Sonoma Oral & Facial Surgery

Almost certainly this is not in your head. There are a few reasons why you would experience mobility of the prosthesis (teeth), all of which should be addressed ASAP. -While least likely, the implants could be failing. If this were the case, you would likely have pain. -The abutments (interface between the implants and teeth) could be loose. If the abutments were not tightened (torqued) to the correct level, they can become loose and lead to mobility. If this is the case, the teeth need to be temporarily removed and the abutments torqued to the correct level. -The prosthetic screws are loose. These screws attach the teeth to the abutments. If there is mobility, it almost always due to the prosthetic screws. Your dentist/provider should check these screws and torque them as needed. Understand that mobility, regardless of the source, can lead to implant failure. In the post-operative period, this is a complaint that needs to be taken seriously and addressed as soon as possible.

It’s a simplistic answer, and likely an incorrect one as well, to say that you shouldn’t have had implants placed..... there’s a reason that you considered the All-on-4 in the first place, likely your teeth were in poor condition and you were looking for full arch options. The All-on-4, when done correctly, is far and away the best option to replace a full arch of teeth. While your autoimmune condition may have played a part in the failure of these implants, it’s impossible to truly determine the cause of failure without seeing the full picture. The success rate of the All-on-4 is as a matter of routine in the range of 97-99%. This is verifiable through studies that date back to 1990. Your autoimmune condition may have lowered the success rate somewhat, but I’d still expect a success rate in the range of >90%.

If I am understanding your story correctly, you as the patient have done nothing wrong. The fact that your prosthetic screws keep coming loose points to the prosthesis (teeth) being functionally overloaded. This happens as a result of clenching/grinding, or the teeth not being properly adjusted into a natural occlusion. If you clench/grind your teeth, then you absolutely need a night guard..... as a matter of routine, all of my All-on-4 patients receive a night guard with the final prosthesis..... if your bite is not adjusted properly, then this needs to be addressed and corrected by your dentist. The ONLY reason that abutments need to be replaced after the final prosthesis has been made is because prosthetic screws broke off within the abutment and the provider could not retrieve the screw from within the abutment.

The All-on-4 is not a one off procedure. The surgery is completed, there should then be multiple post-operative appointments. The final set of teeth are started 3-4 months after surgery. This process requires at least 4 appointments and 6-8 weeks...and this time table makes the assumption that everything goes as anticipated. As an Oral Surgeon, I am treating more and more salvage cases. These are cases that were previously completed and are either now failing and/or were completed incorrectly. Lastly, if you still are uncertain as to your decision we offer a free consultation to answer all of your questions about any procedure we offer. Best of luck in making your decision!

Right from the start I’ll tell you to get another opinion...... Bone resorption after tooth extraction does occur and it can lead to specific functional and esthetic issues..... but even in cases of severe resorption, there are always implant options. Zygoma implants are specifically designed for cases of severe bone resorption in the upper jaw. Due to poor bone quality, or insufficient quantity, the zygoma implants are placed into the cheek bone (zygoma).....unless you have lost your zygoma due to trauma, the information you were given was incorrect.