Unrestored Xive implant fixture: thoughts?

I'll assume everything is fine with the implant and we are going to restore it. Generally with cases like this you'll make the crown fit to the more mesial tooth. It looks like if you put a crown on the molar behind it and make the implant crown the size of a molar you'll close the diastema. Sometimes in cases where the posterior tooth is too angled and there is too much room to fill with an implant crown you'll have to consider leaving a diastema or extracting the tipped posterior tooth and add another implant.

I'm guessing that this was placed to avoid the sinus and there is nothing wrong with a cleansable diastema. I would just be cautious and have the patient sign a detailed consent. Three yellow flags, overseas patient, second dentist, and less than ideal placement. Clinical appearance vs periapical can be deciding factor! Good Luck!

nice case for summers technique i know that some dentist like short implants and they've been proven to work but I wouldnt feel comfortable doing a case like this. what is the radiopacity in the sinus??

appears two teeth are missing and the implant is poorly placed with possibly some thread exposure due to bone loss. I would take a new radiograph to properly eval it as you dont know when the pt sent one was taken. I am inclined to remove this implant and place two 4.0 wide fixtures with a summers type approach