Jeffrey Schoenberg, DDS

From the information you have given us here, It may be possible to put bonding or a porcelain veneer on the outer aspect of this tooth to make it appear less crooked and more natural in the smile. I do not advise this as a first choice as it could over-contour this tooth and make it more susceptible to cavities and gum issues etc. My advice would be to reconsider an orthodontic consult if even just to re-position this tooth to correct the occlusion and appearance.  If orthodontic treatment is not an option, then bonding or a veneer can treat the aesthetic issue without treating the issue with the general positioning of this tooth. In my opinion, a full crown here to correct the positioning would require significant removal of tooth structure that can compromise the tooth in other ways- I do not think that would be a very good idea. Hope this helps. 

As I don't know the specifics of this case I am not sure, but I am not convinced yet that it can't be corrected with braces.  If there aren't any underlying issues, maybe they can refine the orthodontics case to slightly extrude this tooth? Have you discussed the issue again with your orthodontist? If braces are not possible, then for pure aesthetic purposes a veneer or simple bonding are possible options to extend the length of the tooth to match the other central incisor.

Hope this helps!

Invisalign should typically work regardless of the presence of fillings on anterior teeth, and it shouldn't usually affect intact fillings. However, if these fillings are defective, or they splint the teeth together (such as with a fixed retainer) then this is a contraindication. If your general dentist has not seen any ongoing dental issues and clears you for invisalign / orthodontic treatment, I can't see any reason not to proceed based on the presence of these fillings. 

I do not believe whitening the back of the tooth will have any significant impact on the shade of the veneer, nor do I think the porcelain of the veneer and crown should discolor significantly over time. 

This really depends on the Dentist's technique while removing it. In my opinion, If there has been no other damage to the teeth since the bonding was done, and the dentist removes it carefully, being diligent not to remove any tooth structure, then the tooth structure and gap should be similar, so long as the teeth haven't drifted at all since the bonding was done. Hope this helps. 

Great question. Hard to answer as every case (and every dentist) is different. Veneers are an option, but I would recommend starting with a full workup to know more information, and be open to the different options.

You may consider seeking a few family / friend referrals from people who have had aesthetic dental work. When you see a dentist, you should be able to request an aesthetic workup. They may take photographs, impressions / study models, and radiographs. After studying the case they may present a few options to you- not limited to veneers (possibly orthodontics- meaning braces or invisalign, etc.- depending on their findings). They may make a diagnostic wax up (a physical wax model of what ideal veneers would look like on your teeth should that be the treatment option of choice). They also may try a mockup (based off their wax up, they can place temporary tooth-colored material on your teeth so you can see what veneers would look like for you, and this can be removed quickly and easily). Likewise, they may modify a photo of your teeth digitally so you can have an idea what different treatment options would look like. Lastly, when considering orthodontics or invisalign, they may show you a set of images or a video of the proposed orthodontic progress of your teeth, and how it may look when finished with this treatment.

These aforementioned techniques are a great way to open a detailed dialogue between you and the dentist to relay your chief complaints (what exactly it is you don't like about your teeth), and to have a better idea regarding which treatment options may correct the different issues (such as the midline). If done with a few different dentists,  you may get a better feel for who you are most comfortable with for this process.

Hope this helps.

Unfortunately, teeth that have had a root canal can discolor over time. 

In order to try to lighten the shade, as already mentioned here a combination of internal and external bleaching may be attempted as a first line approach. It's hard to tell, but it looks like you may have a composite filling on this tooth as well- if so, then this filling may not lighten to the same rate as the natural tooth structure during the bleaching. In order to get an improved aesthetic result, if you are able to whiten this tooth successfully, then replacing this filling to match the new lighter shade may further improve the result. 

If this doesn't work to your liking, another more involved option would be a porcelain restoration such as a veneer or crown (depending on how much tooth structure is left after the root canal was completed, etc). In this case, the outer discolored layer would be mostly removed and replaced with a new porcelain layer that would be shade matched specifically to your other teeth for an improved aesthetic result.  

You may consider an aesthetic consult with your dentist to review the details of each treatment options and cost. 

Hope this helps!

It's not too common for bonding to wear away, depending on the type of bonding used. It is more common for it to chip off or discolor. If it chips off, depending on how much, then yes the gap can be partially or fully visible again. If it discolors, then the gap may not be visible, but the bonding will look unnatural.  In any of these cases, re-bonding the tooth is usually a pretty simple procedure should it be necessary. Once you remove all the old bonding and expose the original enamel surface in this area, it can be re-bonded just as it was the first time. Hope this helps!

It's hard to say based off this one photo. It may be beneficial to see a dentist for an aesthetic / cosmetic workup, discuss your chief complaint in detail with them, and see what the different options are. They may be able to take photos, and show you a mock-up image of how they can change the appearance of the teeth, and with what treatment. Something simple such as bonding may treat the issue. Likewise, with veneers it is possible to re-shape teeth, and sometimes close the gap you are talking about for a good result.  If veneers are an option, I think it is possible to do it within the four month time frame you are discussing, but this is up to the treating dentist and their treatment plan. Hope this helps!  

I don't think I would start looking at implants without being fully informed about the periodontal condition. Why not look into the periodontal diagnosis, and see what is involved with treating it?. What periodontal treatment were they recommending? It may be possible that with simple periodontal maintenance, or perhaps a few periodontal procedures you can improve the health of the supporting structures of your teeth (gums and bone) and reduce the risk of losing teeth in ten years. 

My recommendation is to further review the periodontal condition and evaluate your options, and make an informed decision based on this.