My Dental Implants Sit Higher Than My Natural Teeth. My Dentist Doesn't Seem Too Worried? (photo)

I'm afraid once your implants are placed there are few options. Your case  needs very carefull and thought out treatment planning due to the fact that you show all your gums when you smile. What did you have before the implant bridge? Where you happy with the way it looked before?

The teeth look fake and big because they are to high on your gums. Specially the left lateral incisor.  This could be due to improper implant placement or improper planning prior to implant placement. Many times you can set up the case by using braces and or grafting to bring down the gum and bone. This way you avoid having this "high tooth" look. If you were already missing teeth, then it may be very difficult and making a conventional bridge without implants may give you a better outcome. Also, the implants could have been placed in different sites to take advantage of better bone or gums in the area.

At this point there are very limited things you can do to fix this without any major additional work. The bridge would have to come off and a temporary one placed. We can play around with changing contours and see. You may end up needing a Connective Tissue Graft and or re-placing the implant in a lower or different possition. Your dentist is indifferent about it because he knows this is not easily fixed, but if you are not happy, you should see 2nd or 3rd opinions. However, it will be additional cost. However, this can be improved.

 

Good luck

Dr. T

I am very sorry that you are not happy with the gum around the implant crowns.

This is a case of having been warned that this might happen.

Once teeth are lost, the bone and gum shrinks and it is very difficult to replace those tissues except in skilled hands.

The high gum line will naturally amplify the problem.

To correct this is very difficult as the bone architecture supports the gum and the gum lline.

I have 2 suggestions that you may consider:

1 soft tissue graft under the gum by a specialist

2 replace crowns/bridge with new ones with the gum area masked in pink gum coloured porcelain again by a reputable ceramist

Redoing bone grafting would mean taking out implants.

Unfortunately it is very hard to determine exactly what is going on with your case as your pictures are too blurry to see.  It appears that your left lateral incisor has a longer crown and that the gum is more recessed in that area.  This may be due to overcontouring of the implant abutment as it emerges from the implant and through the gum.  If the gum was level with the adjacent teeth before restoration of the implant and now appears recessed, that is most probably the issue.  Your dentist can try removing the crown and abutment, placing an undercontoured provisional restoration and allowing the soft tissue to rebound back to its original position before remaking the final restoration again. Other potential issues are poor implant angulation or placement which will require more complicated resolutions.  My best advice would be to visit a restorative dentist that is very experienced in implant dentistry to discuss your issues. Remember, implant dentistry in the esthetic zone is complicated and must be planned carefully by both the surgeon and restorative dentist for a great result. 

Best of Luck!