I am unhappy with my front tooth implant. The gum seems to have disappeared. How can I fix it? Pink on the top of crown? (photo)

Question

The front tooth was extracted in between two pregnancies, The implant placed after my son was born. I had bone graft at time of extraction and during implant being placed. I seemed to really lose a lot of gum after they “exposed” the implant. There’s hardly gum left between front and side tooth and two front teeth. Dentist added bonding to side tooth to minimize the space where there is no gum now but I still hate how asymmetrical the gum line is, what are my options? Re do crown with pink gum?

Kara Kramer, DMD · Answer

This is a very difficult area to manage. It is difficult to give you an exact answer without seeing your xrays and seeing you clinically. Generally speaking, you have 3 options and can do one or a combination: 
1. Remove the implant and build gum/bone in that area and redo the implant. 
2. Change the proportion of the adjacent teeth with a gum lift/veneers or crowns. All of your teeth would appear larger with this option.
3. It appears you have a hypermobile lip. You can manage this either Botox or a lip repositioning procedure
I would consult a periodontist who is an expert in the gum and bone.

Ramin Mahallati, DDS · Answer

Hello and thank you for your question. The best way to answer this would be with an in-person consultation where they can go over your options, but it may be possible to adjust the crown to make you happier with your final result. There are several steps in creating dental implants. The Provisional (Temporary Crowns) are critical in finalizing the esthetics and look of the final restorations (Permanent Crowns).  During the Provisional phase the shape, contour arrangement, position and color of the teeth can be tried and assessed to make sure you like the results. Then the temporary crowns can be used as a template for making the permanent crowns this will ensure the subsequent crown matches the color and shape of the surrounding teeth so and once it is placed will fit in naturally with the rest of your teeth. I recommend getting a consultation with a prosthodontist to determine if you’re a candidate. A prosthodontist is a dental specialist who has advanced training in restoring and replacing teeth and can create a customized treatment using the latest techniques in dental implants.

Joel Klasfeld, DDS · Answer

Since the tissue above the implant has receded, the crown that now fills the space is completely out of proportion. Unfortunately, your high smile line makes this area very visible.  The treatment here will involve bringing symmetry back to your smile.  Most likely it will involve lengthening your gums in adjacent areas (crown lengthening) and adding veneers to those teeth as well.  Depending on just how large the defect is around the implant will determine the extent of work needed, which may include a gingival graft or pink porcelain on the implant crown.In our office, we handle complex cases like yours with a systematic approach using proper diagnostics such as digital smile design and a trial smile to ensure results.  Our experienced team consisting of cosmetic dentists and specialists work in conjunction with our on site dental laboratory with master ceramist to match colors and deliver the best esthetics possible.

Emery Cole, DMD, FAGD · Answer

This can be one of the hardest cosmetic issues facing dentistry, the front tooth implant on a high smile "thin biotype" female.  So many factors to consider and it can be very difficult to convince the body to grow excessive gum tissue where there is less bone support.You will need some very skilled and experienced dentists involved to get the best result, which you may have already.  Options can include and are not limited to 1) masking with pink composite/porcelain on the crown at the gumline  2) additional gum surgery 3) redesigning the implant abutment and/or crown.Once again, this is an extremely difficult cosmetic issue and your dental team will cover the advantages and disadvantages of all the options they feel may improve your result.

I am unhappy with my front tooth implant. The gum seems to have disappeared. How can I fix it? Pink on the top of crown? (photo)

Answers (4)

Answer: Implant Front Tooth High Smile Line

Answer: Implant Front Tooth High Smile Line

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Everything you need to know about Dental Implants

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I am unhappy with my front tooth implant. The gum seems to have disappeared. How can I fix it? Pink on the top of crown? (photo)

Answers (4)

Answer: Implant Front Tooth High Smile Line

Answer: Implant Front Tooth High Smile Line

Browse related questions

Recommended reading

Everything you need to know about Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.