Alphonse Gargiulo, DDS, MS

Healing caps will not provide the retention needed for the crowns to be permanently cemented.  What is your hesitancy to get abutments placed?

In our office we use digital technology to replace front teeth in the best possible location for function and esthetics.  I believe implants would be a better option for you.  If a bridge is proposed utilizing the 2 adjacent teeth to 8 & 9 (which are 7 & 10) they are lateral incisors and typically a smaller and weaker tooth so the success rate is low if they are used to support a 4 unit bridge.

I would find an office that utilizes digital technology!

My suggestion would be to spend your travel money with a local surgeon who can follow up with you after such a large undertaking to ensure that everything is progressing and healing as it should.  This is an important part of the treatment.  Dental treatment is not one and done, you will need regular maintenance and it is always advantageous to have the original surgeons/restorative doctors follow you on a regular 6 month basis as a minimum.  

As with the color of your skin and freckles your gum tissue has pigmentation which can cause random darker pigmented areas.  This is unique to you and really cannot be changed.  Regarding the level of your gum tissue this can be adjusted with surgery by a periodontist which can make your teeth longer and even out your smile.  The amount of tissue that can safely be removed would need to be evaluated at a consultation appointment.  As for the white spots in your teeth, while your teeth were developing when you were an infant to toddler it is possible you took a medication or were bumped or hit in the mouth which can cause these spots to occur while the teeth are forming under the gums.  Without a crystal ball we will never know exactly what caused them.  In order to have uniform teeth color veneers or crowns on your teeth would need to be placed.  A good cosmetic dentist would be able to transform your smile.  It appears from your picture that your bite is off (or you could be positioning your jaw like that for the picture) which would need to be evaluated before major cosmetic work is scheduled.

With your past periodontal problems (bleeding gums) a bridge will only make it more difficult to clean and maintain health.  The problems you mention, sinus grafting, etc. are for the top jaw.  Tooth #30 is in the lower jaw in a location that is highly successful for implant placement. 

The implant will certainly provide a better longterm solution for you.