Can you help me with something? I had all-on-four dentures placed for my anterior teeth. Should they be placed 2-3 mm from the gumline or should they exactly follow the gumline? Mine are not following the gumline and my lips feel and look bulky. Was this done properly?
Elena
Dear Elena,
This is a gumline.
I’m glad you wrote. I think we’re having a terminology issue, but I think I know what your question is really asking. When we’re talking about a gumline, it is where the gums meet with the teeth. If you’re talking about a complete denture with your all on four dental implant treatment, then that would be the acrylic that meets at the white “tooth” part.
The problem I suspect you are talking about is where the teeth “hit” in relation to the bony ridge that the denture is placed on. Where they are placed depends on whether you are talking about completely removable dentures or something that is anchored, like your all-on-four.
If you are in completely removable dentures, then the teeth need to be placed directly on top of the ridge. If they are more forward than that, your dentures will tip any time you bite down.
If, on the other hand, you are talking about an implant retained denture then they can be placed a little further forward than that because they are secure and are not going to tip when you bite. The 2-3 mm you mentioned are well within the range of acceptable placement. That being said, there are other things to consider besides chewing with denture placement such as appearance of the teeth, the patient’s speech, fullness of the patient’s lips, vertical dimension, and their bite placement for proper occlusion. There should always be a wax try-in of the dentures before the acrylic version is made to check all of these things. I’m wondering if your dentist did this.
If your denture is attached to the implants with screws, its position can still be changed. The denture can be removed and then reset into a different position. Your dentist may be willing to do this for free. If he or she isn’t, then the fee would not be much. I hope this helps.
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