Can I have an implant redone? (photos)

I completely agree that the esthetics are lacking with your crown.  The color and position of the front tooth is all wrong and the gum line looks lopsided around implant.   It is easy to replace a crown with one that is more attractive in color and shape.  It is possible to do a gingivectomy to develop symmetry of the gum tissues.  You might need to remove and replace implant and do bone graft as the alternative but my first choice is a gingivectomy or gum lift.If you walked ito my office as a patient I would suggest we start with a new temporary crown and the do a DNA Appliance to correct the entire upper arch giving you a full wide smile before any permanent work was done.  Ideally as a child you would have been in an expander but a DNA Appliance will grow you orthopedically into a full wide smile, improve your airway and absolutely improve your overall appearance.

There a number of different options that you have to either mask or correct the esthetic issue.  Depending on the how deep the implant is placed in the gum and if the implant is healthy without any bone loss, the best place to start is by having your surgeon complete a radiographic survey including conventional radiographs and a Dental CT scan (3D x-ray).  If the implant is healthy, then you have a few options:1. Remove the crown, bulk up the soft tissue thickness above the implant (unpredictable), place a new temporary crown, and evaluate the area prior to restoring a new crown.2. The laboratory can fabricate a new crown that uses pink ceramics next to the current gingival level. This will reduce the appearance and dull the overall negative esthetics3. You can remove the crown, bury the implant, (add/ bulk the soft tissue if necessary) and consider an all ceramic anterior bridge.   4. Removal of the implant will most likely result in additional soft/ hard tissue shrinkage.  You can consider going this route but don't anticipate your surgeon to be to predictably grow the bone back with a procedure called (distraction osteogenesis) which is unpredictable in the wrong hangs.Hope this helps.

Your question is a very good one, but not a simple process. What would be involved is removal of the present implant, followed by significant bone grafting to re-build the ridge to a natural width and height.  after healing a new implant can be placed.  These procedures take time (perhaps up to 10-12 months) DURING WHICH TIME YOU WILL NEED A TEMPORARY REPLACEMENT For THE FRONT. This can be a flipper or a snap-on smile.  There is also the option of removing the implant and going with a fixed cemented bridge.  Do yourself a favor and find an experienced implant ,cosmetic dentist to go over your new care.

 See a periodontist and have him assess whether the implant is placed in an optimal position. If it is then see a prosthodontist who can place an abutment and crown in the most favorable position to match the other incisor. So many variables!

From a treatment planning point of view it is very difficult to ascertain the implant health based on the picture you have provided but there are some obvious aesthetic issues with the implant at the #9 site. There are a number of diagnostics that must be gathered before you can accurately treatment plan, most importantly a CBCT scan to determine the bone health in the area.I would caution you on accepting re-treatment of this area and encourage you to seek out someone who has extensive implant surgical experience. This area of your mouth, as you have pointed out, is aesthetically significant and you are unhappy with the aesthetic results obtained with the first treatment. Dealing with the bone health in the area you have indicated is very challenging on initial treatment. Secondary treatments can make things much worse and you could lose more bone and more teeth in that area if it is not done correctly. It appears from the picture that you have lost significant bone in the area already and you have to ensure that if a secondary treatment is to be done that bone and soft tissue grafting are the main focus.Your case is not a simple one and it requires a very skilled surgeon to ensure you end up with healthy tissue in th area to support your implant. I would recommend contacting the American Academy of Implant Dentistry and asking them to recommend someone in your area. Please let us know how your treatment progresses