Proper Shape Of Gums All on 4 Bridge

Proper Shape Of Gums All on 4 Bridge

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 Comments

  1. William

    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.

    August 4, 2020 at 5:57 pm Reply
    1. Ramsey Amin

      Make sure to use a waterpick underneath. There are two of them that I suggest on this page. Hopefully the implants are fine!

      https://www.burbankdentalimplants.com/recommended-products/

      August 6, 2020 at 6:27 pm Reply
  2. Pia

    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.

    September 30, 2019 at 5:15 am Reply
    1. Ramsey Amin

      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

      October 11, 2019 at 5:20 am Reply
  3. Sheila H Crone

    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.

    March 18, 2019 at 1:26 pm Reply
    1. RamseyAminDDS

      You are welcome. 😁

      March 19, 2019 at 5:38 am Reply
  4. Sheila H Crone

    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.

    March 17, 2019 at 6:38 pm Reply
    1. RamseyAminDDS

      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

      March 18, 2019 at 4:51 am Reply
  5. ELIZABETH Velazquez

    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.

    March 17, 2019 at 5:07 pm Reply
    1. RamseyAminDDS

      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?

      March 17, 2019 at 5:45 pm Reply
  6. Sheila Crone

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

    February 22, 2019 at 2:31 am Reply
    1. RamseyAminDDS

      many people need this much to support their lips.

      March 7, 2019 at 5:21 am Reply
  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….

    October 27, 2018 at 6:37 am Reply
  8. Alicia

    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

    October 24, 2018 at 10:32 pm Reply
    1. RamseyAminDDS

      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

      October 28, 2018 at 6:04 pm Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!