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Short History of Implantology

Archaeological surveys have shown that even ancient civilisations, due to functional and aesthetic needs, compensated for tooth loss in people, using various materials such as ceramics, metal, ivory, shells, bones. There are traces up to 5,000 years old, namely from 3,000 BC (Bremner, 1954), which confirm that people made effort to replace missing teeth in various manners even back then.
In Egypt, missing teeth were replaced by teeth of deceased people or animals; Phoenicians used gold alloys, whereas the Chinese used treated bamboo. It is believed that the Maya civilisation made the first artificial tooth for a live patient. One of the oldest examples of tooth implant was found in 1981, in the Kalabak necropolis near Izmir, Turkey, dating from 550 BC. In Honduras, South America, archaeologists found a mandible dating from 600 AD with a tooth made from shell. Also, a female skull was discovered in Copan, Honduras, dating from 800 AD, where teeth were ornamented and decorated with coloured stones (Ring, 1995)

In England, surgeon Charles Allen was the first who left written traces of dentistry. He practiced implantology, but believed it was inhumane to transplant a tooth from one individual to another, and therefore used animal teeth (Allen, 1687).

In 1764, John Hunter transplanted a tooth from one individual to another, and that became a common practice until 1800, using teeth of poor people who sold them or those of deceased individuals (Asbell, 1988). However, that method was prone to spreading infections and diseases such as tuberculosis and syphilis, and it was not practiced after that period (Dahle, 1990). Another reason for a low success rate of this technique was lack of knowledge about instrument sterilisation and poor immune response of dental receptors.
The 19th century brought several metals which were used as materials for dental transplants.

In 1806, Giuseppanagelo Fonzi invented a mineral tooth, which could be implanted on the place of an extracted tooth using platinum hooks. His major achievement was the idea about a manually produced individual tooth that would fully meet aesthetic and functional requirements and be resistant to chemical impacts.

J. Maggiolo, A French dentist from the University of Nantes, published the first book about modern implantology, titled Le Manuel de l’Art du Dentiste, in 1809. He designed an implant made from 18-carat gold to support a porcelain crown after the place of an extracted tooth healed (Ring, Oct 1995).

In 1840, Chapin A. Harris designed an implant that supported a lead-based porcelain crown and was strong enough for chewing. This implant was functional for 27 years (Ring, Oct 1995). Subsequently, several more doctors, including Payne, Bonwill, Berry, Scholl, Rogers, Lewis, Ollier, Wright, produced implants which replaced individual teeth or a whole arcade using other metal alloys, such as silver and platinum (Dahle, 1990). High toxicity of these metals and incompatibility with organic tissues led to a failure of this procedure.

EJ Greenfield was the first to develop an implant in 1913 which was later developed into the form we use today. He created an iridium-platinum cylinder welded with gold to imitate the root of a missing tooth (Ring, Oct 1995).

Inspired by surgeons who placed implants in hip surgeries, brothers Alvin and Mozes Strock, dentists, developed screws consisting of a biocompatible chromium-cobalt-molybdenum alloy, called Vitallium, in the 1930s, and tested them on dogs and humans. These two dentists are considered to have made the first bone implant.

In 1942, Formiggini designed endodontic implants by creating space between an iodised compress held in a dental alveolus. That implant had the shaped of a spiral, so that the bone was connected to the metal. This is also one of pioneering examples of the modern-day today design. Raphael Chercheve, Gustav Dahl, Aron Gershkoff, Norman Goldberg, Lew, Bausch and Berman worked on improving this prototype.

Per-Ingvar Branemark from the University of Gothenburg is ranked as the father of modern implantology. In 1952, he confirmed that a bone had grown around an implant and accreted with it without rejection. After several decades, the metal compatible with bones was identified. 13 years after Brenemark’s discovery, in 1965, the first titanium implant was made and applied on Gosta Larsson, a Swedish patient.

At the Osseointegration Conference  in Toronto, in 1982, after Brenemark presented resulted of his surveys with titanium, the standards for wide application of the titanium component was an artificial replacement for the root of a damaged or lost tooth were defined. Since then, there have been several milestones in the modern history of implantology:
– 1988 – zygomatic implant
– 1989 – industrial process of producing ceramic crowns
– 1998 – “All on 4” treatment.

Sources: / historia implantologia / history of tooth replacement and dental implants and current status of dental by Maj E. Drew Moore, DDS, MS

Bojana Golić, Doctor of Dental Medicine