The History of Dental Implants
Dental implants are now considered the most advanced solution for missing teeth and some dentists have as high as a 97% long-term success rate. Dental Implants are the only reliable solution that:
- Support surrounding teeth
- Continue to stimulate natural bone formation
- Restore a patient’s smile and confidence
- Restore a patient’s ability to chew
It is evident that throughout the history of civilization the aesthetics of a full smile coupled with restoring the function of being able to chew food has driven people to replace missing teeth.
A brief look through time:
- 4000 years ago in ancient China, carved bamboo pegs were used to replace missing teeth.
- 3000 years ago an Egyptian king had a copper peg hammered into his upper jaw bone. Although this may have been placed post-death, this is the first recorded case of a metal replacement tooth being fixed to a jawbone.
- A 2300-year-old iron false tooth was recently found among real teeth in a Celtic grave in France. Experts believe they were fitted to improve the smile post-death, as it would have been absolutely excruciating to have it hammered into the jaw.
- 2000 years ago people often tried to replace lost teeth with animal ones, or teeth bought from slaves and poor people. An implant taken from an animal would be classified today as a heteroplastic implant whereas an implant from another human would be classed as a homoplastic implant. Replacement teeth from another person or animal’s mouth would be likely to suffer infection and would be rejected by the host.
- Archaeologists have discovered ancient skulls dating from roughly 1350 years ago where teeth have been replaced by many different types of material ranging from jade to sea shells; in some cases the replacement tooth has even fused with the jawbone. One example is that of Dr and Mrs Wilson Popenoe, who in 1931 were excavating Mayan ruins in Honduras and found a jaw with three carved, tooth-shaped shells in the lower jaw of a human’s remains. What is interesting is the bone structure around the shell showed signs of regeneration.
Major developments in dental implants came much later
In the eighteenth century, forward thinking researchers began to experiment with gold and alloys, despite efforts these experiments often had poor results.
In 1886 a doctor mounted a porcelain crown on a platinum disc; again yielding poor long-term success. The issue throughout time has always been that the body and the bone rejected the foreign bodies. For a successful dental implant, you need the replacement tooth to actually fuse to the bone. This is known as osseointegration.
Modern dental implants are made out of titanium because it has special properties that give it a high success rate of osseointegration. In 1952, an orthopaedic surgeon unintentionally discovered these special properties. He realized he was unable to remove a titanium cylinder he had placed in a rabbit femur during a study of bone healing and regeneration. Upon realization that the bone had grown in such close proximity to the titanium cylinder that it had fused together, he continued to experiment further in both animal and human subjects. In 1965, Branemark, the orthopaedic surgeon, placed his first titanium dental implant into a live human volunteer.
This was a pivotal moment in dental history and the process has been greatly improved over recent decades through research and a desire for perfection. Modern dental implants are composed of a high-grade titanium alloy screw, often with a roughened surface to improve osseointegration. This titanium screw is fixed to the jaw where the tooth used to be and is then allowed a period of healing. Once the screw has fused to the jaw, a post is inserted with a crown on the top. This method has high long-term success rates with the correct care and oral hygiene in place.
Arguably, one of the largest factors in the high success rate of dental implants is the advanced training required. According to the Faculty of General Dental Practice (FGDP), “Their insertion involves various surgical and restorative dental procedures and therefore dentists placing implants must be competent to carry out these procedures.” (http://www.fgdp.org.uk/_assets/pdf/publications/policy%20documents/implant%20training%20stds%20jun%2012.pdf)
Various postgraduate training providers offer courses that ensure dentists who want to become dental implantologists have the required expertise and understanding. One such course is run by the FGDP at the prestigious Royal College of Surgeons of England where one of the most established Dental Implant dentists in the UK, Dermot McNulty (BDS DipImpDent RCS Eng) of Bath Spa Dentistry, is a lecturer, examiner, and cohort director. It is the progressive attitude of dentists such as Dermot, who aim to improve the quality of service and levels of success rates in the practice of dental implants as a whole that continue to drive dental implants toward having higher success rates across the country.