Generalities in Oral Implantology: History
Replacing lost teeth with prosthetic devices has been a human concern since the dawn of time. Numerous archaeological discoveries attest to this throughout human history and in all places. Devices come from a variety of sources: mineral, animal, and human.
Since the last millennium, oral implantology has brought a new and original dimension to dentistry. It has undergone a dazzling, irreversible evolution, making it unthinkable today to design a treatment plan without including a therapeutic option with implants.
The 20th century was decisive in the advancement of techniques and materials: bone grafts, filling materials, implants with specific geometry and the digital acquisition of modern imaging with computer-assisted surgical simulation.
All these new techniques have broadened the scope of indications for implants.
This is why the dentist must take into consideration the evolution of these techniques and adapt to increasingly efficient medicine.
- History:
The history of dental implants goes back to an extremely ancient period, which confirms man’s constant concern to replace missing teeth.
Different materials were used: animal, human, or mineral origin
For example, a metal implant was discovered in an Egyptian mummy dating back to around 1000 BC.
In ancient times, people sometimes replaced lost teeth with those of other people or animals. But it wasn’t until the 20th century that truly healthy and effective solutions were found.
- History of implantology: the different periods
II.1. Ancient period (BC to 1000 AD)
- It was during the time of the dynasties of Egypt that the first attempts at settlement were made.
- During archaeological excavations in Egypt, the first skulls were found on exhumed skulls
prostheses. They were made from teeth carved from ivory and held together by gold wires. They were therefore reserved for an elite, and certainly not very functional.
- X-ray examinations of the exhumed skulls show good bone integration of the artificial roots in carved ivory.
Materials used: Carved animal teeth.
- .2. Medieval period (from 1000 to 1800)
During the medieval period, implantology was essentially limited to transplants performed by hairdressers.
Teeth are taken from individuals from disadvantaged social classes and implanted in wealthy individuals.
This method carried risks of bacterial contamination and infection.
- Fundamental period (from 1800 to 1910)
Endosseous implantology truly began at this time.
- In 1809, Maggilio experimented with gold roots supporting an ivory tooth.
- In 1888, Berry developed principles of biocompatibility and primary stability: The latter insists on:
- the need for immediate implant stability;
- the use of “safe” materials, avoiding any transmission of disease.
- Premodern period (from 1910 to 1930)
Payne and Greenfield are the precursors of implantology (at the beginning of the 20th century).
- A delayed start of the implant for 6 to 8 weeks is suggested,
- the importance of intimate bone-implant contact is emphasized.
- The concepts of “clean” surgery and deferred operation are discussed.
- Modern period (from 1930 to 1978)
During this period, various biomaterials, as well as surgical and prosthetic innovations, were studied. Three types of implants were developed: endosseous implants I, subperiosteal implants, and endosseous implants II.
- Endosseous implants I :
- 1930: buried screw-shaped implant made of Vitallium with a healing cap
- 1940: Strok develops the endodontic implant.
VITALIUM STROCK IMPLANT
b – Subperiosteal implants :
ENDODONTIC IMPLANT
- They were developed in 1941 by Dahl in Sweden. They are particularly useful in cases of total edentulism after taking surgical bone impressions.
- creates the first juxta-osseous implant. It is a simple Stellite bar with four rods (two canine rods and two molar rods perforating the gum and supporting a total prosthesis.)
DAHL UPPER MAXILLARY IMPLANT DAHL MANDIBULAR IMPLANT
c – Endosseous implants II :
From the 1940s onwards, different forms of implants were created.
- 1947: double helix spiral implant created by Chercheve, tripod implant (needle) created by Scialom
- 1967: Blade implant introduced by Linkow, frequently used until the 1980s.
- Obtaining a fibrous interface: fibro-integration, was desirable, ankylosis was considered a negative element for the implant prognosis.
This is why all these implants have resulted in therapeutic failures.
CHERCHEVE SPIRAL IMPLANT
IMPLANT NEEDLES
LINKOW ENDOSSEOUS BLADE
- Contemporary period (osseointegration or Brånemark period) Development of the concept of osseointegration by Brånemark:
- It was during the 1950s in Sweden that the first research on tissue integration of materials was carried out. Knowledge was acquired on different types of materials.
-In the 1980s, a Swedish surgeon, Professor Bränemark , after several studies carried out on completely edentulous patients treated with titanium implant prostheses , discovered the attraction of bone cells to this material.
The affinity of titanium towards living bones ( biocompatibility of the material with the human body) was discovered by the Swede Per-Ingvar Brånemark.
– Professor Brånemark, who is recognized as the father of modern dental implantology, is also the one who discovered the phenomenon of osseointegration , that is, the ability of living bone to
colonize and integrate or weld to the titanium of the implant.
Osseointegration thus allows the implant to play a stable and resistant anchoring role , just like a natural dental root. Indeed, it has been demonstrated that dental implants made of titanium are resistant to masticatory forces and reliable over time. Moreover, when osseointegration is completed
around the implant, the only way to remove this implant is to drill the bone that is all around it.
- Osseointegration , is defined by Brånemark et al. (1985) as an “anatomical and
direct functional interface between the remodeled living bone and the loaded implant surface”. This type of interface allows for the maintenance of a high long-term success rate.
The most fundamental characteristics compared to the previous period are :
- the search for direct apposition to the bone-implant interface whereas previously, fibro-integration was sought in order to mimic the alveolo-dental ligament;
- the most immediate loading possible, whereas previously the implant feeding and its activation were delayed.
Wet -nursing:
This waiting phase, called “ nursing ”, aims to allow the bone to heal around the implant : this is osseointegration.
- Post-Branmark period (immediate loading with osseointegrated implants)
- In the early 1990s, a few published clinical and animal studies showed that immediate loading of implants can lead to a high rate of osseointegration.
- We then look at the simplification of surgical and prosthetic techniques presented by the Swedish school as prerequisites.
One of the simplifications is to avoid the need to nurse the implants for 3 to 6 months.
Then, the delayed loading period is eliminated in the patient with an edentulous mandible, by implementing immediate loading protocols within 72 hours.
Immediate loading:
In 1999, Brånemark published a clinical article with a new implant system intended for immediate loading.
The indications initially limited to the edentulous mandible are extended to all clinical situations of edentulism , in healed or post-extraction sites. The success rates of implants are high, similar to those obtained by classic methods of deferred loading.
Generalities in Oral Implantology: History
Untreated cavities can cause painful abscesses.
Untreated cavities can cause painful abscesses.
Dental veneers camouflage imperfections such as stains or spaces.
Misaligned teeth can cause digestive problems.
Dental implants restore chewing function and smile aesthetics.
Fluoride mouthwashes strengthen enamel and prevent cavities.
Decayed baby teeth can affect the health of permanent teeth.
A soft-bristled toothbrush protects enamel and sensitive gums.