8 Common Dental Implant Problems

Read more to learn about the causes of common dental implant issues, how to prevent them, and the appropriate steps to take.

Written by: Dr. Ramsey Amin

1) Bulkiness of All-on-4 Implants

The All-on-4 or 6 dental implant replaces not only your teeth but also missing gum and bone, which is why there is a pink component. This comprehensive replacement can make the implant feel bulkier than natural teeth. In some cases, zygomatic implants may add a bit more thickness to the bridge on the inside of the upper arch.

Unlike natural teeth, which are not connected to one another, the bridge is a solid horseshoe shape. It is crucial that it is connected from one side to another to provide “cross-arch stability,” which is essential for long-term success. A full set of dental implants with severe bone loss or a significant underbite or overbite may feel a bit bulkier than those with a regular bite and moderate bone loss.

2) Broken All-on-4/6 Dental Implants

No All-on-4 dental implant bridge materials are indestructible. The preferred material for the bridge is zirconia, which is highly durable when properly made. It’s important that the bridge is designed to be convex and easy to clean everywhere, while maintaining a minimum material thickness to prevent fracture. Most fractures in All-on-X dental implant bridges occur due to bite problems or insufficient bridge thickness from the gumline to the top of the teeth. Incorrect dimensions can lead to the bridge cracking in half. Additionally, having too many implants can also contribute to this issue.

3) Implant Failure After All-on-X Implant Bridge Inserted

Implants can fail. If an implant fails after the final bridges are installed, there are limited options to replace the implant while retaining the same bridge. Typically, if an implant fails in the middle of the bridge, it can be removed, and the All-on-4 can be supported by the remaining implants.

However, if the failed implant is at the end, providing terminal support, oftentimes the entire bridge would need to be remade, even if multiunit abutments are used.

Panoramic failing dental implants

failing dental implants. The bone appears to be black and missing around the 3 implants. 

4) Bone Loss/Gum Recession

Exposure of the implant or abutment metal can occur, especially in lower full-arch All-on-4/6 cases, where the abutment may show better cleanliness. If thinning gums or bone causes implant exposure, a gum graft can cover it and slow or stop recession.

Thick gums from the start can prevent this issue, though some may need gum grafts from the palate due to thin gums.

5) Infected All-on-4 Dental Implants

Infections can occur post-surgery or years later, with early infections being treatable but late infections potentially causing bone and gum loss (peri-implantitis). Regular monitoring by a skilled dentist is crucial.

Infections often enter through pockets between bone and gum. Good daily oral hygiene and avoiding smoking/vaping are key prevention methods. Recurrence of original gum disease can happen, which sometimes can be prevented with special antibiotics around the time of surgery.

6) Reduced Sensation

Because All-on-4 dental implants lack nerves, feeling your bite can be challenging, known as “proprioception.” This sensation will normalize over time, and while you may not feel temperature changes, this is not usually a concern.

7) Altered Speech

Speech changes post-All-on-4 are typically temporary, with most people adjusting after a short period. The thicker feel of the teeth may require a bit longer to adapt, but technologies like facial and digital scanning can reduce this issue. Rarely, a speech therapist may be needed.

8) Lip and Face Support

The restoration should provide proper lip and face support, determined by pretreatment diagnostics. Accurate bone leveling should support the lip or face with a fixed bridge, rather than a removable overdenture. Skillful dentistry is critical.

For those with facial wrinkles, additional skin fillers may be necessary. Prototypes can help ensure proper lip and face contouring.

Balancing lip and face support is crucial, as too much can lead to lip biting and too little to tongue biting. The transition line between natural and implant gums should ideally be hidden, avoiding a caved-in appearance and achieving a natural facial profile. To address dental implant problems, consult an AAID-credentialed dental implant dentist for evaluation and treatment. They have the expertise to assess your needs, design a personalized plan, and complete it successfully.

What to do if you’re experiencing dental implant problems

Sadly, it is not uncommon for dentists to need to perform “re-do” implant dentistry…saving, removing, or replacing failed dental implants with problems.

The first step to fixing all-on-4 dental implant problems is to schedule a consultation with an AAID-credentialed dental implant dentist.

When you choose an AAID-credentialed dental implant dentist, you can rest assured you’re choosing an expert with the education, training, and proficiency to evaluate your needs, design a personalized treatment plan, and successfully complete it. To find a dental implant expert near you, click the button below!

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Dr. Ramsey Amin, DDS maintains an implant-only practice in Burbank, California. He performs all “full-scope implantology” with prosthetic reconstructions, including zygomatic and pterygoid implants. He is the President of the AAID Western District. He can be reached at https://www.burbankdentalimplants.com.

12 Questions to Ask When Choosing an Implant Dentist

A printable worksheet to take with you to your appointment

12 Questions image mockup