Zola A Makrauer, DMD

The three unit bridge in your mouth will not prevent you from orthodontics. From the look of you photos orthodontics is the way to go. I your bite is not correct then the laminates will fail and break. Please seek another opinon.

Yes. Without an examination it is impossible to guarantee a correct answer, but from you description it sounds like you have advanced gum disease and require full dentures or something supported on implants.

When an implant crown retaining screw fractures it is of concern. All of the newer style implants are designed to keep stress to a minimum on the screw. If the screw has broken twice I would have the dentist take a close look and the bite. The bite might look good  but when you move your jaw from side to side the tooth might me hitting or interfering. If the implant is an older style external hex design then it is a design problem and you might always have broken screw issues unless the implant is replaced with a newer style.

Most of the time teeth need to be extracted as a result of external resorption. Orthodontics is an option if a crowded condition exists. You have to be careful because you could end up with a space or not enough gum tissue in between the teeth that will result in a black space. Ask the orthodontist about the possibility of this. The alternative is an implant to replace the tooth or a permanent fixed bridge. 

I would advise that you have the implant placed. There are two issues to consider. 1. is the size of the teeth. From the picture your two front teeth look very large and the two teeth next to them look much smaller. The shape of the teeth can be changed with veneers, crowns and implant crowns. I would not consider a bridge in this area it is an aggressive procedure and is difficult to clean and maintain. 2. the gum tissue needs to be addressed. It does not look level. The use of a talented periodontist for the implant and the gums would be your best bet. In the end the teeth will be easy to clean and look great if you have a problem down the road you will only have to deal with one tooth and not all four again. Good luck with whatever you decide.

I never only do six veneers on the upper jaw the choices are, 2,4,8.or 10. If you do six and end them on the upper canine it will look just like you placed six veneers on the upper teeth! We want them to blend in so in looks natural. I would try to bleach the teeth first and then evaluate how wide your smile is. Remember people look at you from the side and see your profile. If you have to do the lowers then you can get away with six on the lower jaw. It is well worth the investment to do it properly.

There are many ways to avoid the dark metal margin around a dental crown. You should discuss your concern with the dentist prior to making the crown. An all ceramic crown can be made to avoid this or a porcelain bonded to metal crown can be made in such a way to avoid having the metal margin show.

I have seen Porcelain Veneers last for as much as thirty years. If your Veneers have lasted ten years I would consider this a good result. If the time frame is shorter then there is an underlying reason why they are failing. Many times veneers can fail because of fracture. This is most common when the bite is not correct. You should discuss this with your dentist.

Chances are that the small part of the crown will pass in a day or two. We see this on a regular basis and most people do not realize that it happened! I would have your dentist check the crown because it might be necessary to replace it. Best of luck!