Replacing missing teeth is not new. This is a practice that has been in existence for centuries. As dental technologies and techniques have advanced, so has the ability to make increasingly lifelike restorations for missing teeth. It was not long ago that dental implants were a rare option for replacing teeth. Now they are quickly becoming the more preferred method for restoring function and appearance. Improvements in placement are to be expected as dental technology continues to advance. Evidence of future advancements in this area are rooted in a rich history.
In the Beginning
Humankind has been in the business of helping people maintain their teeth since ancient times. As far back as 2500 B.C., Egyptians devised a method of stabilizing teeth that had loosened due to periodontal disease. Other cultures followed suit, and some used various substances to replace missing teeth. This included making tooth-like structures out of materials such as animal bones and teeth, wood and ivory.
There is evidence that the first dental implant was placed around 600 A.D. Apparently the Mayan civilization was adept at replacing missing mandibular teeth with pieces of shells. In the 1970s X-rays were taken of ancient Mayan mandibles and they revealed that bone had formed around the shell implants, much like bone forms around blade implants designed for shallow bone ridges.
In addition to the Mayan culture, apparently the Honduran culture also managed dental implants. A stone implant thought to have been placed around 800 A.D. was found in the mandible of an early Honduran. These findings show that replacement of missing teeth has a long history and dental implants are not a new idea of modern dental technology.
Experimentation with Dental Implants
Throughout the centuries, there have been attempts to create the ideal dental implant to replace missing teeth. There was a period in time during the 1500s to around the 1800s in Europe when the teeth of the dead were collected by various means for transplantation into the mouth of the living. Teeth were also gathered from poor people for transplantation.
An interesting experiment in the 1700s by a Dr. John Hunter supported the notion of transplanting teeth from one human to another. He implanted an incompletely developed tooth into the comb of a rooster. The tooth eventually became firmly embedded in the rooster’s comb. Blood vessels grew from the comb straight into the pulp of the tooth.
Dr. Hunter was not the only pioneer in dental implants during this era. A gold tube was inserted in a fresh extraction site by J. Maggiolo in 1809. After healing, a dental crown was placed on the tube. The procedure was not successful, however. Eventually, extensive inflammation of the gums caused it to fail. Still, others experimented with various materials such as silver capsules, iridium tubes and corrugated porcelain to produce results.
Experimentation with dental implants continued into the 1900s. Dr. E. J. Greenfield designed an artificial root made from iridio-platinum soldered with 24-karat gold to fit precisely into the jawbone of his patient. This device was made in a lattice design with a hollow core. The idea of bone melding with the metal was behind his design. Dr. Greenfield’s surgical technique for preparing the implant site is still used today.
Early implants had a short lifespan. This did not change until 1937 when Dr. A.E. Strock developed an implant using Vitallium®. He placed implants in both humans and animals with relative success. He then published a paper describing the physiological effects of the material in the bone. Vitallium showed no post-operative complications or reactions. It appeared to be well tolerated. Today, Vitallium is still used in some types of implants.
A significant change in the history of dental implants occurred during the 1950s. Titanium was discovered to permanently bond with living bone tissue. Professor Per-Ingvar Brånemark, an orthopedic surgeon, made the discovery. Working with his team on several studies, he developed experiments resulting in what he termed osseointegration. This is the irreversible and lasting attachment of bone to a metallic implant without connective tissue, a crucial factor in a successful dental implant.
Brånemark’s discovery was applied to the dental patient with missing teeth. Endosteal implants are based on his findings and design. Thanks to his work, dental implants are highly successful.
Dental Implants of the 21st Century
The highly successful dental implants we have now are the result of tireless experimentation by those interested in maintaining the oral health and aesthetics of their patients. Improvements continue as dental technology advancements are made.
Dental implants are quickly becoming more of a standard procedure for tooth replacement over bridgework and dentures. This has to do with the aesthetics as well as oral health. Implants are better for bone health because they help stimulate bone growth and keep the bone from resorbing, as it does when a tooth is missing.
As efficient and effective as today’s dental implants are, dental technology is continually advancing to create better replacements for missing teeth. The future advancements include technologies in stem-cell research and nanotechnology, both of which have promising implications for restoration of missing teeth.
Currently, dental implants are the only real solution for permanently replacing missing teeth. The cost of implants prohibit many from receiving them, so these patients depend on more affordable options. As costs for the procedures decrease, the demand will increase.
Advancements in dental technology that support the implant procedure continue to develop. Improvements include introduction of robot-assisted dental implant surgery, 3D printing and elimination of bacterial biofilms, to name a few. These improvements indicate that dental implants will last longer and have even lower failure rates.
As dental technology improves, dental implants will become more affordable and they will be of higher quality than the present implants. Improvements will also make it possible for those who may not be good candidates at this time due to bone loss to overcome those obstacles. For example, 3D printing of hyperelastic bone will make bone grafting more available and efficient for patients who lack the bone density for an implant.
The Best Is Yet to Come
Nanodentistry may sound like something from a sci-fi movie; however, it has been around since 2000. Nanotechnology entered the field of medicine and dentistry followed. Nanotechnology is expected to impact diagnosis, materials, restorative dentistry and oral surgery. This new field of dentistry holds the promise of achieving maximum therapeutic efficiency with few side-effects. As it relates to dental implants, nanodentistry can enhance bone growth. This will improve the stability and strength of dental implants. It has already been shown that bone growth is improved by 150% with nanoscale deposits of hydroxyapatite and calcium phosphate on the implant surface.
Advancements in dental technologies are paving the way for a bright future for patients interested in dental implants. Issues such as weak or sparse bone will no longer be a barrier to getting implants. The prognosis for successful implants will increase with improved technology. The rate of implant failures will decrease as well. All things considered, dental implants are here to stay, and they will only get better as time goes on. In the future, dental implants may be the standard procedure for replacement of missing teeth.
