Part 1 - Osseointegration – From Accidental Finding To The First Dental Implant- The Early Years! ES/EN
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Anyone who knows anything about dental implants is aware of the story of Per-Ingvar Brånemark and how he accidentally discovered the process he later named as osseointegration. You're probably also aware that despite him being named as one of the most influential people in the dental profession, he wasn't actually a dentist.
But did you know that as a young researcher in his native Sweden, he wasn't interested in titanium or indeed teeth? Instead, Brånemark was working towards advancing world knowledge about the anatomy of blood flow. That's where his initial passions lay.
It just so happened that at the time he was using an optical device which he inserted inside a rabbit's leg in order to observe the bone tissue inside. That optical device was encased inside a titanium tube.
The rest, as they say, is history.... but how did Brånemark go from investigating the anatomy of blood flow in the early 1950's to placing the very first dental implants into a human patient in 1965?
Here's how the story unfolds....
Right from the problematic attempts to remove the titanium tubes, Brånemark quickly realised that he was on to something. Rather than dismissing the issue as a setback, he saw osseointegration (as he named it) of great clinical importance and he wanted to find out more. He understood that in order to do so, he needed access to a whole host of experts in the world of physics, biology, and chemistry.
So, under his guidance over the next 8 years, a handpicked team involving some of the best clinical minds of the time turned their attention towards the connections between bone and titanium. These included tests on...
- Mandibular defects in rabbits and dogs and the replacement of tiny bones using autologous (obtained from the same animal) bone grafts.
- Anchorage testing using a variety of titanium implant surfaces and....
- Rejection testing using small titanium tubes implanted into the underarms of willing volunteers.
All tests carried out in rabbits, dogs, and humans were clinically studied in great detail with long-term follow-ups; and while testing continued to throw up astonishing results, one thing became very clear... Neither animals nor humans showed any signs of rejecting the titanium implants.
It was on the basis of these findings that Brånemark decided to further his studies into mandibular defects, in particular, edentulous problems. From his own words, it was felt that...
“both osseointegration and bone grafting would be highly useful in these areas”.
The first dental implants
While there is much documented about the first dental implant patient, prior to this, Brånemark and his team were carrying out further tests on the teeth of dogs. During the first experiments teeth were removed and replaced using simple screw-shaped titanium implants. After an initial 3-4 month period to allow for bone fusion, prosthetic teeth were then fitted. Different types of prosthetic designs were also tested from gold to porcelain to see which fared better.
In addition, microscopic analysis of the anchoring bone tissue found that in most cases implant integration was a success. What's more, it was calculated at that point that implants could be maintained for 10 years with little or no problems, provided bone tissue remained healthy and showed no signs of contamination.
The human approach
Armed with this knowledge Brånemark knew that it was now safe to assume that bone anchorage using titanium implants was not only possible but very probable in humans.
So eventually In 1965 after years of tests, Gösta Laarson became the very first edentulous human patient to be fitted with dental implants. Yet despite the fact that Laarson was now able to eat, talk, and smile once again, at that stage the world certainly wasn't ready for dental implants. In fact, it took Brånemark almost another ten years to win the war of attrition against the academic establishment and another 7 years more before his dental implants were to be accepted the world over.
In the next part, we're going to look at the early years of dental implants and the studies that Brånemark and his team carried out between 1965 and 1980 to convince the world that dental implants were indeed the future.