Week 1: History of Implants

Who used ligature wire made of gold to stabilize teeth in 2,500 BC

Ancient Egyptians

Who developed new ways to solder gold bands and use ox bones to restore human teeth in 500 BC

Etruscans

Who carved teeth from ivory and used gold wire to tie them together, creating the first form of “fixed bridge” in 300 BC

Phoenicians

In around 600 AD who used pieces of shells as implants to restore mandibular teeth

Mayan Civilization

Where between the 1500s and 1800s were teeth collected from poor people for the use of allotransplantation

Europe

Allotransplantation

transplantation of cells, tissue, or organs to a recipient from a donor, or from one site to another on the same donor

What were the first substitutes for missing or diseased teeth

1. replantation

2. transplantation

Replantation

the reinsertion of the tooth into the same alveolus from which it was removed or lost

Transplantation

the insertion of a tooth into a prepared dental alveolus (not the original location)

• their tooth (autogenous)

• organism of the same species tooth (homologous) - became popular in the 17th century

Dental Implant

a biocompatible device placed in the bone of the maxilla or mandible to provide support for a prosthetic reconstruction

What are 2 traits implants can have?

1. can be considered an artificial root

2. made from alloplastic materials (biocompatible) - metals, porcelains, compound materials

Dr. John Hunter (1700s)

• extensively documented the anatomy of the mouth and jaw

• wanted to prove teeth could be transplanted between patients

• experimented with the implantation of an underdeveloped tooth into the comb of a rooster (started to grow blood vessels in the pulp area) - considered the first tooth transplant

J. Maggiolo (1809)

• placed a gold implant into a fresh extraction site (extensive inflammation occurred/determined that gold is not a good material for implants)

What other materials were tried but failed

• silver

• corrugated porcelain

• iridium

the most common titanium alloy used for the fabrication of dental implants is

Ti-6A1-4V

How much is in Ti-6A1-4V

Titanium:

Aluminum

Vanadium

• 90

• 6

• 4

Endosseous oral implantology

• known as non-tooth implants (began in the 19th century, Maggiolo)

• Maggiolo was able to successfully insert a gold implant into a freshly extracted tooth socket - crown added after healing

Dr. C.T. Gramm (1898)

placed lead implants into a dog’s maxilla

• implants were grooved and secured

• demonstrated new bone could grow around implants

Scholl (1905)

• reported implantation of a corrugated porcelain root

• anchored pins in the crown and to adjacent restorations

• emphasized the need to keep the implant immobile during the healing process

Adams (1937)

1. developed a submerged screw-shaped cylindrical implant

-rounded bottom

- smooth gingival collar

- healing cap

2. the ball head was used to retain an overdenture

3. Female components within the denture

• designed to flex with vertical and lateral forces

Alvin and Moses Strock (1939)

inserted vitalium implants immediately post extraction

• first long term implant - 17 yrs

Strock developed what in 1940

endodontic and endosteal implants

• first evidence for bone apposition for osseointegration

Formiggini (1947)

considered to be the father of modern dental implantology

• developed the single helix wire spiral implant of stainless steel or tantalum

• first to develop a coordinated system of instrumentation

Per-Ingvar Branemark

stumbled upon osseointegration in 1969 through his thesis while studying the flow of blood in the rabbit femur

ooseointegration

direct structural and functional contact between normal, living bone and the surface of a load carrying implant

When did Branemark perform the first ever dental implant surgery on a patient

1965

Who did Branemark partner with to manufacture dental implants

Sweden’s defense company, Bofors

What was considered the turning point of implants

1982 Toronto Conference

• the worldwide scientific community accepted Branemark’s works

Branemark’s Career

considered endetulism to be equal to amputation

discovered osseointegration

created implants for compromised areas throughout the human body

Dr. Leonard Linkow

• responsible for numerous innovations in implant dentistry

• held 36 different patents

• only dentist to ever be nominated for the nobel prize in medicine

What did Dr. Leonard Linkow develop?

The blade implant

• required shared support with natural teeth

What must Dental Techs understand?

• implant systems and compatibility

• platform sizes and connections

• stock vs. custom abutments

• multi-unit abutments

• scan bodies and analogs