to start over with a new restoration. Your dentist’s experience plays a big role in managing these complex situations.

Bone loss and gum recession are potential long-term issues that you might face. If the gum tissue thins or recedes, metal parts of the implant or abutment can become exposed, sometimes requiring soft tissue grafts to protect the area and improve aesthetics. People with naturally thin gums may need these additional procedures right from the start.

Infections at the implant site can occur either shortly after surgery or years later. These infections, sometimes called peri-implantitis, lead to bone and gum loss around the implants and are often linked to poor oral hygiene or smoking. Staying on top of your dental care and having regular dental check-ups are important to reduce this risk.

Because All-on-4 implants lack natural nerves, your bite may initially feel less sensitive, which can affect how well you sense pressure and temperature. This may feel odd but usually improves over time. Similarly, speech changes can occur, as the thicker prosthetic may slightly alter how you talk. Most people adapt fairly quickly, though some may benefit from additional therapies.

Facial aesthetics are another consideration. The implant restoration should provide proper lip and face support, but if this isn’t accurately planned, you might experience issues like lip biting or an unnatural smile line. The skill of your dentist in using facial scanning and prototype testing will influence the final look and feel.

All things considered, while All-on-4 dental implants offer many advantages, they come with a range of potential downsides including bulkiness, risk of fracture, implant failure, bone loss, infection, altered sensation, speech changes, and facial appearance concerns. Choosing an experienced dental team and maintaining excellent oral hygiene can help you minimize these risks and achieve the best possible outcome.

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