I am wondering if the all-on-4 implant dentures should be placed 2 to 3mm from the gumline, or should they follow the gum line? Is this how it’s typically done or different for each dentist? Because of where the dentures were placed, I now have bulky lips.
Steve from Idaho
Luis,
First, let’s discuss the terminology because the word gumline means the edge of the gum that meets the tooth. If your teeth are extracted, then you no longer have a gumline there. When the teeth are replaced with dentures, the gumline then refers to the edge of the pink acrylic on the denture where it meets the false tooth. In other words, the gumline is determined by where the teeth are placed, so the teeth are always placed right at the gumline.
I believe what you mean is the placement of the teeth in relation to the ridge of the jawbone under the denture. When you have removable dentures, they need to be placed directly over the bony ridge because if they are placed too far forward, the denture will tip up in the back of your mouth whenever you bite anything with your front teeth.
All-on-4 dentures are implant-retained and they won’t tip when you bite. So it’s not as important that they be placed right over the ridge. The teeth being 2 to 3mm from the ridge is within normal range, so it sounds like their placement is fine from a functional viewpoint. However, they should also consider the appearance of your lips, and there should be a wax try-in of the dentures before they are finished. For quality dentures, the dentist should have had the teeth set up in pink wax on a plastic plate and then it can be tried in before it is processed in acrylic. Then you and the dentist should evaluate their appearance, speech, fullness of the lips, vertical dimension, and the bite to ensure everything looks good before the dentures are completed.
Your dentures are already finished, but there may still be an easy fix by having the dentures unscrewed from the implants and the teeth re-set. It can be done fairly easily to have the front teeth cut off and re-processed, and if your dentist doesn’t want to do this for free, it shouldn’t be expensive. But I should add that there may be other reasons the teeth have to be where they are placed. Nevertheless, you shouldn’t have bulky lips. If you feel like your dentist isn’t listening to your concerns about the appearance of your face, get a second opinion.
This blog is brought to you by Tulsa dentist Dr. Ryan Noah.