Gap/Space Under My Implant Bridge

A gap or space can develop under a dental implant bridge or even a bridge with natural teeth. The focus of this post will be on implant bridges, especially immediate “all on X”/”all on 4″/”all on 6” dental implant procedures for the full arch replacement.

Gap Space Under Bridge
Gap space under ALL on X dental implant bridge temporary.

This most commonly occurs on an ALL ON 4/full mouth zirconia or acrylic bridge within the first month after the immediate temporary is placed.

Why is there a gap underneath my dental bridge?

I am going under the assumption that you had your teeth extracted, implants placed and a bridge made on the same day or by the next day. With this procedure, which I do very commonly in my practice, when the bridges inserted there is some swelling of the gums making that space really tight. Typically what happens over the course of 2-8 weeks after the procedure is the swelling comes down around the gums and it shrinks back to normal size…leaving a gap.

A common complaint is that it is difficult to speak. With this space under the dental implant full arch bridge, it is hard to pronounce certain sounds that start with “S” and “H” because too much airflow goes through.

Gap Under All on 4 Implants
Gap Under All on 4 Hybrid -Look at the Sides

A small gap would be considered normal and its best to just let it heal because it will likely increase.

Space Under Dental Bridge Affects Speech

It is more of a problem on the upper jaw because the space affects your speech. On the lower jaw I sometimes encourage to design to have somewhat of a “high water” design so that it is easy to clean. A gap or space under the lower jaw does not usually create any speech issues at all as long as the tissue surface of the bridge is convex rather than concave.

A very short-term remedy would be to place orthodontic wax into that space with your dentist permission during the time that it is healing. In my practice once I convert the patient over to a prototype PMMA provisional temporary that is closed up so that we can work out all of the details before we go to the final zirconia bridge on the implants.

Gap Under All on 4 Hybrid
Gap space under ALL on X dental implant bridge temporary.

Cleaning under the bridge for an all on 4 dental implant procedure with or without zygomatics/pterygoids is pretty much the same. A water pick and a toothbrush as long as the bridges designed well to be very easily cleansed. This is probably one of the biggest issues with these type of bridges over time and honestly has got a lot to do with how the surgery was done and whether or not multiunit abutments are used with proper margin height.

Multi Unit Dental Implant Abutments
Multi Unit Dental Implant Abutments

I know this sounds a bit technical, but bottom line is the space can be closed quite easily in temporary settings but if you have your final bridge it can be very difficult if it is made out of zirconia to close that space (although it is possible). It is more simple to do with the acrylic type of bridges because plastic can be bonded with additional acrylic.

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

24 thoughts on “Gap/Space Under My Implant Bridge”

  1. I’m 9 months on my hearing all on four upper arch and experiencing nawing pain through out the day. The space between the arch and my gums seems to be good size at different points in the day but the front seems to be squeezing my gums and irritating them causing me to live on ibuprofen… will this get better after I get into my next set of teeth or is this pain and gum irritation a forever thing ?

    Reply
  2. Just got my final lower arch of Zirconia. It’s been 14 months.
    It feels deep with the Zirconia gum on the left & really short on the right. I can also feel the 2 front abutments making me think the went too short.

    Reply
  3. I have my final full upper arch prosthetic. I asked for BruxZir Zirconia Esthetic. Unfortunately after being in the temporary PMMA for 2 months, somewhere along the process the changes the Dentist made did not get incorporated into the final . He claims he did not know how it happened and now says that the changes are minor and can be fixed with additional material. It is my understanding that Zirconia cannot be ” fixed” in this manner and leads me to believe that I do not have a solid monolithic piece of Zirconia in my mouth. How can I tell ?

    Reply
  4. I feel a tiny piece, kind of a little point made of metal pushing through the pink fake gingivae part of my temporary hybrid., attached to my upper all on 5 implants placed in January. I might be grinding teeth in my sleep! Does this ever happen yet it’s not a failed implant but just something which happens at the end of the temp cycle after initial surgery? I see my dentist to be released for final crowns/ bridge attached to the implants in 3 weeks. Please reassure me, or just tell me if this is my middle implant failing. I’m SO WORRIED!! I have no pain which is how my oral surgeon says that it would feel if it failed. I’m even scared to call him bc I fear he will blame me and say I have been grinding but I’m not aware of it if this if the case though I have a very strong bite. Thank you for your response.

    Reply
    • This is likely a very minor issue if this just on the biting surface. This is likely just the titanium cylinder showing through.

      The provisional bridge may not fully cover the titanium cylinder, leaving a portion of it exposed. This can happen if the bridge is not properly contoured or is too thin in certain areas.

      It is generally very easily corrected in the final and not something you should worry about 😉 😊

      Reply
  5. Hi,
    I have had my permanent implant bridge fitted for three weeks and have gaps and some of the implants are visible. I constantly feel like there is something stuck between my gums and the bridges and have a constant pressure. The top bridge was cemented onto the implants and the bottom is screwed on. I feel like I want to rip them out of my mouth there is so much discomfort. Is any of this usual. I would add photos to show what I mean but I don’t know how. Any advice you can give would be appreciated.
    Thankyou

    Reply
  6. I have gaps around my permanent implant bridge which food is getting stuck in. Also I feel constant pressure, is this normal. Its 3 weeks since I got my permanent arches anndI feel like I want to rip both arches out of my mouth it’s so bad. It seems like it’s getting worse instead of better. I would send photos but I don’t know how to attach them. Any advice would be greatly appreciated.
    Thankyou

    Reply
    • Give yourself at least 3 months to get used to it. At that point you should reassess. These are typically worked out in the prototype phase. Although most people can adapt there is a tiny portion of the population that has a really hard time. This is something that I work very hard at with facial scanning and digital prototyping.

      Reply
  7. Hi Dr.
    had a lot of problems with zirconia implants. First made wrong now have a small hole which brings air through and a slight pulling sensation in font teeth. Is this normal. Dentist does not want to be bothered any longer. I feel lost.

    Reply
    • Do you have an all on four style bridge like what is being discussed here? Is it zirconia? You could take it out and bond the underside to fill in the space. It can usually be fixed!

      Reply
      • Thank you. My Dentist told me there is nothing I can do final is final. Yes it is Zirconia and I have 5 implants. Very upset. It does look like it might be closing , I am having some on and off after three weeks, so I am assuming they are moving. I am allergic to PMMA badly so I don’t know if I would be allergic to the bonding and need to find a dentist with a lab close by. Otherwise they leave me without teeth for five weeks. Sounds crazy. Thank you for answering. But again according to my dentist This is it.

        Reply
  8. Hello Dr.Amim I am from Sacramento and just got back from having 14 extractions 2 sinus lifts and bone graphs with 10 implants 4 on top and 6 on the bottom 2 more will follow the sinus lift and bone graph healing my temporary archs are being held in with re line it ..and it is painful to say the least the final teeth will be Prettau Zirconia. I paid 15k for both archs..all on 6 zirconia…but I feel I need this work checked out ….6/15/21 was my surgery I am back in Sacramento but can’t talk with the temporary arcs…need some advice from another professional on this work I paid 7500 for this part and I want to make sure I get the best for the next 7500 zirconia finish and the best procedure …I have a 3D scan on DVD…please help me

    Reply
  9. I gave 6mm of bone above a missing tooth where I plan to have an implant. Is it necessary to get a sinus lift and build additional bone before doing the implant?

    Reply
  10. Today, when I look at how perfect my teeth look, I can’t thank you enough, Dr. Amin. for your unwavering support, for your guidance and for doing such a wonderful job with my zygomatic implants. I will be forever grateful.

    Reply
    • HELLO!!!!!!!! Wow! So glad to see you on the forum! Thank you for allowing me to treat you and trusting my team and I!
      Merry Christmas!

      Reply
  11. Today, when I look at how perfect my teeth look, I can’t thank you enough, Dr. Amin. for your unwavering support, for your guidance and for doing such a wonderful job with my zygomatic implants. I will be forever grateful.

    Reply
    • HELLO!!!!!!!! Wow! So glad to see you on the forum! Thank you for allowing me to treat you and trusting my team and I!
      Merry Christmas!

      Reply

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